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Walsh, Simone and Lyons, Suzi (2010) Drug-related deaths among recently released prisoners. Drugnet Ireland, Issue 35, Autumn 2010, p. 25.

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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. 

Profile of cases examined
Between 1998 and 2005, 2,442 drug-related deaths were recorded on the NDRDI. One hundred and thirty of the individuals who died had a documented history of imprisonment. Of the 130 individuals, 105 were not in prison at the time of death. The analysis presented in this article is based on these 105 individuals, of whom: 
  •  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.
Time between release from prison and death
Of the 105 individuals, 89 had a known date of release (see Figure 1). Of these, nine (10.1%) died on day one or day two, and 16 (18.0%) died between day three and day seven. Almost half (42, 47.2%) of the 89 deaths occurred within the first month of release. 

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.  

1. See, for example, Binswanger I et al. (2007) Release from prison – a high risk of death for former inmates. New England Journal of Medicine, 356(2): 157–165; Kariminia A et al. (2007) Suicide risk among recently released prisoners in New South Wales, Australia. Medical Journal of Australia, 187(7):387–390.
2. See, for example, Jones R, Gruer L, Gilchrist G et al. (2002) Recent contact with health and social services by drug misuers in Glasgow who died of a fatal overdose in 1999. Addiction, 97: 1517–1522; Seymour A, Oliver J and Black M (2000) Drug-related deaths among recently released prisoners in the Strathclyde region of Scotland. Journal of Forensic Science, 45(3): 649–654.
3. Lyons S, Walsh S, Lynn E and Long J (2010) Drug-related deaths among recently release prisoners in Ireland 1998 to 2005. International Journal of Prisoner Health, 6(1): 26­–32. Available at www.drugsandalcohol.ie/13332

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