Substance Use Related Mortality Among Recently Released Persons

Background/Purpose: Published literature indicates that recent release from a correctional facility is a contributing factor for drug-related fatalities, with a higher risk of occurrence within two weeks of release. With the prevalence of drug-related mortality among this population, the purpose of this study is to analyze associations between behavioral health variables and demographics on the likelihood of substance-related mortality among persons recently released from a correctional facility.

Methods:

Data is from the National Violent Death Reporting System (NVDRS), which includes all violent deaths from 32 states in the U.S., collected each year from 2003 to 2015. Our sample included all violent deaths among individuals recently released from a correctional facility. NVDRS data includes reports from death certificates, corner examiner reports, law enforcement agencies and toxicology reports. To establish substance-use related mortalities, toxicology test results were used to form a binary variable. Additional measures in the NVDRS include race/ethnicity, age, gender, education level, marital status, manner of mortality, binary measures of mental health problems, substance use-related problems, currently in treatment for mental health, and a history of mental health treatment.

A multivariate logistic regression model examined associations between demographics, manner of death and behavioral health variables and the likelihood of substance-related mortality.

Results:

There were 39.51% (N=469) non- substance use mortalities, and 60.49% (N=718) substance use mortalities.

The multivariate analysis showed that individuals who died due to homicide (OR= 2.98) and undetermined causes (OR= 7.95) showed significantly higher odds of substance-use related mortality compared to individuals who died by suicide. Individuals who were Black/African American (OR= 2.09), and Hispanic (OR= 2.06) also showed significantly higher odds of a substance use related mortality compared to White non-Hispanic individuals. Also, those with alcohol problems (OR= 2.02), and those with substance abuse problems (OR= 2.42) showed higher odds of a substance-use related mortality. The multivariate analysis resulted in statistically significant lower odds of substance-use related mortality amongst certain variables. Additionally, those with less than High school/GED equivalent (OR= 0.69) showed significantly lower odds of a substance-use related mortality compared to those with high school/GED. Last, those who were previously married (OR= 0.61) showed significantly lower odds of a substance use related mortality compared to those who were never married.

Conclusions/ Implications:

The study resulting in higher odds of substance-use related fatalities among those with substance use problems emphasizes a need for screening and referral to treatment during release from incarceration. Those identified as higher risk can be allocated case managers who will follow-up and ensure engagement in treatment. Higher odds among minorities supports a need for preventative approaches and providers that are culturally competent to ensure culturally responsive care. Future studies should evaluate the release process provided by correctional facilities to persons during release. Research on the release process will contribute to the provision of quality of this process for those in need. Qualitative research with minorities upon release will also provide meaningful insight into the cultural-specific needs of this population.