OVERDOSE RISK AFTER PRISON RELEASE

NEW YORK (Reuters) -- Recently incarcerated, HIV-infected intravenous
drug>users have an eight times greater risk of fatal overdose during the
fiirst
two weeks after prison release than in the subsequent 10 weeks,
researchers say.

Investigators led by Dr. S.R. Seaman of the Institute of Public Health at
Cambridge University in Cambridge, England, believe that "lives could be
saved" through research into intervention programs that might "reduce the
number of deaths from overdose that occur soon after release."

Their study, published in the current issue of the British Medical
Journal, focused on the death rates of 316 Scottish HIV-infected
intravenous drug users between 1983-1994. The researchers say 75% of those
addicts served prison sentences during that time.

Thirty-three of the study subjects died from non-AIDS causes during the
study period.

Twenty-six of those men had spent time in prison. The UK investigators say
three of them died "within 2 days of release, two at 5 days after release,
(with) one death each at 9, 12, 66, and 74 days after release. The
remaining deaths occurred more than 100 days after release."

Of the seven deaths occurring within two weeks of release, six were
overdose-related, while the seventh arose from direct injection into an
artery.

The researchers say that when fatal overdose rates in the first two weeks
after release were compared with rates over a longer 12-week postrelease
period, overdose risks were still eight times higher during those first 14
days compared with the following 10-week period.

The study authors speculate that "the time immediately after release is
one of intensified risk (for drug-abusing prisoners), probably caused by a
decrease in tolerance to drugs as a result of less frequent injecting
while in prison, or the lower purity of drugs found in prison."

They advocate the development of prison-based interventions which might
educate inmates as to the heightened risks of overdose which occur just
after release. Services like these "might reduce the risk of recently
released inmates (of) dying from overdose," the study authors say.
SOURCE: British Medical Journal (1998;316:10-12)