Abstract：
BACKGROUND: Overdose is the leading cause of death for people released from prison, and opioid agonist treatment is associated with reductions in mortality after imprisonment. However, few studies have explored the interplay of the potential modifiable risk factors and protective factors for mortality after release from prison. We aimed to describe all-cause mortality and overdose mortality among individuals released from Norwegian prisons during 2000-22 and to identify pre-existing risk factors associated with both types of mortality among these individuals for 6 months.
METHODS: For this prospective analysis, we used data from the Norwegian Prison Release Study (nPRIS), which includes all people in prison in Norway between Jan 1, 2000, and Dec 31, 2022; the Norwegian Cause of Death Registry; the Norwegian Prison Registry; the Norwegian Patient Registry; and Statistics Norway. All prisons in Norway that were open during this period were included. People who did not have a Norwegian personal identification number or were serving their sentence outside of prison units were excluded from this analysis. To identify pre-existing risk factors associated with all-cause and overdose mortality among people released from prison, we left-censored the observation period on Jan 1, 2010, creating a subsample of individuals. We calculated crude mortality rates (CMRs) and corresponding 95% CIs as the number of deaths per 100 000 person-years for several time periods after release. The primary outcomes were all-cause mortality and overdose mortality according to the ICD-10, assessed in all participants and analysed via two separate Cox proportional-hazards models.
RESULTS: The total nPRIS cohort included 112 877 individuals released from prison in Norway between 2000 and 2022, 11 995 (10·6%) of whom were female and 100 865 (89·4%) of whom were male. We identified 13 004 instances of all-cause mortality and 3085 instances of overdose mortality during the 1 463 035 person-years. The estimated CMR for all-cause mortality was 889 (95% CI 874-904) per 100 000 person-years and for overdose mortality was 211 (203-218) per 100 000 person-years. Among people diagnosed with opioid use disorder before entering prison during 2010-22 (n=6830), provision of opioid agonist treatment was estimated to be associated with reductions in both all-cause mortality (hazard ratio 0·58, 95% CI 0·39-0·85) and overdose mortality (0·51, 0·31-0·82) in the 6 months after leaving prison after adjustment for sociodemographic, prison-related, and clinical characteristics.
CONCLUSIONS: In people diagnosed with opioid use disorder released from Norwegian prisons, opioid agonist treatment provided while in prison was a protective factor for both all-cause and overdose mortality at 6 months. Provision of opioid agonist treatment while in prison is crucial in reducing mortality for 6 months after release and should be available to all people in prison who have treatment needs.
BACKGROUND: South-Eastern Norway Regional Health Authority and the Research Council of Norway.
METHODS: For this prospective analysis, we used data from the Norwegian Prison Release Study (nPRIS), which includes all people in prison in Norway between Jan 1, 2000, and Dec 31, 2022; the Norwegian Cause of Death Registry; the Norwegian Prison Registry; the Norwegian Patient Registry; and Statistics Norway. All prisons in Norway that were open during this period were included. People who did not have a Norwegian personal identification number or were serving their sentence outside of prison units were excluded from this analysis. To identify pre-existing risk factors associated with all-cause and overdose mortality among people released from prison, we left-censored the observation period on Jan 1, 2010, creating a subsample of individuals. We calculated crude mortality rates (CMRs) and corresponding 95% CIs as the number of deaths per 100 000 person-years for several time periods after release. The primary outcomes were all-cause mortality and overdose mortality according to the ICD-10, assessed in all participants and analysed via two separate Cox proportional-hazards models.
RESULTS: The total nPRIS cohort included 112 877 individuals released from prison in Norway between 2000 and 2022, 11 995 (10·6%) of whom were female and 100 865 (89·4%) of whom were male. We identified 13 004 instances of all-cause mortality and 3085 instances of overdose mortality during the 1 463 035 person-years. The estimated CMR for all-cause mortality was 889 (95% CI 874-904) per 100 000 person-years and for overdose mortality was 211 (203-218) per 100 000 person-years. Among people diagnosed with opioid use disorder before entering prison during 2010-22 (n=6830), provision of opioid agonist treatment was estimated to be associated with reductions in both all-cause mortality (hazard ratio 0·58, 95% CI 0·39-0·85) and overdose mortality (0·51, 0·31-0·82) in the 6 months after leaving prison after adjustment for sociodemographic, prison-related, and clinical characteristics.
CONCLUSIONS: In people diagnosed with opioid use disorder released from Norwegian prisons, opioid agonist treatment provided while in prison was a protective factor for both all-cause and overdose mortality at 6 months. Provision of opioid agonist treatment while in prison is crucial in reducing mortality for 6 months after release and should be available to all people in prison who have treatment needs.
BACKGROUND: South-Eastern Norway Regional Health Authority and the Research Council of Norway.
摘要：
背景：过量是释放出狱人员死亡的主要原因，阿片类药物激动剂治疗与监禁后死亡率的降低有关。然而,很少有研究探讨监狱释放后死亡的潜在可改变的危险因素和保护因素之间的相互作用.我们旨在描述2000-22年间从挪威监狱释放的个体的全因死亡率和过量死亡率，并确定这些个体中与这两种类型的死亡率相关的预先存在的风险因素6个月。
方法：对于本前瞻性分析，我们使用了挪威监狱释放研究(nPRIS)的数据，其中包括2000年1月1日至2022年12月31日在挪威监狱中的所有人；挪威死因登记处；挪威监狱登记处；挪威患者登记处；和挪威统计局。挪威在此期间开放的所有监狱都包括在内。没有挪威个人身份号码或在监狱以外服刑的人被排除在这一分析之外。确定与从监狱释放的人的全因死亡和过量死亡相关的预先存在的风险因素，我们在2010年1月1日对观察期进行了保留,创建了一个个体子样本.我们将粗死亡率（CMR）和相应的95％CI计算为发布后几个时间段内每10万人年的死亡人数。主要结果是根据ICD-10的全因死亡率和过量死亡率，在所有参与者中进行评估，并通过两个独立的Cox比例风险模型进行分析。
结果：nPRIS队列包括2000年至2022年在挪威从监狱释放的112877人，其中11995人（10·6％）为女性，100865人（89·4％）为男性。在1463035人年期间，我们确定了13004例全因死亡率和3085例超剂量死亡率。全因死亡率的估计CMR为889（95％CI874-904）/10万人年，过量死亡率为211（203-218）/10万人年。在2010-22年期间进入监狱前被诊断患有阿片类药物使用障碍的人中（n=6830），估计提供阿片类药物激动剂治疗与降低全因死亡率（危险比0·58，95％CI0·39-0·85）和过量死亡率（0·51，0·31-0·82）在调整社会人口统计学后离开监狱后的6个月内，与监狱有关,和临床特征。
结论：从挪威监狱释放的被诊断患有阿片类药物使用障碍的人，在监狱中提供的阿片类药物激动剂治疗是6个月时全因死亡率和过量死亡率的保护因素。在监狱中提供阿片类药物激动剂治疗对于降低释放后6个月的死亡率至关重要，并且应该向所有有治疗需求的监狱中的人提供。
背景：挪威东南部地区卫生局和挪威研究委员会。
方法：对于本前瞻性分析，我们使用了挪威监狱释放研究(nPRIS)的数据，其中包括2000年1月1日至2022年12月31日在挪威监狱中的所有人；挪威死因登记处；挪威监狱登记处；挪威患者登记处；和挪威统计局。挪威在此期间开放的所有监狱都包括在内。没有挪威个人身份号码或在监狱以外服刑的人被排除在这一分析之外。确定与从监狱释放的人的全因死亡和过量死亡相关的预先存在的风险因素，我们在2010年1月1日对观察期进行了保留,创建了一个个体子样本.我们将粗死亡率（CMR）和相应的95％CI计算为发布后几个时间段内每10万人年的死亡人数。主要结果是根据ICD-10的全因死亡率和过量死亡率，在所有参与者中进行评估，并通过两个独立的Cox比例风险模型进行分析。
结果：nPRIS队列包括2000年至2022年在挪威从监狱释放的112877人，其中11995人（10·6％）为女性，100865人（89·4％）为男性。在1463035人年期间，我们确定了13004例全因死亡率和3085例超剂量死亡率。全因死亡率的估计CMR为889（95％CI874-904）/10万人年，过量死亡率为211（203-218）/10万人年。在2010-22年期间进入监狱前被诊断患有阿片类药物使用障碍的人中（n=6830），估计提供阿片类药物激动剂治疗与降低全因死亡率（危险比0·58，95％CI0·39-0·85）和过量死亡率（0·51，0·31-0·82）在调整社会人口统计学后离开监狱后的6个月内，与监狱有关,和临床特征。
结论：从挪威监狱释放的被诊断患有阿片类药物使用障碍的人，在监狱中提供的阿片类药物激动剂治疗是6个月时全因死亡率和过量死亡率的保护因素。在监狱中提供阿片类药物激动剂治疗对于降低释放后6个月的死亡率至关重要，并且应该向所有有治疗需求的监狱中的人提供。
背景：挪威东南部地区卫生局和挪威研究委员会。
