Incidence and predictors of non-fatal drug overdose after release from prison among people who inject drugs in Queensland, Australia

Winter, R. J., Stoove, M., Degenhardt, L., Hellard, M. E., Spelman, T., Jenkinson, R., McCarthy D. R. and Kinner, S. A. (2015) Incidence and predictors of non-fatal drug overdose after release from prison among people who inject drugs in Queensland, Australia. Drug and Alcohol Dependence, 153 43-49. doi:10.1016/j.drugalcdep.2015.06.011


Author Winter, R. J.
Stoove, M.
Degenhardt, L.
Hellard, M. E.
Spelman, T.
Jenkinson, R.
McCarthy D. R.
Kinner, S. A.
Title Incidence and predictors of non-fatal drug overdose after release from prison among people who inject drugs in Queensland, Australia
Journal name Drug and Alcohol Dependence   Check publisher's open access policy
ISSN 1879-0046
0376-8716
Publication date 2015-08
Sub-type Article (original research)
DOI 10.1016/j.drugalcdep.2015.06.011
Volume 153
Start page 43
End page 49
Total pages 7
Place of publication Shannon, Clare Ireland
Publisher Elsevier Ireland
Collection year 2016
Language eng
Formatted abstract
Introduction: Release from prison is a period of elevated risk for drug-related harms, particularly among people who inject drugs (PWID). Non-fatal overdose can cause serious morbidity and predicts future fatal overdose, however neither the incidence nor the risk factors for non-fatal overdose following release from prison are well understood.
Methods: Structured health-related interviews were conducted with 1051 adult prisoners in Queensland, Australia prior to release and approximately 1, 3 and 6 months post-release. Incidence of self-reported overdose in the community was calculated for PWID and all prisoners for three discrete time periods. Negative binomial regression with robust error variance was used to identify pre-release predictors of overdose among PWID.
Results: The incidence of reported overdose was highest between 1 and 3 months post-release (37.8 per 100 person-years (PY) among PWID; 24.5/100 PY among all ex-prisoners). In adjusted analyses, the risk of post-release non-fatal overdose was higher for PWID who reported: being unemployed for >6 months before prison, having been removed from family as a child, at least weekly use of benzodiazepines and/or pharmaceutical opiates in the 3 months prior to prison, and ever receiving opioid substitution therapy (OST). Pre-release psychological distress and a lifetime history of mental disorder also predicted overdose, whereas risky alcohol use in the year before prison was protective.
Conclusions:  PWID have a high risk of overdose following release from prison. Imprisonment is an opportunity to initiate targeted preventive interventions such as OST, overdose prevention training and peer-delivered naloxone for those with a high risk profile.
Keyword Drug overdose
Drug users
Injecting drug use
Prisoners
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2016 Collection
School of Medicine Publications
 
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