Pubdate: Thu, 07 Jul 2016
Source: Toronto Star (CN ON)
Copyright: 2016 The Toronto Star
Contact:  http://www.thestar.com/
Details: http://www.mapinc.org/media/456
Author: Holly Honderich
Page: GT2

FATAL DRUG OVERDOSES HIGH AMONG RELEASED PRISONERS, STUDY FINDS

Research shows death rate is 12 times higher for people who were
jailed in past year

A new study into drug overdose deaths in Ontario among recently
incarcerated adults points to the need for better services to treat
them in the community.

One in 10 adults in Ontario who died of a drug overdose between April
2006 and March 2013 had been incarcerated in a provincial facility
within one year of death, a study from researchers at St. Michael's
Hospital and the University of Toronto has found.

That rate of death is 12 times higher than that of the general
population, the study, published Wednesday in PLOS ONE, a
peer-reviewed scientific journal, found.

The study "points quite clearly to this population as a key population
to prevent deaths from overdose," said Dr. Fiona Kouyoumdjian, a
post-doctoral fellow with the Centre for Research on Inner City Health
with St. Michaels and a co-author of the study.

Researchers reviewed files from Ontario's coroner information system,
which records all drug-related deaths, to identify such deaths among
adults in Ontario between 2006 and 2013.

The team compared these records with data from the Ontario Ministry of
Community Safety and Correctional Services to identify people who had
been incarcerated within one year of death.

Most deaths due to drug overdose among the recently incarcerated -
about 77 per cent - involved the use of one or more opioids.

The findings are consistent with related research in the U.K. and the
United States, said Dr. Nav Persaud, family doctor and scientist with
the Li Ka Shing Knowledge Institute at St. Michael's and lead author
of the study.

A key factor behind the spike in overdose deaths after incarceration
is linked to a drop in tolerance to opioids while behind bars.

But while concentration of fatal overdoses among the recently
incarcerated was anticipated, the sheer rate of death among the
stigmatized population is "striking," Kouyoumdjian said, a sentiment
echoed by fellow researchers.

"It's disturbing," said Dr. Sheryl Spithoff, an addiction medicine
physician at Women's College Hospital.

"We knew that overdose deaths increased shortly after release . . .
but these numbers are high. I think higher than most people have suspected."

Researchers say the results point to a critical window of opportunity
for preventing overdose deaths, particularly as so many occurred just
days after incarceration: 20 per cent of deaths occurred within one
week of release, and 9 per cent occurred within just two days.

"This study identifies such an important group in a critical time
period and a specific point of contact that we can reduce overdose
deaths in the province," said Dr. Pamela Leece, a physician with the
substance use service at Women's College Hospital.

Decreased exposure to substances, safer prescribing methods, opioid
substitution, enhanced education with respect to drug use and
overdoses and access to naxolone are among the most effective
preventative strategies, Persaud said.

The recommendations come just days after Ontario's Ministry of Health
announced that it would make naloxone - an antidote for drug overdoses
- - available without a prescription in pharmacies throughout Ontario.

Despite the recent change, the researchers say the study highlights
current gaps in the services and prevention strategies provided to
incarcerated Canadians and the services they need.

"The focus really needs to be on ensuring access to these treatments .
. . that are available in the community," Kouyoumdjian said. "There
are opportunities to improve."
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MAP posted-by: Matt