Abstract
BackgroundAlthough prevention of opiate overdose has been gaining attention as a harm reduction measure with community drug users, there is scarce information about drug overdose in prison. In correctional institutions without a drug free environment, awareness of overdose events is an important public health concern. This study explores the frequency with which inmates in a state penitentiary system report having witnessed drug overdose events in prison. It also explores whether participants who have witnessed an overdose in prison and know someone who died from an overdose in prison significantly differ from those that do not in selected sociodemographic variables and drug use history to identify a target population for prevention interventions.MethodsData comes from a cross-sectional survey of sentenced inmates in the state prisons of Puerto Rico. A complex probabilistic, multistage sampling design was used. A total of 1,179 individuals participated for an 89% response rate.ResultsFactors associated with witnessing an overdose event in prison include: male sex, age 25 or older, drug use during current incarceration, and drug injection in prison. Factors associated with knowing someone who died from an overdose in prison include: male sex, age between 25–35, previous incarcerations, and drug use during current incarceration.ConclusionWitnessing a drug overdose is a frequent occurrence within the prison system. The likelihood of witnessing an overdose is greater with being male, polydrug use and drug injection in prison. Findings signal an urgent public health challenge that requires prompt interventions to reduce this drug related harm within the correctional system, including adequate access to medication with opiate agonists.
Highlights
Prevention of opiate overdose has been gaining attention as a harm reduction measure with community drug users, there is scarce information about drug overdose in prison
Significant associations were found for being male, and age between 25 and 35 years (52.4% witnessed an overdose while 38.7% knew someone who died from an overdose in prison)
The prevalence of non-fatal overdose among opiate users varies among cities and age groups [13], the finding that nearly half of male inmates in this study belief they have witnessed a drug overdose during the current or a prior incarceration and nearly a third report that they know someone who died from an overdose in prison, suggests that this event is occurring in proportions comparable to what is reported from studies conducted with community drug users in other countries
Summary
Prevention of opiate overdose has been gaining attention as a harm reduction measure with community drug users, there is scarce information about drug overdose in prison. This study explores the frequency with which inmates in a state penitentiary system report having witnessed drug overdose events in prison. It explores whether participants who have witnessed an overdose in prison and know someone who died from an overdose in prison significantly differ from those that do not in selected sociodemographic variables and drug use history to identify a target population for prevention interventions. Prevention of opiate overdose has been gaining attention as a harm reduction measure with community drug users [1,2,3], there is scarce information regarding the frequency with which drug users experience an overdose while in prison. Complications from drug overdose include serious clinical conditions such as pulmonary edema, cardiac arrhythmia, cognitive impairment, rhabdomyolysis, and indirect physical injury [14,20,21,22]
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