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BACKGROUND: On average more than 20,000 inmates are released from North Carolina state prisons each year. These former inmates or releasees are at risk for many negative health outcomes including unintentional poisoning. The purpose of this study was to examine the injury and violence related deaths that occurred among recent releasees as compared with the general population, with a specific focus on overdose deaths.
METHODS: The study sample included all N.C. inmates released from state prisons from January 1, 2008 to December 31, 2010. Data was linked between NC-Violent Death Reporting System (NC-VDRS), Vital Records (death certificates) and the N.C. Department of Public Safety (Corrections). Data were linked using probabilistic matching on names and dates of births. The CDC Injury matrix was used to classify deaths as injury or violence related based on ICD10 cause of death codes. Time from release to death was calculated by subtracting the date of death from the date of release. Substance abuse and mental health histories were also collected while incarcerated.
RESULTS: A total of 42,272 inmates were released from N.C. Correctional facilities during the study period—2,877 of these inmates had multiple incarcerations. The majority of released inmates were male (89%), black (58%) and between the ages of 45 and 54 (38%). A total of 928 deaths occurred among these former inmates during the 18 months that followed their release. 427 deaths (46%) were injury or violence related, and 168 deaths were classified as unintentional poisoning (ICD10 X40-X49) for a rate of 397.4 per 100,000 for this population. Additional analyses will focus on the time-frame of overdoses as it relates to their time of release and substance abuse, mental health histories and length of incarceration.
CONCLUSIONS: Recently released inmates are a special population with unique public health risk factors. The overdose rate among this population was 36 times higher than the general population and as such the releasee population merits special considerations. The provision of education and treatment programs during and after incarceration, and the distribution of naloxone (opiate antidote) to inmates upon release should be considered. Post release probation/parole officers should beware of the overdose risk and take steps to reduce the possibility of premature death.