Drug use and re-imprisonment: A prospective study of the Norwegian Offender Mental Health and Addiction (NorMA) cohort

Background

Re-imprisonments are common among people in prison who use drugs. This study aims to describe sociodemographic factors, mental health and level of pre-prison substance use in a cohort of people in prison, and to investigate re-imprisonment during follow-up according to their level of pre-prison drug use.

Methods

This was a prospective study using baseline data from the Norwegian Offender Mental Health and Addiction (NorMA) cohort (n = 733) recruited in 2013-2014 linked to data from the Norwegian Prison Registry and the Norwegian Cause of Death Registry. Self-reported drug use before imprisonment was measured at baseline using the Drug Use Disorder Identification Test (DUDIT). The outcome of interest was re-imprisonment examined using Cox regression. We excluded 32 persons because they were not released before the study ended. The study sample included 701 persons, with a total time-at-risk of 2479 person-years.

Results

Almost half of the study sample reported high-risk drug use before imprisonment (DUDIT score >24). During the study period, 43% (n = 267) were re-imprisoned. People with high-risk use had a hazard ratio (HR) of 4.20 (95% CI: 2.95-5.97) of re-imprisonment compared with people with low-risk use (DUDIT score <6). Older age and more education than primary school were associated with a reduced risk of re-imprisonment.

Conclusion

Compared with low-risk use, high-risk drug use is highly prevalent among people in prison and is associated with higher rates of re-imprisonment. This highlights the need for screening and treatment of drug use disorders among people in prisons.

PriSUD-Nordic-Diagnosing and Treating Substance Use Disorders in the Prison Population: Protocol for a Mixed Methods Study

Background

A large proportion of the prison population experiences substance use disorders (SUDs), which are associated with poor physical and mental health, social marginalization, and economic disadvantage. Despite the global situation characterized by the incarceration of large numbers of people with SUD and the health problems associated with SUD, people in prison are underrepresented in public health research.

Objective

The overall objective of the PriSUD (Diagnosing and Treating Substance Use Disorders in Prison)-Nordic project is to develop new knowledge that will contribute to better mental and physical health, improved quality of life, and better life expectancies among people with SUD in prison.

Methods

PriSUD-Nordic is based on a multidisciplinary mixed method approach, including the methodological perspectives of both quantitative and qualitative methods. The qualitative part includes ethnographic fieldwork and semistructured interviews. The quantitative part is a registry-based cohort study including national registry data from Norway, Denmark, and Sweden. The national prison cohorts will comprise approximately 500,000 individuals and include all people imprisoned in Norway, Sweden, and Demark during the period from 2000 to 2019. The project will investigate the prison population during three different time periods: before imprisonment, during imprisonment, and after release.

Results

PriSUD-Nordic was funded by The Research Council of Norway in December 2019, and funding started in 2020. Data collection is ongoing and will be completed in the first quarter of 2022. Data will be analyzed in spring 2022 and the results will be disseminated in 2022-2023. The PriSUD-Nordic project has formal ethical approval related to all work packages.

Conclusions

PriSUD-Nordic will be the first research project to investigate the epidemiology and the lived experiences of people with SUD in the Nordic prison population. Successful research in this field will have the potential to identify significant areas of benefit and will have important implications for ongoing policy related to interventions for SUD in the prison population.

International Registered Report Identifier (IRRID)

DERR1-10.2196/35182