Understanding drug-related mortality in released prisoners: a review of national coronial records

Andrews, Jessica Y. and Kinner, Stuart A. (2012) Understanding drug-related mortality in released prisoners: a review of national coronial records. BMC Public Health, 12 1: 270.1-270.7. doi:10.1186/1471-2458-12-270

Author Andrews, Jessica Y.
Kinner, Stuart A.
Title Understanding drug-related mortality in released prisoners: a review of national coronial records
Journal name BMC Public Health   Check publisher's open access policy
ISSN 1471-2458
Publication date 2012-04-04
Year available 2012
Sub-type Article (original research)
DOI 10.1186/1471-2458-12-270
Open Access Status DOI
Volume 12
Issue 1
Start page 270.1
End page 270.7
Total pages 7
Place of publication London, United Kingdom
Publisher BioMed Central
Language eng
Formatted abstract
Background: The prisoner population is characterised by a high burden of disease and social disadvantage, and ex-prisoners are at increased risk of death following release. Much of the excess mortality can be attributed to an increased risk of unnatural death, particularly from drug overdose; however, relatively few studies have investigated the circumstances surrounding drug-related deaths among released prisoners. This study aimed to explore and compare the circumstances of death for those who died from accidental drug-related causes to those who died from all other reportable causes.

Methods: A nationwide search of the Australian National Coroners Information System (NCIS) was conducted to identify reportable deaths among ex-prisoners from 2000 to 2007. Using a structured coding form, NCIS records for these cases were interrogated to explore causes and circumstances of death.

Results: Coronial records for 388 deceased ex-prisoners were identified. Almost half of these deaths were a result of accidental drug-related causes (45%). The majority of accidental drug-related deaths occurred in a home environment, and poly-substance use at or around the time of death was common, recorded in 72% of drugrelated deaths. Ex-prisoners who died of accidental drug-related causes were on average younger and less likely to be Indigenous, born in Australia, married, or living alone at or around the time of death, compared with those who died from all other reportable causes. Evidence of mental illness or self-harm was less common among accidental drug-related deaths, whereas evidence of previous drug overdose, injecting drug use, history of heroin use and history of drug withdrawal in the previous six months were more common.

Conclusions: Drug-related deaths are common among ex-prisoners and often occur in a home (vs. public) setting. They are often associated with use of multiple substances at or around the time of death, risky drug-use patterns, and even among this markedly disadvantaged group, extreme social disadvantage. These findings reflect the complex challenges facing prisoners upon release from custody and indicate a need to consider drug overdose within the wider framework of ex-prisoner experiences, so that preventive programmes can be appropriately structured and targeted.
Keyword Heroin-related deaths
Drug-related deaths
Australian prisoners
Overdose mortality
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Article number 270

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2013 Collection
School of Public Health Publications
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Created: Fri, 11 Jan 2013, 21:52:58 EST by Geraldine Fitzgerald on behalf of School of Public Health