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. 2018 Sep;108(9):1207-1213.
doi: 10.2105/AJPH.2018.304514. Epub 2018 Jul 19.

Opioid Overdose Mortality Among Former North Carolina Inmates: 2000-2015

Shabbar I Ranapurwala  1 , Meghan E Shanahan  1 , Apostolos A Alexandridis  1 , Scott K Proescholdbell  1 , Rebecca B Naumann  1 , Daniel Edwards Jr  1 , Stephen W Marshall  1
Affiliations

Opioid Overdose Mortality Among Former North Carolina Inmates: 2000-2015

Shabbar I Ranapurwala et al. Am J Public Health. 2018 Sep.

Abstract

Objectives: To examine differences in rates of opioid overdose death (OOD) between former North Carolina (NC) inmates and NC residents and evaluate factors associated with postrelease OOD.

Methods: We linked NC inmate release data to NC death records, calculated OOD standardized mortality ratios to compare former inmates with NC residents, and calculated hazard ratios to identify predictors of time to OOD.

Results: Of the 229 274 former inmates released during 2000 to 2015, 1329 died from OOD after release. At 2-weeks, 1-year, and complete follow-up after release, the respective OOD risk among former inmates was 40 (95% confidence interval [CI] = 30, 51), 11 (95% CI = 9.5, 12), and 8.3 (95% CI = 7.8, 8.7) times as high as general NC residents; the corresponding heroin overdose death risk among former inmates was 74 (95% CI = 43, 106), 18 (95% CI = 15, 21), and 14 (95% CI = 13, 16) times as high as general NC residents, respectively. Former inmates at greatest OOD risk were those within the first 2 weeks after release, aged 26 to 50 years, male, White, with more than 2 previous prison terms, and who received in-prison mental health and substance abuse treatment.

Conclusions: Former inmates are highly vulnerable to opioids and need urgent prevention measures.

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Figures

FIGURE 1—
FIGURE 1—
Eligibility and Person-Time Accrual of North Carolina Former Inmates: 2000–2015 Note. OOD = opioid overdose death; P = person; PY = person-years.
FIGURE 2—
FIGURE 2—
Annual Opioid Overdose Death Rates Among North Carolina (NC) Residents and Former NC Inmates Along With Standardized Mortality Ratios: 2000–2015 Note. CI = confidence interval; OOD = opioid overdose death; PY = person-years; SMR = standardized mortality ratio. Vertical lines represent 95% CIs for SMRs. aStandardized rate.
See this image and copyright information in PMC

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