Mortality among Danish drug users released from prison

To determine the mortality of drug users after release from prison in Denmark, a cohort of drug users was identified from two national registers during 1996 - 2001: the drug treatment register (T) and the register of viral hepatitis (H). Incarcerations were extracted from the national penal register, vital status from the civil register, and causes of death from the death certificate register and the police register of drug-related deaths. We identified 15,885 drug users (T: 15,735, H: 896), 62% of the estimated drug-using population in Denmark. There were 1000 observed deaths, of which 51% were classified as overdose deaths. Mortality in the treatment cohort was 2.4/100 person years (py) (95% C. I. 2.2 - 2.5/100 py) compared to the general population expectation of 0.2/100 py. Within the first 2 weeks after release from prison, 26 deaths were observed among 6019 released drug users corresponding to 13/100 py (95% CI 8 - 19/100 py). Overdose deaths accounted for 24/26 deaths (92%) in the first two weeks compared to 121/179 (68%) hereafter (pB/0.001). We conclude that drug users released from prison are at high risk of overdose death. We suggest that methadone treatment should be evaluated as a way to decrease mortality after release from prison.