O'Connor Allyson W, Sears Jeanne M, Fulton-Kehoe Deborah
Department of Health Systems and Population Health, University of Washington, 3980 15th Ave NE, Fourth Floor Box 351621, Seattle, WA 98195, USA.
Department of Health Systems and Population Health, University of Washington, 3980 15th Ave NE, Fourth Floor Box 351621, Seattle, WA 98195, USA; Department of Environmental and Occupational Health Sciences, University of Washington, Box 359116, Seattle, WA 98195-8772, USA; Harborview Injury Prevention and Research Center, Box 359960, 325 Ninth Avenue, Seattle, WA 98104, USA; Institute for Work and Health, Toronto, Ontario, Canada.
Drug Alcohol Depend. 2022 Dec 1;241:109655. doi: 10.1016/j.drugalcdep.2022.109655. Epub 2022 Oct 12.
Persons released from prison are at an increased risk of mortality compared to the non-incarcerated population, particularly from drug- and opioid-related overdose. Contributors to overdose mortality vary with changing patterns of substance use and updating overdose and mortality statistics may help focus resources for persons released from prison.
In this retrospective cohort study, records for 33,811 people released from Washington State Department of Corrections prisons between 2014 and 2018 were linked to Washington State death records from 2014 to 2019. We calculated post-release mortality rates by cause of death, including overdose and substance-related mortality. Hazard ratios for risk factors for all-cause, non-overdose, and overdose mortality were estimated using Cox proportional hazards regression.
862 deaths were identified among persons released from prison. The all-cause mortality rate was 747 per 100,000 person-years (95 % CI: 699-800), and drug overdose was the leading cause of death (216 per 100,000 person-years; 95 % CI: 190-244). Psychostimulant-related mortality (152 per 100,000 person-years; 95 % CI: 131-177) and opioid-related mortality (138 per 100,000 person-years; 95 % CI: 118-161) were the most prevalent among substance-related causes of death, with the greatest mortality risk occurring within two weeks after release. Older age at most recent release, previous incarceration, and drug-related convictions were significant risk factors for all-cause and overdose mortality within six years after release.
Psychostimulants were the greatest contributors to substance-related mortality for persons released from Washington State prisons. Greater efforts to prevent psychostimulant- and opioid-related overdose are needed.
与未被监禁的人群相比，出狱人员的死亡风险更高，尤其是死于与毒品和阿片类药物相关的过量用药。过量用药死亡率的影响因素随物质使用模式的变化而变化，更新过量用药和死亡率统计数据可能有助于为出狱人员集中资源。
在这项回顾性队列研究中，将2014年至2018年间从华盛顿州惩教部监狱释放的33811人的记录与2014年至2019年的华盛顿州死亡记录相链接。我们按死亡原因计算了出狱后的死亡率，包括过量用药和与物质相关的死亡率。使用Cox比例风险回归估计全因、非过量用药和过量用药死亡率的风险因素的风险比。
在出狱人员中确定了862例死亡。全因死亡率为每10万人年747例（95%CI：699 - 800），药物过量是主要死因（每10万人年216例；95%CI：190 - 244）。与精神兴奋剂相关的死亡率（每10万人年152例；95%CI：131 - 177）和与阿片类药物相关的死亡率（每10万人年138例；95%CI：118 - 161）是与物质相关死因中最常见的，最大死亡风险发生在释放后的两周内。最近一次释放时年龄较大、以前曾被监禁以及与毒品相关的定罪是释放后六年内全因和过量用药死亡率的重要风险因素。
精神兴奋剂是华盛顿州监狱出狱人员与物质相关死亡率的最大促成因素。需要加大力度预防与精神兴奋剂和阿片类药物相关的过量用药。
