Drugs, Alcohol Killing Ex-Prisoners Even Years After Release

A significant number of deaths among former prisoners are substance use-related, according to a new study from Sweden published in the journal Lancet Psychiatry.

The study of nearly 48,000 former prisoners found that 34 percent of deaths among men and 50 percent of deaths among women were connected to alcohol or drug use. Furthermore, among the deaths that were determined to be from preventable causes (such as accidents or suicide), even higher rates were related to substance use: 42 percent of deaths among men and 70 percent of deaths among women.

Approximately 6 percent (2,874) of the former prisoners followed during the course of the study died during a follow-up period that lasted an average of five years. About 44 percent (1,276) of these deaths were attributed to preventable causes.

Unique Risk to Former Prisoners

Previous research has suggested that various psychiatric disorders, including substance use disorders, schizophrenia and depression, increase the likelihood of death among released prisoners. However, this new study found that only drug abuse and alcohol use were associated with higher rates of death among former prisoners.

This study is also among the first to demonstrate that released prisoners with histories of substance abuse and addiction face a higher risk of death even years after their release. Previously, it was known that such prisoners face a high risk of preventable death in the weeks immediately following their release, but it had not been demonstrated that the higher risk persisted as much as five years following the conclusion of their prison sentences.

Although the overall rate of incarceration in Sweden is significantly lower than many other high-income countries, including the United States, the rate of substance use and the prevalence of serious psychiatric illnesses among prisoners is very similar to other such countries. As a result, the Swedish researchers believe that their results are relevant for countries such as the U.S. and the United Kingdom.

By addressing substance use among former prisoners though preventive and therapeutic programs, countries could greatly reduce the rate of preventable death among prisoners following their release. The researchers estimate that England and Wales could reduce their overall preventable deaths by around 3 percent, while the U.S., which has a much higher incarceration rate (and therefore a much higher number of released prisoners), could reduce overall preventable deaths by as much as 9 percent.

Saving Money and Lives

The second report on inmate substance abuse from the National Center on Addiction and Substance reveals that while approximately 65 percent of U.S. inmates meet the criteria for substance abuse and addiction, only 11 percent receive treatment. Furthermore, less than 1 percent of the $74 billion spent on incarceration in 2005 was for prevention and treatment programs.

Substance abuse is known to be a factor in the majority of many types of crimes and to play a major role in recidivism. The National Center on Addiction and Substance Abuse report adds to the evidence that spending more on prevention and treatment could save the justice system significant money in the long term. The results of the Swedish study further suggest that preventive and treatment services will not only save money, but also save lives.

There is still hope.

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