High risk of overdose death following release from prison
Overdose death is the most common cause of death after release from prison among Norwegian prisoners. The increased risk of overdose death starts immediately after release.
In one of the internationally most comprehensive single site studies on deaths following release from prison, The Norwegian Centre for Addiction Research in collaboration with researchers from the Norwegian Institute of Public Health and the National Addiction Centre at King's College, London, found that the risk of dying from an overdose is highest during the first days after ending a sentence. The study, which has data on all releases from Norwegian prisons in a 15 year period (2000-2014), also shows that overdose deaths comprise 85% of all deaths occurring within one week and this peaked risk is more than twice as high as compared to the second week.
Further, the study shows a decline in the number of overdose deaths from the start of the millennium through 2014, which mirrors a drop in the number of overdose deaths as seen in the general population for the same period. Despite the numerical decline, the immediate risk of overdose death remains high post release, throughout the observation period.
Overdose deaths after release is commonly caused by opioids (e.g. heroin) and persons with a history of opioid use disorders likely have the highest risk of overdose death following release. It is therefore important to identify this vulnerable group during incarceration to allow the implementation of evidence based measures to prevent overdose deaths immediately after release. Because overdose deaths are potentially preventable and mostly occur in a part of the prison population which can be identified and recognised, the incarceration also presents an opportunity to initiate treatment and other rehabilitating measures.
The transition between prison and life in the civil society is a critical period for many following release. Therefore, evidence based treatments should be offered to persons with drug use disorders while incarcerated. It is crucial that measures initiated in prison are transferred appropriately and continued as a continuum of care post release. Having an appointment with a treatment provider or a volunteer on the outside of the prison on the day of release can be of great importance and would introduce an immediate connection with the civil society.