ArticleBMJ open2023
Burden of opioid toxicity death in the fentanyl-dominant era for people who experience incarceration in Ontario, Canada, 2015-2020: a whole population retrospective cohort study.
Article in BMJ open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
What it found
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The trial behind it
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Who cites it
9 citing papers in PubMed.
- Clarifying the evidence and implications of prioritizing extended-release buprenorphine for opioid agonist treatment in Canada's federal correctional system.Canadian journal of public health = Revue canadienne de sante publique · 2026Article
- Mind the gap: a quality improvement study to determine health care value of rapid-access telemedicine addiction treatment in recently incarcerated individuals.BMC health services research · 2025Article
- Overall and substance use-specific healthcare utilization among individuals with and without criminal justice involvement in Ontario, Canada.International journal of prison health · 2025Article
- Article
- Opioid toxicity deaths in Indigenous people who experienced incarceration in Ontario, Canada 2015-2020: a whole population retrospective cohort study.Lancet regional health. Americas · 2025Article
- The burden of drug overdose deaths among correctional populations: implications for interventions.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2024Article
- Prison Buprenorphine Implementation and Postrelease Opioid Use Disorder Outcomes.JAMA network open · 2024Article
- Creating an 11-year longitudinal substance use harm cohort from linked health and census data to analyse social drivers of health.International journal of population data science · 2024Article
- Article
Corrections and comments
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Authors and funding
15 authors.
Funding
Abstract
objectivesTo describe mortality due to opioid toxicity among people who experienced incarceration in Ontario between 2015 and 2020, during the fentanyl-dominant era.
designIn this retrospective cohort study, we linked Ontario coronial data on opioid toxicity deaths between 2015 and 2020 with correctional data for adults incarcerated in Ontario provincial correctional facilities.
settingOntario, Canada.
participantsWhole population data. MAIN OUTCOMES AND MEASURES: The primary outcome was opioid toxicity death and the exposure was any incarceration in a provincial correctional facility between 2015 and 2020. We calculated crude death rates and age-standardised mortality ratios (SMR).
resultsBetween 2015 and 2020, 8460 people died from opioid toxicity in Ontario. Of those, 2207 (26.1%) were exposed to incarceration during the study period. Among those exposed to incarceration during the study period (n=1 29 152), 1.7% died from opioid toxicity during this period. Crude opioid toxicity death rates per 10 000 persons years were 43.6 (95% CI=41.8 to 45.5) for those exposed to incarceration and 0.95 (95% CI=0.93 to 0.97) for those not exposed. Compared with those not exposed, the SMR for people exposed to incarceration was 31.2 (95% CI=29.8 to 32.6), and differed by sex, at 28.1 (95% CI=26.7 to 29.5) for males and 77.7 (95% CI=69.6 to 85.9) for females. For those exposed to incarceration who died from opioid toxicity, 10.6% died within 14 days of release and the risk was highest between days 4 and 7 postrelease, at 288.1 per 10 000 person years (95% CI=227.8 to 348.1).
conclusionsThe risk of opioid toxicity death is many times higher for people who experience incarceration compared with others in Ontario. Risk is markedly elevated in the week after release, and women who experience incarceration have a substantially higher SMR than men who experience incarceration. Initiatives to prevent deaths should consider programmes and policies in correctional facilities to address high risk on release.
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