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Ex-Prisoners Face Higher Risks Of Opioid Overdose Death

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Overdose death risks, especially from opioid use, of recently released inmates are higher compared to that of the general population, a new Canadian study has found. Findings suggest there is a need for improved treatment and education among ex-prisoners as they rejoin society.

Researchers found that, on average, 88 adults in Ontario die in the year after release from incarceration because of drug toxicity. This corresponds to one in 10 of all overdose-related deaths in adults in the province. About three-fourths of the ex-prisoners who died of an overdose were below 45 years old. In addition, about 77 percent of the deaths among former inmates were linked to opioid usage.

For the study - the first of its kind - the researchers from the University of Toronto and St. Michael's Hospital studied coroner reports from 2006 to 2013 with details on the persons' circumstances of death. The team matched this data to those of the adults released from provincial correctional facilities.

The team found that 9 percent of the overdose-related deaths happened within the first two days of the inmates' release. About 20 percent of the deaths occurred within the first week of being released.

The working theory is that the period following the release is one of the riskiest. Past studies suggested that when people are sent to prison, their drug activities either end or decrease. Prior to their jail time, they have become tolerant to taking a certain amount of drugs. When they resume taking the same amount following their release, they are more at risk of an overdose.

The team found that in 59 percent of the opioid overdose-related deaths, human intervention, such as the administration of naloxone, may have been possible. Naloxone is used to block the effects of opioid drugs such as fentanyl, methadone, oxycodone or heroin. Naloxone administration requires another person capable of recognizing overdose signs and responding to it.

Study author and family physician Dr. Nav Persaud said that this group is "obviously a high-risk population."

"At least some of these deaths are preventable and there may be opportunities to prevent overdose deaths by supporting this vulnerable group - during incarceration and immediately following release," added Dr. Persaud, a St. Michael's Hospital researcher.

The findings were published in the PLOS ONE journal on July 6.

Persaud said that further studies and policies should focus on the immediate human interventions following a person's release from incarceration. This includes assistance in directing ex-prisoners to treatment programs and giving them improved access to naloxone, overdose-prevention initiatives and even drug substitute treatments.

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