Bukten Anne, Stavseth Marianne Riksheim, Skurtveit Svetlana, Tverdal Aage, Strang John, Clausen Thomas
Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway.
Division for Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.
Addiction. 2017 Aug;112(8):1432-1439. doi: 10.1111/add.13803. Epub 2017 Apr 7.
The time post-release from prison involves elevated mortality, especially overdose deaths. Variations in overdose mortality both by time since release from prison and time of release has not been investigated sufficiently. Our aims were to estimate and compare overdose death rates at time intervals after prison release and to estimate the effect on overdose death rates over calendar time.
DESIGN, SETTING, PARTICIPANTS, MEASUREMENTS: This 15-year cohort study includes all individuals (n = 91 090) released from prison (1 January 2000 to 31 December 2014) obtained from the Norwegian prison registry, linked to the Norwegian Cause of Death Registry (2000-14). All-cause and cause-specific mortality were examined during different time-periods following release: first week, second week, 3-4 weeks and 2-6 months, and by three different time intervals of release. We calculated crude mortality rates (CMRs) per 1000 person-years and estimated incidence rate ratios (IRR) by Poisson regression analysis adjusting for time intervals after prison release, release periods and time spent in prison.
Overdose deaths accounted for 85% (n = 123) of all deaths during the first week following release (n = 145), with a peak during the 2 days immediately following release. Compared with week 1, the risk of overdose death was more than halved during week 2 [IRR = 0.43; 95% confidence interval (CI) = 0.31-0.59] and reduced to one-fifth in weeks 3-4 (IRR = 0.22; 95% CI = 0.16-0.31). The risk of overdose mortality during the first 6 months post-release was almost twofold higher in 2000-04 compared with 2005-09 (IRR = 0.53; 95% CI = 0.43-0.65) and 2010-14 (IRR = 0.47; 95% CI = 0.37-0.59). The risk of overdose death was highest for those incarcerated for 3-12 months compared with those who were incarcerated for shorter or longer periods, and recidivism was associated with risk of overdose death.
There is an elevated risk of death from drug overdose among individuals released from Norwegian prisons, peaking in the first week. The risk has reduced since 2000-04, but is greatest for those serving 3-12 months compared with shorter or longer periods.
出狱后的一段时间内死亡率会升高，尤其是过量用药致死率。关于出狱时间和释放时间对过量用药死亡率的影响差异尚未得到充分研究。我们的目的是估计和比较出狱后不同时间间隔的过量用药死亡率，并评估日历时间对过量用药死亡率的影响。
设计、研究地点、参与者、测量方法：这项为期15年的队列研究纳入了从挪威监狱登记处获取的所有出狱人员（n = 91090，2000年1月1日至2014年12月31日），并与挪威死亡原因登记处（2000 - 14年）相链接。在出狱后的不同时间段检查全因死亡率和特定原因死亡率：第一周、第二周、3 - 4周以及2 - 6个月，并按三个不同的释放时间间隔进行分析。我们计算了每1000人年的粗死亡率（CMR），并通过泊松回归分析估计发病率比（IRR），同时对出狱后的时间间隔、释放期和在狱时间进行了调整。
在出狱后的第一周（n = 145），过量用药致死占所有死亡人数的85%（n = 123），在出狱后的前两天达到峰值。与第一周相比，第二周过量用药致死风险降低了一半以上[发病率比（IRR）= 0.43；95%置信区间（CI）= 0.31 - 0.59]，在第3 - 4周降至五分之一（IRR = 0.22；95% CI = 0.16 - 0.31）。出狱后头6个月内，2000 - 04年的过量用药致死风险几乎是2005 - 09年（IRR = 0.53；95% CI = 0.43 - 0.65）和2010 - 14年（IRR = 0.47；95% CI = 0.37 - 0.59）的两倍。与监禁时间较短或较长的人相比，监禁3 - 12个月的人过量用药致死风险最高，且再次入狱与过量用药致死风险相关。
挪威出狱人员中药物过量致死风险升高，在第一周达到峰值。自200
