Three-year mortality and predictors after release: a longitudinal study of the first-time drug offenders in Taiwan

Aims To assess the possible increase in mortality rate and associated socio-demographic and judiciary determinants among first-time drug offenders during the first 3 years after release from correctional facilities. Setting and participants A total of 22 224 male and 4444 female adults who had served a sentence of at least 1 day in correctional facilities for illegal drug-related offences were identified from the judiciary records of the Ministry of Justice, Taiwan. Design and measurements The underlying causes of death were defined by the International Classification of Diseases, ninth revision. Findings All-cause standardized mortality ratios (SMR) were 7 for schedule I (e.g. heroin) and 3 for schedule II (e.g. methamphetamine) drug offenders, respectively; accidents, suicide and circulatory diseases were three leading causes of death. After release, the risk of death among those drug offenders without subsequent incarceration increased gradually until the 9th month. Those who were aged 30 years or older, had an engagement with a higher-ranked schedule substance or who received severe sentences were two to three times more likely to die. Substantial reduction in the risk of death was linked with re-imprisonment. Conclusions The SMR estimates for external causes were greater than those for disease-related causes in drug offenders, and schedule I drugs-related mortality rate was twice as high as that with schedule II drugs. In transitioning from the correctional setting to the community, the health needs of drug offenders should be addressed by the provision of continuous, adequate medical care tailored to individual background, medical history and drug experience.