Meta-analysis of drug-related deaths soon after release from prison

Eliabeth L.C. Merrall, Azar Kariminia, Ingrid A. Binswanger, Michael S. Hobbs, Michael Farrell, John Marsden, Sharon J. Hutchinson, Sheila M Bird

Research output: Contribution to journalArticle

274 Citations (Scopus)

Abstract

Aims The transition from prison back into the community is particularly hazardous for drug-using offenders whose tolerance for heroin has been reduced by imprisonment. Studies have indicated an increased risk of drug-related death soon after release from prison, particularly in the first 2 weeks. For precise, up-to-date understanding of these risks, a meta-analysis was conducted on the risk of drug-related death in weeks 1 + 2 and 3 + 4 compared with later 2-week periods in the first 12 weeks after release from prison.

Methods English-language studies were identified that followed up adult prisoners for mortality from time of index release for at least 12 weeks. Six studies from six prison systems met the inclusion criteria and relevant data were extracted independently.

Results These studies contributed a total of 69 093 person-years and 1033 deaths in the first 12 weeks after release, of which 612 were drug-related. A three- to eightfold increased risk of drug-related death was found when comparing weeks 1 + 2 with weeks 3–12, with notable heterogeneity between countries: United Kingdom, 7.5 (95% CI: 5.7–9.9); Australia, 4.0 (95% CI: 3.4–4.8); Washington State, USA, 8.4 (95% CI: 5.0–14.2) and New Mexico State, USA, 3.1 (95% CI: 1.3–7.1). Comparing weeks 3 + 4 with weeks 5–12, the pooled relative risk was: 1.7 (95% CI: 1.3–2.2).

Conclusions These findings confirm that there is an increased risk of drug-related death during the first 2 weeks after release from prison and that the risk remains elevated up to at least the fourth week.
LanguageEnglish
Pages1545-1554
Number of pages10
JournalAddiction
Volume105
Issue number9
Early online date23 Jun 2010
DOIs
Publication statusPublished - Sep 2010

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Prisons
Meta-Analysis
Pharmaceutical Preparations
Prisoners
Heroin
Language
Mortality

Keywords

  • street drugs
  • substance-related disorders
  • mortality
  • overdose
  • prisons
  • prisoners
  • meta-analysis

Cite this

Merrall, E. L. C., Kariminia, A., Binswanger, I. A., Hobbs, M. S., Farrell, M., Marsden, J., ... Bird, S. M. (2010). Meta-analysis of drug-related deaths soon after release from prison. Addiction, 105(9), 1545-1554. https://doi.org/10.1111/j.1360-0443.2010.02990.x
Merrall, Eliabeth L.C. ; Kariminia, Azar ; Binswanger, Ingrid A. ; Hobbs, Michael S. ; Farrell, Michael ; Marsden, John ; Hutchinson, Sharon J. ; Bird, Sheila M. / Meta-analysis of drug-related deaths soon after release from prison. In: Addiction. 2010 ; Vol. 105, No. 9. pp. 1545-1554.
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abstract = "Aims The transition from prison back into the community is particularly hazardous for drug-using offenders whose tolerance for heroin has been reduced by imprisonment. Studies have indicated an increased risk of drug-related death soon after release from prison, particularly in the first 2 weeks. For precise, up-to-date understanding of these risks, a meta-analysis was conducted on the risk of drug-related death in weeks 1 + 2 and 3 + 4 compared with later 2-week periods in the first 12 weeks after release from prison. Methods English-language studies were identified that followed up adult prisoners for mortality from time of index release for at least 12 weeks. Six studies from six prison systems met the inclusion criteria and relevant data were extracted independently. Results These studies contributed a total of 69 093 person-years and 1033 deaths in the first 12 weeks after release, of which 612 were drug-related. A three- to eightfold increased risk of drug-related death was found when comparing weeks 1 + 2 with weeks 3–12, with notable heterogeneity between countries: United Kingdom, 7.5 (95{\%} CI: 5.7–9.9); Australia, 4.0 (95{\%} CI: 3.4–4.8); Washington State, USA, 8.4 (95{\%} CI: 5.0–14.2) and New Mexico State, USA, 3.1 (95{\%} CI: 1.3–7.1). Comparing weeks 3 + 4 with weeks 5–12, the pooled relative risk was: 1.7 (95{\%} CI: 1.3–2.2). Conclusions These findings confirm that there is an increased risk of drug-related death during the first 2 weeks after release from prison and that the risk remains elevated up to at least the fourth week.",
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Merrall, ELC, Kariminia, A, Binswanger, IA, Hobbs, MS, Farrell, M, Marsden, J, Hutchinson, SJ & Bird, SM 2010, 'Meta-analysis of drug-related deaths soon after release from prison' Addiction, vol. 105, no. 9, pp. 1545-1554. https://doi.org/10.1111/j.1360-0443.2010.02990.x

Meta-analysis of drug-related deaths soon after release from prison. / Merrall, Eliabeth L.C.; Kariminia, Azar; Binswanger, Ingrid A.; Hobbs, Michael S.; Farrell, Michael; Marsden, John; Hutchinson, Sharon J.; Bird, Sheila M.

In: Addiction, Vol. 105, No. 9, 09.2010, p. 1545-1554.

Research output: Contribution to journalArticle

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AU - Merrall, Eliabeth L.C.

AU - Kariminia, Azar

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AU - Hobbs, Michael S.

AU - Farrell, Michael

AU - Marsden, John

AU - Hutchinson, Sharon J.

AU - Bird, Sheila M

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N2 - Aims The transition from prison back into the community is particularly hazardous for drug-using offenders whose tolerance for heroin has been reduced by imprisonment. Studies have indicated an increased risk of drug-related death soon after release from prison, particularly in the first 2 weeks. For precise, up-to-date understanding of these risks, a meta-analysis was conducted on the risk of drug-related death in weeks 1 + 2 and 3 + 4 compared with later 2-week periods in the first 12 weeks after release from prison. Methods English-language studies were identified that followed up adult prisoners for mortality from time of index release for at least 12 weeks. Six studies from six prison systems met the inclusion criteria and relevant data were extracted independently. Results These studies contributed a total of 69 093 person-years and 1033 deaths in the first 12 weeks after release, of which 612 were drug-related. A three- to eightfold increased risk of drug-related death was found when comparing weeks 1 + 2 with weeks 3–12, with notable heterogeneity between countries: United Kingdom, 7.5 (95% CI: 5.7–9.9); Australia, 4.0 (95% CI: 3.4–4.8); Washington State, USA, 8.4 (95% CI: 5.0–14.2) and New Mexico State, USA, 3.1 (95% CI: 1.3–7.1). Comparing weeks 3 + 4 with weeks 5–12, the pooled relative risk was: 1.7 (95% CI: 1.3–2.2). Conclusions These findings confirm that there is an increased risk of drug-related death during the first 2 weeks after release from prison and that the risk remains elevated up to at least the fourth week.

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Merrall ELC, Kariminia A, Binswanger IA, Hobbs MS, Farrell M, Marsden J et al. Meta-analysis of drug-related deaths soon after release from prison. Addiction. 2010 Sep;105(9):1545-1554. https://doi.org/10.1111/j.1360-0443.2010.02990.x