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Drug Alcohol Depend. 2018 Apr 1;185:189-191. doi: 10.1016/j.drugalcdep.2017.12.014. Epub 2018 Feb 9.

Risk of fentanyl-involved overdose among those with past year incarceration: Findings from a recent outbreak in 2014 and 2015.

Author information

1
Department of Social Medicine, University of North Carolina, 333 S. Columbia St., Chapel Hill, NC 27516, USA; Center for Health Equity Research, University of North Carolina at Chapel Hill, 335 S. Columbia St., Chapel Hill, NC 27516, USA. Electronic address: Lauren_Brinkley@med.unc.edu.
2
Center for Prisoner Health and Human Rights, The Miriam Hospital, 8 Third St., 2nd floor, Providence, RI 02906, USA; Department of Health Services, Policy and Practice, Brown University School of Public Health, 121 South Main St., Providence, RI 02903, USA.
3
Department of Epidemiology, Brown University School of Public Health, 121 South Main St., Providence, RI 02903, USA.
4
Center for Health Equity Research, University of North Carolina at Chapel Hill, 335 S. Columbia St., Chapel Hill, NC 27516, USA.
5
Department of Epidemiology, University of North Carolina, 135 Dauer Dr., Chapel Hill, NC 27599, USA.
6
Center for Prisoner Health and Human Rights, The Miriam Hospital, 8 Third St., 2nd floor, Providence, RI 02906, USA; Department of Epidemiology, Brown University School of Public Health, 121 South Main St., Providence, RI 02903, USA.
7
Department of Emergency Medicine, Boston University, 1 Boston Medical Center Pl., Boston, MA 02118, USA; Injury Prevention Research Center, Boston University, 1 Boston Medical Center Pl., Boston, MA 02118, USA.

Abstract

Overdose is the leading cause of unintentional injury-related death. Rhode Island (RI) has the highest rate of illicit drug use nationally and the 5th highest overdose mortality rate. RI has experienced an outbreak of fentanyl-related overdoses. In incarcerated populations, risk of overdose is greatly elevated. However, little is known about fentanyl-related overdose post-release. In the current analyses, we identify changes in fentanyl-related fatal overdose among those who died in 2014 and 2015 who were incarcerated in the year before death. We linked data from the RI Office of the Medical Examiner with records from the RI Department of Corrections. We calculated risk ratios and 95% confidence intervals using log-binomial regression to compare risk of fentanyl-involved overdose death. We also compared median time to death since release, median sentence length, and median number of incarcerations in 2014 and 2015. Results indicate that the risk of dying of a fentanyl-related overdose increased (RR: 1.99 (95% CI: 1.11-3.57, p = 0.014)) from 2014 to 2015 among those with past year incarceration. This study is one of the first to describe fentanyl-related fatal overdose among those with past year incarceration. In 2015 the median sentence was longer among those with a fentanyl-related overdose death and the median time from release to death among all who had past year incarceration extended past 90 days. Access to medications for addiction treatment, overdose education, and naloxone should be available during community re-entry and extended beyond the early post-release period.

KEYWORDS:

Fentanyl; Incarceration; Overdose

[Indexed for MEDLINE]

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