ArticleCMAJ open
Fatal overdoses after release from prison in British Columbia: a retrospective data linkage study.
Article in CMAJ open. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.
- Multinational appraisal of the epidemiological distribution of opioid fatalities: a systematic review and meta-analysis.Frontiers in psychiatry · 2023Pooled it
- Opioid use disorder in custodial settings: Continuity of opioid agonist therapy at a critical clinical inflection point.Canadian family physician Medecin de famille canadien · 2026Article
- The health status of incarcerated people in Canada: a narrative review.Frontiers in public health · 2026Review
- A qualitative study of the impacts of a government crackdown against revenue sharing between pharmacies and patients in Vancouver, Canada.Discover public health · 2026Article
- Mortality and return to custody of individuals with a history of drug use one year post-release from the New South Wales custodial system.Scientific reports · 2025Article
- "Before medically advised" hospital discharge and the risk of subsequent drug overdose: A case-crossover analysis.Journal of hospital medicine · 2025Article
- Housing status and accidental substance-related acute toxicity deaths in Canada, 2016-2017.Health promotion and chronic disease prevention in Canada : research, policy and practice · 2024Article
- Article
- Psychiatric morbidity among women in Norwegian prisons, 2010-2019: a register-based study.BMC psychiatry · 2023Article
- Article
- Fatal and nonfatal opioid overdose risk following release from prison: A retrospective cohort study using linked administrative data.Journal of substance use and addiction treatment · 2023Article
- Access to tablet injectable opioid agonist therapy in rural and smaller urban settings in British Columbia, Canada: a qualitative study.Substance abuse treatment, prevention, and policy · 2023Article
- Exploring the contextual risk factors and characteristics of individuals who died from the acute toxic effects of opioids and other illegal substances: listening to the coroner and medical examiner voice.Health promotion and chronic disease prevention in Canada : research, policy and practice · 2023Article
- Article
Corrections and comments
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Authors and funding
3 authors at 1 institution in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPeople recently released from prison are at increased risk of preventable death; however, the impact of the current overdose epidemic on this population is unknown. We aimed to document the incidence and identify risk factors for fatal overdose after release from provincial prisons in British Columbia.
methodsWe conducted a retrospective, population-based, open cohort study of adults released from prisons in BC, using linked administrative data. Within a random 20% sample of the BC population, we linked provincial health and correctional records from 2010 to 2017 for people aged 23 years or older as of Jan. 1, 2015, who were released from provincial prisons at least once from 2015 to 2017. We identified exposures that occurred from 2010 to 2017 and deaths from 2015 to 2017. We calculated the piecewise incidence of overdose-related and all-cause deaths after release from prison. We used multivariable, mixed-effects Cox regression to identify predictors of all-cause death and death from overdose.
resultsAmong 6106 adults released from prison from 2015 to 2017 and followed in the community for a median of 1.6 (interquartile range 0.9-2.3) years, 154 (2.5%) died, 108 (1.8%) from overdose. The incidence of all-cause death was 16.1 (95% confidence interval [CI] 13.7-18.8) per 1000 person-years. The incidence of overdose deaths was 11.2 (95% CI 9.2-13.5) per 1000 person-years, but 38.8 (95% CI 3.2-22.6) in the first 2 weeks after release from prison. After adjustment for covariates, the hazard of overdose death was 4 times higher among those who had been dispensed opioids for pain.
interpretationPeople released from prisons in BC are at markedly increased risk of overdose death. Overdose prevention must go beyond provision of opioid agonist treatment and naloxone on release to address systemic social and health inequities that increase the risk of premature death.
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