Release from Prison & the Risk of Overdose: New Research

When we do our educational groups at the Cumberland County Jail and the Maine Correctional Center in Windham, we stress the importance of learning about tolerance and the risks associated with lowered tolerance upon release.

Drug and alcohol tolerance is typically lowered upon release from facilities such as prison or detox (see "Loss of tolerance and overdose mortality after inpatient opiate detoxification: follow up study") but there is research citing that release from prison/jail puts a person at highest risk for overdose. Below is the most recent published research, followed by prior publications/articles.

"Meta-analysis of drug-related deaths soon after release from prison" 
(ABSTRACT, Addiction, June 23, 2010)
"Release from Prison - A High Risk of Death for Former Inmates"
(NE J of Medicine, 2007)
"Heroin users released from methadone detox or jail may be at higher risk for overdose, according to UCSF researchers"
(UCSF, 2001)
"Preventing Fatal Overdose"- Powerpoint slideshow
(NY State Office of Alcoholism and Substance Abuse Services)
"Mortality from overdose among injecting drug users recently released from prison: database linkage study"
 (British Medical Journal, 1998)


While the information is alarming, it is important to note that there are things people can do to reduce their risk of overdose upon release.  Here are a few things we share with incarcerated individuals during our groups:

• Do a little less if you haven’t used lately. Even if it’s only been a few days, your body may react to the drug like it did when you first began to use. If your health has worsened or you’ve lost weight since your last use, consider that too when measuring your dose
• Take the drug in a way that gets you high more slowly—snorting heroin or cocaine rather than injecting it, for example
• Try to use with someone who knows what to do in case you go out. If you must use alone, let a friend know so they can check in on you
• Try to find out as much as you can about the stuff you plan to use: it may have gotten stronger since the last time you tried it
• Be careful if you’re using a new drug, as it will be hard to know how much to do. Try to use with someone who has some experience with the drug you’re doing, and with new users.
• Taken from: http://www.harmreduction.org/downloads/od2000.pdf

For more detailed information about our project, visit our website http://substanceabuse.portlandmaine.gov/phopp.asp; if you'd like to learn more about the Harm Reduction Coalition (a leader in overdose prevention education), visit http://www.harmreduction.org.

Chronic Pain: Risk Management

Over the course of the last hour I came across three separate yet related articles that address the issues regarding the treatment and management of chronic pain.  Below you'll find links to each article so please feel free to offer your perspective about what patients chronic pain patients might need to function, what doctors are up against and the addiction & overdose risks attached to these particular drugs (Oxycontin, methadone, Vicodin, etc).

Pain Management Fails Due to Rx Drug Abuse Fears 

(Pain-Topics.org, January 8, 2010)

"Millions of Americans with significant acute or chronic pain are being undertreated as physicians fail to provide comprehensive pain treatment, according to recent reviews. The failure is due to inadequate training of physicians, personal biases and, increasingly, fears of prescription analgesic drug abuse." Read On...

Managing the Emotional Aspects of Pain 

(Crossroads for Women blog, January 15, 2010)

"A recent article found on CNN.com talked about how living with chronic pain can hurt personal relationships. Michael E. Geisser, a professor of physical medicine and rehabilitation at the University of Michigan, states in the article, “It has been shown that relationships in which one partner has chronic pain tend to be more strained, have more marital distress, more conflict, and a greater likelihood for divorce.” Read On...

Even Legitimate Opioid Use May Cause Overdose 

(Reuters Health, January 19, 2010)

"Perhaps it's not surprising, but people who take high doses of opioid painkillers even for legitimate medical reasons are at risk of overdosing, new research shows." Read On...


For local and national treatment options, please visit SAMHSA's Treatment Locator at: www.findtreatment.samhsa.gov .  In Maine you can also dial 211 or visit www.211maine.org