International research has found an increased risk of mortality among prisoners within the days and weeks following their release from prison.1 Many of these deaths are drug­ related and the increased mortality risk is thought to be caused by the altered tolerance to drugs which an individual may develop while in prison.2 A recently published paper based on data from the National Drug-Related Deaths Index (NDRDI) for the years 1998–2005 examined the relationship between date of release from prison and drug-related death.3 This was the first study of its kind in Ireland. 

•  the majority (93, 88.6%) were male;
• most (69, 65.7%) were aged between 20 and 29 years (median age 29 years);
•  the majority (88, 83.8%) were unemployed;
•  21 (20.0%) were living in unstable accommodation, and 10 (9.5%) were homeless;
•   64 (61.0%) had a history of injecting, and 36 (34.3%) were injecting at the time of death;
•  11 (10.5%) had a blood-borne viral infection recorded in their history, of whom five were co-infected with two or more viruses.

Deaths by poisoning within the first month of release
Of the 42 deaths within the first month of release, 38 were due to poisoning (Table 1), and many of those who died were injecting drugs at the time of their death. Of the 14 deaths involving a single drug, 11 involved an opiate, mainly heroin and/or methadone. Of the 24 deaths involving polysubstances, 23 involved an opiate (in addition to one or more other substances).  

The findings of this study are consistent with those of international studies in this area. The number of cases reported in this study is likely to be underestimated, as history of imprisonment is not routinely recorded in the NDRDI data sources. The study highlights the need for education and awareness among prisoners and their families and friends about the risk of overdose in the days and weeks following release. Many of these deaths are preventable and the findings of the study support the need for an overdose prevention strategy.