Death in the first-time drug offenders in community reentry: A population-based longitudinal study

Objective: To assess possible excess risk of death and associated sociodemographic and judiciary determinants among first-time adult drug-involved offenders over the 3 years after release from correctional facilities.

Methods: On the basis the 1995-2001 judiciary records pertaining to drug-related offenses provided by Taiwan's Ministry of Justice Statistics Office with encrypted identification information, we identified 35503 adults who had served sentence at least one day in correctional facilities (ie, jail, prison, or observation/rehabilitation institution) for illegal drug-related offenses. With linkage with 1995-2005 death registration data, the causes of death were extracted according to the ICD-9.

Results: The estimated all-cause SMR for the first-time drug offenders were approximately 3~4, and the estimates were even greater for causes like suicide, homicide, and mental disorders (ie,10~25). In general, females' hazard of death gradually increased over the 3-year period, yet males appeared to have the highest hazard peak near the end of the first year. Drug offenders who were involved with lower-ranked schedule substance and had subsequent reimprisonment were less likely to decease (aHR=0.53~0.65; 0.19~0.42, respectively). Certain judiciary treatments, including the combination of observation or rehabilitation with prison, were related to an increased risk of death (aHR= 1.89 95% CI: 1.24-2.87).

Conclusions: The findings offer support that sociodemographic and judiciary factors might be associated with differential risk of drug-offenders' premature death in the community reentry. This information may have values in the design of policies or intervention to address the healthcare and social welfare needs of drug offenders while transitioning from correctional setting to community.