Journal
DRUG AND ALCOHOL DEPENDENCE
Volume 153, Issue -, Pages 43-49Publisher
ELSEVIER IRELAND LTD
DOI: 10.1016/j.drugalcdep.2015.06.011
Keywords
Drug overdose; Prisoners; Drug users; Injecting drug use
Categories
Funding
- National Health and Medical Research Council (NHMRC) [409966]
- NHMRC [603756, 1090445, 1041742, 1062877, 1054674, 1004765]
- NHMRC Centre for Research Excellence on Injecting Drug Use (CREIDU) [1001144]
- CREIDU
- Australian Government under the Substance Misuse Prevention and Service Improvements Grants Fund
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Introduction: Release from prison is a period of elevated risk for drug-related harms, particularly among people who inject drugs (PVVID). Non-fatal overdose can cause serious morbidity and predicts future fatal overdose, however neither the incidence nor the risk factors for non-fatal overdose following release from prison are well understood. Methods: Structured health-related interviews were conducted with 1051 adult prisoners in Queensland, Australia prior to release and approximately 1, 3 and 6 months post-release. Incidence of self-reported overdose in the community was calculated for PWID and all prisoners for three discrete time periods. Negative binomial regression with robust error variance was used to identify pre-release predictors of overdose among PWID. Results: The incidence of reported overdose was highest between 1 and 3 months post-release (37.8 per 100 person-years (PY) among PWID; 24.5/100 PY among all ex-prisoners). In adjusted analyses, the risk of post-release non-fatal overdose was higher for PVVID who reported: being unemployed for >6 months before prison, having been removed from family as a child, at least weekly use of benzodiazepines and/or pharmaceutical opiates in the 3 months prior to prison, and ever receiving opioid substitution therapy (OST). Pre-release psychological distress and a lifetime history of mental disorder also predicted overdose, whereas risky alcohol use in the year before prison was protective. Conclusions: PWID have a high risk of overdose following release from prison. Imprisonment is an opportunity to initiate targeted preventive interventions such as OST, overdose prevention training and peer-delivered naloxone for those with a high risk profile. (C) 2015 Elsevier Ireland Ltd. All rights reserved.
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