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January 11, 2007 - Los Angeles Times (CA)

Study: Prisoners Face High Death Rate After Release

A Study Finds Their First Two Weeks of Freedom Are the Riskiest, Largely Because of Drug Use

By Alan Zarembo, Times Staff Writer

Return to Drug War News: Don't Miss Archive

During their first two weeks out of prison, ex-convicts face nearly 13 times greater risk of death than the general population, according to a study of more than 30,000 former inmates published today.

The leading cause was overdose of illegal narcotics, the researchers found.

Though the study did not look at the reason for the high number of drug overdoses, the researchers surmised that the stress of release and the former prisoners' reduced tolerance to drugs after their incarceration were major factors.

"If people have been avoiding drug use and they return to their usual doses after release, they will have lost tolerance," said lead researcher Dr. Ingrid Binswanger of the University of Colorado Health Sciences Center.

The study, published in the New England Journal of Medicine, suggests that the criminal justice system is doing an inadequate job of easing the transition to society, experts said.

It "highlights the critical period immediately following release, which corrections policy has not yet really focused on," said UC Irvine criminologist Joan Petersilia, who was not involved in the research.

There are more than 1.5 million adults in state and federal prisons, and more than 650,000 are released each year.

Despite the large number of prisoners reentering society each year, there have been no previous studies of their mortality rates in the United States, Binswanger said.

The research team tracked 30,237 inmates in Washington state released from July 1999 through December 2003. The former prisoners were tracked for an average of 1.9 years after being released.

Experts said that although the study was based in Washington state, there was no reason its findings would not be applicable nationwide.

Over the entire study period, 443 of the former inmates died. Their death rate -- adjusted for age, sex and race -- was 3.5 times greater than that of the general population.

They died at a higher rate for every major cause of death: 12.2 times the rate for drug overdose compared with the general population, 10.4 times for homicide, 4.7 times for liver disease, 3.4 times for suicide, 3.4 times for motor vehicle accidents, 2.1 times for cardiovascular disease and 1.7 times for cancer.

To a large extent, the death rates are a reflection of a poor, uneducated inmate population, experts said.

More than 70% of the subjects had been diagnosed with drug or alcohol dependence.

By far, the highest death risk occurred in the first two weeks after release. Of all the former prisoners who died over the course of the study, 38, or 10%, died in that two-week period. Of those deaths, 27 were from drug overdoses, most commonly of cocaine.

"It is a time of enormous social stressors," said Dr. Clarissa Krinsky of the University of New Mexico Health Center, who is preparing to publish a study of former prisoners in New Mexico that came to similar conclusions. "You're suddenly without a home, without a job."

Dr. Jacqueline Tulsky, a professor of clinical medicine at UC San Francisco who has studied the difficult transition from prison to freedom, said lives could be saved by offering drug treatment, transitional housing and other services to newly released convicts.

The full study is available at the NEJM website.

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