Imprisonment of opioid‐dependent people in New South Wales, Australia, 2000–2012: a retrospective linkage study

Abstract

Objective: There are few data about the incarceration of opioid-dependent people involving large representative cohorts. We aimed to determine the prevalence and duration of incarceration in a large cohort of opioid-dependent people in Australia using data linkage methods, and estimate the costs associated with their incarceration. Method:Retrospective linkage study of all entrants to opioid substitution therapy (OST) for the treatment of opioid dependence in NSW, 1985NSW, -2010, with data on incarceration, 2000-2012. The number and duration of incarcerations were calculated. The average daily cost of incarceration was applied to days of incarceration in the cohort.Results: Among 47,196 opioid-dependent people, 37% (43% of men and 24% of women) had at least one episode of incarceration lasting one or more days. Men had a median of three (ranging between 1-47) incarcerations, and women, two (1-35). Indigenous men spent 23% of follow-up time incarcerated, compared with 8% for non-Indigenous men; similarly, Indigenous women spent a substantially greater proportion of time incarcerated than non-Indigenous women (8% vs. 2%). Costs of incarceration of this cohort between 2000 and 2012 totalled nearly AUD$3 billion.Conclusions: This is the first study to examine incarceration of opioid-dependent people across an entire population of such users. Our findings suggest that a substantial minority of opioid-dependent people experience incarceration, usually on multiple occasions and at significant cost. Treatment for opioid dependence, inside and outside prisons, may help reduce incarceration of this cohort.

Opioid substitution therapy as a strategy to reduce deaths in prison: retrospective cohort study

“…Opioid-dependent people commonly experience imprisonment,6 and there are several reasons to believe that opioid-dependent prisoners may be at particular risk of unnatural death in prison. Drug withdrawal has been implicated as a possible trigger for suicide in the first days of incarceration 7 8.…”

Opioid substitution therapy as a strategy to reduce deaths in prison: Retrospective cohort study

“…Opioid-dependent people commonly experience imprisonment, 6 and there are several reasons to believe that opioiddependent prisoners may be at particular risk of unnatural death in prison. Drug withdrawal has been implicated as a possible trigger for suicide in the first days of incarceration.…”

A cross-sectional study of correlates of imprisonment in opioid-dependent men and women in New South Wales, Australia

“…In the United States, with the world’s highest incarceration rate [1], it has been conservatively estimated that one-quarter to one-third of heroin dependent persons are detained in a correctional facility annually [2]. In a state-wide data linkage study in an Australian jurisdiction, approximately one in five people with a history of opioid dependence was imprisoned annually, and 37% of the cohort was imprisoned at least once over a 12-year follow-up period [3]. …”

“…Despite the known risks and poor outcomes of imprisonment for opioid dependent people, and the identification of factors that increase imprisonment risk in the general population, the correlates of imprisonment of opioid dependent people are largely unstudied. Population studies have shown that imprisonment is not inevitable for opioid dependent people [3], and understanding factors that increase risk of imprisonment may assist in understanding trajectories of offending in opioid dependence. The aim of this study was to determine prevalence of adult imprisonment in an opioid dependent sample, and associations with socio-demographic characteristics, adverse childhood experiences and adolescent-onset substance use and psychiatric disorders.…”

“…The aim of this study was to determine prevalence of adult imprisonment in an opioid dependent sample, and associations with socio-demographic characteristics, adverse childhood experiences and adolescent-onset substance use and psychiatric disorders. Given disparities between opioid dependent men and women in the prevalence of imprisonment [3], adverse childhood events and mental disorders [15, 16], we also aimed to determine if the correlates of imprisonment varied by gender.…”