Some individuals at risk of drug-related death after release may have neither self-identified as a drug user nor been diagnosed or detected as a drug user while in prison.

Numbers of drug-related deaths during weeks 1 + 2, 3 + 4 and 5вЂ“12 after release could be extracted from the published literature or by contacting the authors.Дrug usage or dependency was not an eligibility criterion for entry into the study. The 12-week follow-up period is sufficiently long to detect variations in risk. Studies of prisoners' mortality were eligible for inclusion if English-language and:ДЄdult prisoners aged 18вЂ“35 years were included in the study (in order to fit the age profile of drug-users in prisons ) and follow-up for mortality was from the time of index release for at least 12 weeks. This investigation was designed to update, and make more precise, our understanding of the high risk of drug-related death soon after release from prison. To characterize further the decay in risk over time, we have pooled the RR of drug-related death during weeks 1 + 2 and 3 + 4 versus weeks 5вЂ“12 after release. overdose or accidental poisoning) in the first 2 weeks after release compared with weeks 3вЂ“12 after release. Through meta-analysis of studies of prisoners' mortality published by August 2009, we have summarized the RR of drug-related death (i.e. Preferable definitions of index release are: either first release in a defined accrual period (as first release, unlike last release, is independent of 12-week survival status) or all releases in a defined accrual period. The most recent release from prison is outcome-dependent for those who die and so gives biased ascertainment of deaths. Index release has been defined variably in the literature. The research team receives a file, without the need for prisoner names, from the prison service with such minimal details as the released prisoner's age, sex, prison and date of release and sentence duration-with which the death information can then be merged. The corresponding registrar of deaths can then provide the date and cause of death for any person thus listed. The research team needs only to specify to a prison service the criteria for eligible releases. Database linkage requires minimal information about eligible ex-prisoners, is less costly and avoids potential biases from opt-ins and dropouts. These mortality studies have used database linkage as a practical alternative to more traditional, individually consented prospective cohort studies. Similarly large studies of prisoners' mortality post-release have since been conducted elsewhere, focusing upon the persistence of increased risk in and beyond the first 2 weeks. By not requiring knowledge of prisoners' injector status, this study ascertained all drug-related deaths and, hence, avoided reliance on drug-using prisoners' willingness to self-identify. Bird & Hutchinson reinforced these findings in their later, Scottish study of 19 486 male index releases (RR: 7.4, 95% CI: 3.3вЂ“16.3). first showed that, for a cohort of 316 male human immunodeficiency virus (HIV)-infected injecting drug-users in Scotland, the relative risk (RR) of overdose death was eight times higher in the first 2 weeks after release from prison compared with subsequent 2-week periods (weeks 3вЂ“12). For drug-using offenders, imprisonment can enforce a substantial reduction in drug use and, as a result, drug tolerance.

Extreme injector 3.7.1