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. 2022 Feb;112(2):300-303.
doi: 10.2105/AJPH.2021.306621.

Opioid Overdose Deaths Among Formerly Incarcerated Persons and the General Population: North Carolina, 2000‒2018

Shabbar I Ranapurwala  1 , Mary C Figgatt  1 , Molly Remch  1 , Carrie Brown  1 , Lauren Brinkley-Rubinstein  1 , David L Rosen  1 , Mary E Cox  1 , Scott K Proescholdbell  1
Affiliations

Opioid Overdose Deaths Among Formerly Incarcerated Persons and the General Population: North Carolina, 2000‒2018

Shabbar I Ranapurwala et al. Am J Public Health. 2022 Feb.

Abstract

Objectives. To compare opioid overdose death (OOD) rates among formerly incarcerated persons (FIPs) from 2016 to 2018 with the North Carolina population and with OOD rates from 2000 to 2015. Methods. We performed a retrospective cohort study of 259 861 North Carolina FIPs from 2000 to 2018 linked with North Carolina death records. We used indirectly standardized OOD mortality rates and ratios and present 95% confidence intervals (CIs). Results. From 2017 to 2018, the OOD rates in the North Carolina general population decreased by 10.1% but increased by 32% among FIPs. During 2016 to 2018, the highest substance-specific OOD rate among FIPs was attributable to synthetic narcotics (mainly fentanyl and its analogs), while OOD rates for other opioids were half or less than that from synthetic narcotics. During 2016 to 2018, the OOD risk for FIPs from synthetic narcotics was 50.3 (95% CI = 30.9, 69.6), 20.2 (95% CI = 17.3, 23.2), and 18.2 (95% CI = 15.9, 20.5) times as high as that for the North Carolina population at 2-week, 1-year, and complete follow-up after release, respectively. Conclusions. While nationwide OOD rates declined from 2017 to 2018, OOD rates among North Carolina FIPs increased by about a third, largely from fentanyl and its analogs. (Am J Public Health. 2022;112(2):300-303. https://doi.org/10.2105/AJPH.2021.306621).

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Figures

FIGURE 1—
FIGURE 1—
Standardized Annual Opioid Overdose Death Rates and Standardized Mortality Ratio Comparing Formerly Incarcerated Persons With North Carolina Residents: 2000‒2018 Note. FIPS = formerly incarcerated persons; NC GP = North Carolina general population; SMR = standardized mortality ratios calculated using indirect standardization for age, sex, race, and calendar year; SMR L95 = lower 95% confidence interval for SMR; SMR U95 = upper 95% confidence interval for SMR.
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