Male drugs‐related deaths in the fortnight after release from prison: Scotland, 1996–99

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Abstract
Aims  To assess if 15–35‐year‐old males released after 14 + days’ imprisonment in Scotland, 1996–99, had a higher drugs‐related death rate in 2 weeks after release than during subsequent 10 weeks; higher than expected death rate from other causes; and if drugs‐related deaths in the first fortnight were three times as many as prison suicides.Design  Confidential linkage of ex‐prisoner database against deaths.Setting  Scotland's male prisons and young offenders’ institutions during July to December 1996–99; 19 486 index releases after 14+ days’ incarceration.Measurements  Relative risk of drugs‐related death in the first 2 weeks after release (34 deaths) versus subsequent 10 weeks (23). Other causes of death (21) relative to expectation. Drugs‐related deaths in first 2 weeks after release relative to suicides in prison (12).Findings  Drugs‐related mortality in 1996–99 was seven times higher (95% CI: 3.3–16.3) in the 2 weeks after release than at other times at liberty and 2.8 times higher than prison suicides (95% CI: 1.5–3.5) by males aged 15–35 years who had been incarcerated for 14+ days. We estimated one drugs‐related death in the 2 weeks after release per 200 adult male injectors released from 14 + days’ incarceration. Non‐drugs‐related deaths in the 12 weeks after release were 4.9 times (95% CI: 2.8–7.0) the 4.3 deaths expected.Conclusion  Investment in, and evaluation of, prison‐based interventions is needed to reduce substantially recently released drugs‐related deaths.