Department of Social Medicine, University of North Carolina, 333 S. Columbia St., Chapel Hill, NC 27516, USA; Center for Health Equity Research, University of North Carolina at Chapel Hill, 335 S. Columbia St., Chapel Hill, NC 27516, USA.
Center for Prisoner Health and Human Rights, The Miriam Hospital, 8 Third St., 2nd floor, Providence, RI 02906, USA; Department of Health Services, Policy and Practice, Brown University School of Public Health, 121 South Main St., Providence, RI 02903, USA.
Drug Alcohol Depend. 2018 Apr 1;185:189-191. doi: 10.1016/j.drugalcdep.2017.12.014. Epub 2018 Feb 9.
Overdose is the leading cause of unintentional injury-related death. Rhode Island (RI) has the highest rate of illicit drug use nationally and the 5th highest overdose mortality rate. RI has experienced an outbreak of fentanyl-related overdoses. In incarcerated populations, risk of overdose is greatly elevated. However, little is known about fentanyl-related overdose post-release. In the current analyses, we identify changes in fentanyl-related fatal overdose among those who died in 2014 and 2015 who were incarcerated in the year before death. We linked data from the RI Office of the Medical Examiner with records from the RI Department of Corrections. We calculated risk ratios and 95% confidence intervals using log-binomial regression to compare risk of fentanyl-involved overdose death. We also compared median time to death since release, median sentence length, and median number of incarcerations in 2014 and 2015. Results indicate that the risk of dying of a fentanyl-related overdose increased (RR: 1.99 (95% CI: 1.11-3.57, p = 0.014)) from 2014 to 2015 among those with past year incarceration. This study is one of the first to describe fentanyl-related fatal overdose among those with past year incarceration. In 2015 the median sentence was longer among those with a fentanyl-related overdose death and the median time from release to death among all who had past year incarceration extended past 90 days. Access to medications for addiction treatment, overdose education, and naloxone should be available during community re-entry and extended beyond the early post-release period.
过量用药是导致非故意伤害相关死亡的主要原因。罗得岛州（RI）的非法药物使用率在全国最高，过量用药死亡率排名第 5。RI 经历了芬太尼相关过量用药的爆发。在被监禁的人群中，过量用药的风险大大增加。然而，对于出狱后的芬太尼相关过量用药情况知之甚少。在目前的分析中，我们确定了在 2014 年和 2015 年死亡的、入狱前一年被监禁的人群中，与芬太尼相关的致命过量用药的变化情况。我们将 RI 法医办公室的数据与 RI 惩教署的记录进行了关联。我们使用对数二项式回归计算了风险比和 95%置信区间，以比较芬太尼相关过量用药死亡的风险。我们还比较了 2014 年和 2015 年出狱后的死亡中位时间、判决中位长度和入狱中位次数。结果表明，在过去一年被监禁的人群中，2015 年因芬太尼相关过量用药死亡的风险增加（RR：1.99（95%CI：1.11-3.57，p=0.014））。这项研究是首批描述过去一年被监禁人群中芬太尼相关致命过量用药的研究之一。2015 年，芬太尼相关过量用药死亡者的判决中位时间更长，而过去一年被监禁的所有出狱者的中位死亡时间从释放到死亡延长到了 90 天以上。在社区重返社会期间，应提供药物成瘾治疗、过量用药教育和纳洛酮等药物，且不应只在早期出狱后提供。
