(Mortality from overdose among injecting drug users recently released from prison: database linkage study)
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In this week's BMJ, Seaman et al investigate the risk of death from overdose in injecting drug users with HIV, who resume drug use after release from prison. The authors find that overall, imprisonment does not increase injecting drug users' risks of dying from an overdose. However, this risk seems to be eight times higher within the first two weeks after release from prison than it is during the subsequent ten weeks. Seaman et al note that overdose deaths in injectors per annum may outnumber the deaths from suicide in Scottish prisons by three to one.
The authors suggest that lives could be saved by implementing prison based trials of interventions, which would take varying periods of time to undertake, to reduce the number of deaths from overdose. The trials could include providing an information sheet to prisoners who are about to be released; obtaining permission from the inmate for communications between the prison doctor and the inmate's GP or providing an appointment with prison health care staff before the inmate is released.
Seaman et al conclude that further studies will be needed to determine if their estimate of one death from overdose per 1000 days spent recently released, can be generalised to those injectors who are not infected with HIV and to dependent drug users who do not inject.
Dr Sheila Gore, Senior Statistician, Medical Research Council Biostatistics Unit, Institute of Public Health, Cambridge
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