A perfect storm?
The recent and prolonged increase in the number of drug-related deaths, together with news of more offenders dying in the community and worries about the general impact of austerity in terms of reduced access to services, have all combined to raise concerns about the risk of overdose among those released from prison.
We do not have reliable data on this in the UK but a recent Norwegian study suggests that we should be taking action urgently.
The Norwegian study looks at the deaths of all prisoners in the first six months of their release over a fifteen year period (1 Jan 200 to 31 December 2014); the sample comprised 92,663 prisoners released a total of 153,604 times.
The study, authored by Anne Bukten, Marianne Riksheim Stavseth, Svetlana Skurtveit, Aage Tverdal, our own John Strang and Thomas Clausen, found that overdose was the most common reason for death at every time period within this first six months.
During the first week post-release, overdose deaths accounted for 85% of all deaths, with accidents accounting for 6% and suicide for 3%
Overdose deaths peaked during the first days post-release, and thereafter declined gradually during the first month post-release. During the second week post-release, the total number of deaths approximately halved (versus first week), with overdose deaths accounting for 68% of all deaths.
During weeks 3–4 and months 2–6, overdose death accounted for 62 and 46% of all deaths, respectively. We observed this pattern during all release periods.
Importantly, although the pattern remained the same over the whole 15 year time period, the rate of overdose deaths was higher between 2000-2004 than over the next ten years.
Overall, this means that drug use patterns both in terms of substances consumed as well as mode of administration will be reflected in mortality both in the general populations as well as in prison-release populations. The reducing levels of post-release mortality (also found in similar studies in Australia and Scotland) may be explained by a number of factors.
The questions is whether the prison system in its current beleaguered state can organise the effective distribution of naloxone to the dozens of individuals with long term opiate problems it releases every day.
The mission of Breaking Free Group is to create the widest possible access to evidence-based psychological interventions.
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