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. 2023 Sep;19(3):357-363.
doi: 10.1007/s12024-022-00573-3. Epub 2023 Jan 23.

Opioid-related deaths in Ontario correctional facilities and penitentiaries (2009-2019)

Lourdes Button  1 , Andrew S Williams  2 , Christina Lamparter  3 , Karen L Woodall  4
Affiliations

Opioid-related deaths in Ontario correctional facilities and penitentiaries (2009-2019)

Lourdes Button et al. Forensic Sci Med Pathol. 2023 Sep.

Abstract

The opioid crisis is a significant public health issue in North America that began in the 1990s with opioid-related deaths increasing each year. Although studies have been published regarding the incidence of opioid-related deaths in the general population, there is limited information regarding deaths in the prison population. To investigate the impact of the opioid epidemic in this vulnerable population, a retrospective study of all drug-related deaths that occurred in correctional facilities and penitentiaries in Ontario, Canada, between January 2009 and December 2019 was conducted. A total of 90 deaths were attributed to acute drug toxicity and the decedents ranged in age from 18 to 63 years and comprised 81 men and 9 women. The results of this study indicate the number of drug-related fatalities have increased by 375% (from 4 to 19) over the last 11 years. The detection of opioids in drug-related deaths has increased with fentanyl being the most frequently detected drug. Data also indicates the recent emergence of fentanyl-related analogues in this population. The results from this study provide valuable information about drug-related deaths in the Ontario prison system and provide insight into how the opioid crisis and the increased use of fentanyl and its analogues have affected this vulnerable population.

Keywords: Fentanyl; Forensic pathology; Incarceration; Opioid; Toxicology.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Case classification system
Fig. 2
Fig. 2
Number of acute drug toxicity deaths in Ontario correctional facilities and penitentiaries between 2009 and 2019, shown with the proportion of opioid and non-opioid related deaths per year
Fig. 3
Fig. 3
Opioid-related deaths and non-opioid related acute drug toxicity deaths as a proportion of total deaths occurring in custody per year between 2009 and 2019
Fig. 4
Fig. 4
Opioids detected in toxicological tests for the 90 acute drug toxicity deaths. Inclusion, as detected, does not consider significance to cause of death. Multiple opioids may have been detected for one decedent
Fig. 5
Fig. 5
Number of acute drug toxicity deaths categorized by year and by type of opioid present at death
Fig. 6
Fig. 6
Number of acute drug toxicity deaths per year compared to the number of cases where naloxone was detected in acute drug toxicity death cases
See this image and copyright information in PMC

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