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Date: April 29, 2024 Mon
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Results for drug-related deaths
7 results foundAuthor: Police Executive Research Forum Title: Building Successful Partnerships between Law Enforcement and Public Health Agencies to Address Opioid Use Summary: In 2014, deaths caused by opioids—including prescription drugs, heroin, and synthetic opioids such as fentanyl—reached record-breaking levels in the United States. With an estimated 78 Americans dying from opioid overdoses each day, In many places, the opioid epidemic has contributed to a shift in how law enforcement agencies fight opioid abuse in their communities. Historically, many of the law enforcement efforts to curb opioid abuse have focused on using enforcement actions (including arrests and incarceration) to target drug use and distribution. However, as opioid-related deaths continue to rise and as more is understood about the nature of opioid addiction, many law enforcement officials are realizing that a more comprehensive approach is needed. "Targeting the 'supply' side of the drug markets, which is what we've been doing for the last 50 or 60 years, is important work," said Leonard Campanello, Chief of Police for the Gloucester (Massachusetts) Police Department. "But this approach alone hasn’t solved the problem. We still have more people addicted. We have more people dying. As police, we need to start looking at the problem from a public health perspective. When our communities are suffering such great losses, it is critical that we find new ways to help." For decades, many law enforcement agencies have supported comprehensive approaches in which police provide enforcement while public health agencies, educational organizations, court systems, and others provide drug treatment and drug abuse prevention work. What is new is the extent to which the opioid epidemic has caused many law enforcement agencies to increase their own involvement in "demand-side" efforts. Today, police officers in many agencies are themselves administering naloxone to save the lives of opioid users who are in an overdose crisis and connecting people to treatment services. And some law enforcement agencies are facilitating "syringe services" programs and other harm reduction efforts and using public health data to drive policy decisions. These strategies, which focus on reducing opioid-related deaths and mitigating the harms caused by opioid abuse, rely on building strong—and often unprecedented—partnerships between the public health and public safety sectors. Details: Washington, DC: Office of Community Oriented Policing Services, 2016. 110p. Source: Internet Resource: COPS Office Emerging Issues Forums: Accessed December 21, 2016 at: https://ric-zai-inc.com/Publications/cops-p356-pub.pdf Year: 2016 Country: United States URL: https://ric-zai-inc.com/Publications/cops-p356-pub.pdf Shelf Number: 147792 Keywords: Drug Abuse and AddictionDrug Abuse TreatmentDrug-Related DeathsPartnerships |
Author: Police Executive Research Forum Title: The Unprecedented Opioid Epidemic: As Overdoses Become a Leading Cause of Death, Police, Sheriffs, and Health Agencies Must Step Up Their Response Summary: Consider the following pieces of information: - In Philadelphia, 35 people died of heroin overdoses in less than a week last December. - In New York City, fatal drug overdoses, which numbered 1,374 in 2016, are four times more common than homicides. The police are moving mountains to analyze overdose cases quickly, in order to stop the fatalities when an extremely powerful batch of heroin or fentanyl hits the streets. - In Louisville, Kentucky, police had 52 overdose calls over a 32-hour period last February. On average, police save someone's live with naloxone about twice a day, and one person dies from an overdose every day. - In Cabell County, West Virginia, officials reported 26 drug overdoses in a five-hour period, due to a batch of heroin containing fentanyl. The county reported the highest overdose death rate in the state, with 132 deaths among a population of less than 100,000. - In Ohio, the state with the most overdose deaths, an average of 11 people died every 24 hours in 2016, and coroners report that the numbers for 2017 are even higher. In Akron, 16 drug dealers have been sentenced to long prison terms because their product was linked to fatal overdoses, but the police chief doesn't think those prosecutions have "sent a message" to other dealers or slowed down the heroin trafficking. - In Cook County, Illinois, where Chicago and some of its suburbs are located, fentanyl took hold with a vengeance in 2016, causing more than 560 fatal overdoses. When Chicago's opioid overdoses are laid out on a map of the city, it correlates closely with the locations of shootings, prompting one police official to note that "our violent crime problem is our drug problem." - In New Jersey, crime labs have backlogs, but they find a way to turn heroin analyses around in a matter of hours if fatalities are involved. - In Baltimore, where 694 people suffered fatal overdoses in 2016, the Health Department is very concerned about the high likelihood that prescription opioid pills will lead to more cases of heroin addiction. So it is taking action. The Health Department is asking doctors to provide a prescription for naloxone along with every prescription they write for opioid pain pills. The idea is that doctors will think twice about prescribing oxycodone if they have to tell their patients, "Here's a prescription for your shoulder pain. And this other prescription is in case you end up having a heroin overdose." These are a few of the stories that you will find in the report you are holding. This is PERF's third major report about the epidemic of overdoses by persons addicted to opioid drugs. In 2014 and again in 2016, we held national conferences and released reports about the crisis, focusing on what local police and other agencies were doing to reduce the carnage. This new report summarizes what we learned at a third national PERF conference, held at the New York City Police Department's headquarters in April 2017. The reason PERF continues to focus on the opioids crisis is that despite the groundbreaking work that police and other agencies are doing, the epidemic is continuing to worsen. The latest numbers, released by the Centers for Disease Control and Prevention (CDC) in August 2017, are horrible. Drug overdose deaths in 2016 totaled 64,070, a 21-percent increase over the year before. And approximately three-fourths of all drug overdose deaths are caused by opioid drugs. Let's put those numbers in context: - The 64,070 drug fatalities in 2016 outnumber the 35,092 motor vehicle fatalities in 2015. - Drug fatalities in 2016 outnumber American fatalities in the entire course of the Vietnam War, which totaled 58,200. - Drug fatalities in 2016 outnumber AIDS-related deaths in the worst year of the HIV epidemic, when 50,628 people died in 1995. - Drug fatalities in 2016 outnumber the peak year of homicides in the United States, when 24,703 people were murdered in 1991. - Drug fatalities in 2016 outnumber suicides, which have been increasing for nearly 30 years and which totaled 44,193 in 2015. Furthermore, the new CDC statistics confirm what police chiefs have been telling us-Fentanyl is driving the sharp increases in opioid-related fatalities. CDC identified 15,466 fatalities in 2016 resulting from heroin overdoses, but 20,145 fatalities caused by fentanyl or other synthetic opioids. So it is clear that police and other criminal justice agencies, along with public health departments, drug treatment and social service providers, elected officials, and others, must step up their efforts to prevent new cases of opioid addiction, while helping addicted persons through the long and difficult process of getting free of opioid drugs. Details: Washington, DC: PERF, 2017. 92p. Source: Internet Resource: Accessed April 12, 2018 at: http://www.policeforum.org/assets/opioids2017.pdf Year: 2017 Country: United States URL: http://www.policeforum.org/assets/opioids2017.pdf Shelf Number: 149796 Keywords: Drug Abuse and AddictionDrug-Related DeathsOpioid EpidemicOpioidsPrescription Drug Abuse |
Author: United Nations Office on Drugs and Crime (UNODC) Title: Opioid overdose: preventing and reducing opioid overdose mortality Summary: Although data are limited, an estimated 70,000-100,000 people die from opioid overdose each year. Opioid overdose was the main cause of the estimated 99,000- 253,000 deaths worldwide related to illicit drug use in 2010. Opioid overdose is both preventable and, if witnessed, treatable (reversible). In its resolution 55/7 on promoting measures to prevent drug overdose, in particular opioid overdose, the Commission on Narcotic Drugs called upon Member States to include effective measures to prevent and treat drug overdose in national drug policies. In that resolution, the Commission requested the United Nations Office on Drugs and Crime (UNODC), in collaboration with the World Health Organization (WHO), to collect and circulate available best practices on the prevention and treatment of and emergency response to drug overdose, in particular opioid overdose, including on the use and availability of opioid receptor antagonists such as naloxone and other measures based on scientific evidence. This discussion paper outlines the facts about opioid overdose, the actions that can be taken to prevent and treat (reverse) opioid overdose and areas requiring further investigation. Opioids, which can be chemically synthesized or derived from the opium poppy plant, are a group of compounds that activate the brain's opioid receptors, a class of receptors that influence perceptions of pain and euphoria and are involved in the regulation of breathing. Some of the more commonly known and used opioids are morphine, heroin, methadone, buprenorphine, codeine, tramado, oxycodone and hydrocodone. They are used as medicines to treat pain and opioid dependence. If used in excess or without proper medical supervision, opioids can cause fatal respiratory depression. In cases of fatal overdose, the victim's breathing slows to the point where oxygen levels in the blood fall below the level needed to transfer oxygen to the vital organs. As oxygen saturation (normally greater than 97 per cent) falls below 86 per cent, the brain struggles to function. Typically, the individual becomes unresponsive, blood pressure progressively decreases and the heart rate slows, ultimately leading to cardiac arrest. Death can occur within minutes of opioid ingestion. But often, prior to death there is a longer period of unresponsiveness lasting up to several hours. This period is sometimes associated with loud snoring, leading to the term "unrousable snorers". Worldwide, overdose is the leading cause of avoidable death among people who inject drugs. However, it is difficult to accurately estimate the number of fatal opioid overdoses because of the poor quality or limited nature of mortality data available. According to UNODC estimates, drug-related deaths account for between 0.5 percent and 1.3 percent of all-cause mortality at the global level among persons aged 15-64. In that regard, the recent Global Burden of Diseases, Injuries, and Risk Factors Study, 2010 found that there were an estimated 43,000 deaths in 2010 due to opioid dependence and 180,000 deaths due to drug poisoning, resulting in more than 2 million years of life lost. In the United States of America alone, there were an estimated 38,329 drug poisoning deaths in 2010, including 16,651 fatal opioid overdoses related to prescription opioid analgesics in 2010, with the remainder of those deaths largely involving heroin and/or cocaine. Opioid overdose accounts for nearly half of all deaths among heroin injectors, exceeding HIV and other disease-related deaths. Overdose was reported more frequently than were other causes in the 58 cohort studies examined in a 2011 meta-analysis. That meta-analysis also indicated that overdose represented the most common specific cause of death, at 6.5 deaths per 1,000 person-years. Among the 10 per cent of people living with HIV in the United States who also inject drugs, overdose is a common cause of non-AIDS related death. A recent meta-analysis showed that HIV sero-positivity is associated with an increased risk of overdose: people who use drugs have a 74 percent greater risk of overdose if they are HIV-positive compared with their HIV-negative counterparts. In the Russian Federation, overdose is the second leading cause of death for people with HIV after tuberculosis. Nationally reported mortality data in both low-income and high-income countries are often insufficient to estimate overdose deaths. Current data on overdose mortality derive mostly from prospective cohort studies and national reporting systems, largely from high-income countries. To address these challenges, some countries have now adopted a standard case definition, contributing to an improved capacity for reliable overdose data. However, in a significant number of countries, data on overdose are limited, with the result that alternative data sources, often combined with expert opinion, are required to estimate rates. Consequently, overdose mortality generally tends to be underestimated, and nationally reported statistics in that regard are likely to be conservative. For example, against the backdrop of negligible numbers of fatal overdoses reported by national authorities of Central Asian countries, 25.1 percent of injecting drug users surveyed in Kazakhstan, Kyrgyzstan and Tajikistan in 2010 reported having witnessed someone die from an overdose in the previous 12 months. It is likely that people who use opioids also experience a high rate of non-fatal overdose. For instance, 59 percent of known heroin injectors in a study conducted in 16 Russian cities reported having had at least one non-fatal overdose in their lifetime. The proportion of heroin injectors reporting lifetime non-fatal overdose is similarly high in several other cities: 41 percent in Baltimore, 42 percent in New York City, 68 percent in Sydney, 38 percent in London, 30 percent in Bangkok, and 83 percent in Bac Ninh, Viet Nam. Non-fatal overdose can significantly contribute to morbidity, including cerebral hypoxia, pulmonary oedema, pneumonia and cardiac arrhythmia, that may result in prolonged hospitalizations and brain damage. Details: Vienna: UNODC, 2013. 28p. Source: Internet Resource: Discussion paper, UNODC/WHO: Accessed April 18, 2018 at: https://www.unodc.org/docs/treatment/overdose.pdf Year: 2013 Country: International URL: https://www.unodc.org/docs/treatment/overdose.pdf Shelf Number: 149846 Keywords: Drug Abuse and AddictionDrug OverdosesDrug-Related DeathsNarcoticsOpioid CrisisOpioid EpidemicOpioidsPrescriptions Drugs |
Author: Malatras, Jim Title: By the Numbers: Opioid Deaths Continue to Surge in New York State Summary: The opioid epidemic continues to ravage the nation. The sad fact is no matter the region of the country, there are people struggling with opioid addiction. Not only is every region touched, no group - rich or poor, rural or urban, black or white, men or women - is immune from the epidemic's devastating effects. But, as we will describe below, some groups are disproportionately affected. In April 2017, the Rockefeller Institute of Government released a report finding a 71 percent increase in drug deaths in New York State (NYS) from 2010-15. In later reports and using online interactive maps to track drug overdoses and deaths, we found that use of deadly drugs, like heroin and fentany, were rapidly growing. For example, using provisional New York State Department of Health data, we found a 54 percent increase in heroin deaths and a 50 percent increase in emergency room visits due to heroin overdoses, and a 45 percent increase in the use of life-saving overdose medication, like Naloxone, in one year alone (2014-15). Policymakers across the nation have grappled with how to address the epidemic. The solutions have varied from the president of the United States declaring the problem a national public health emergency to once unthinkable solutions in many communities, like safe injection sites. But given all the policies implemented and funding provided to battle the opioid epidemic, could the tide be turning? Recent reports suggest that some county officials are forecasting a decrease in the number of drug deaths in the coming months. It is too early to tell if that is a larger trend. Given this potential change, using the most recent Centers for Disease Control and Prevention data from 2016, we have updated our findings from April 2017 and found that opioid deaths continue to mount. In fact, from 2015 to 2016, New York saw the single greatest annual increase in drug-related deaths in six years. Details: Albany, NY: Rockefeller Institute of Government, 2018. 16p. Source: Internet Resource: accessed May 18, 2018 at: http://rockinst.org/wp-content/uploads/2018/03/2018-03-21-By-The-Numbers-Opioid-Deaths.pdf Year: 2018 Country: United States URL: http://rockinst.org/wp-content/uploads/2018/03/2018-03-21-By-The-Numbers-Opioid-Deaths.pdf Shelf Number: 150266 Keywords: Drug Abuse and AddictionDrug-Related DeathsOpioid Epidemic |
Author: Governing Institute Title: Confronting a Crisis: A Practical Guide for Policymakers to Mitigate the Opioid Epidemic Summary: Ninety-one Americans die every day from opioid overdoses. Victims come from all walks of life: a 19-year-old mother of two from Panama City, Fla., a 28-year-old Army sergeant from upstate New York, a 49-year-old juvenile court mediator from Arizona. For some, addiction started in their youth. For others, it began after an injury or surgery when a doctor prescribed opioids for pain. Opioids, a class of drugs that includes everything from prescription medications, like oxycodone, morphine, tramadol and fentanyl, to illegal drugs like heroin, have led to a public health crisis. The addictive nature of opioids and overprescribing are fueling the epidemic. In the last 15 years, the number of opioids prescribed and sold in the U.S. has quadrupled, even though the amount of pain Americans report is the same. Opioids were involved in more than 33,000 deaths in 2015, but the crisis continues to grow. Drug overdose deaths have significantly increased in Massachusetts, Florida, New York, North Carolina, West Virginia and more than a dozen other states. The opioid epidemic is a public health crisis that is tearing families apart and ruining lives. It also puts an incredible burden on government, including law enforcement agencies, justice departments and the foster care system, as children are orphaned or removed from parents and caretakers struggling with addiction. Though some states are taking significant steps to address the problem, they face continuing challenges in preventing future overdoses and addictions. Some experts contend there isn't nearly enough state or federal funding to combat the epidemic. Others say there are so many stakeholders involved that it's difficult to know where to begin to coordinate efforts. However, collaboration among state and local leaders, public health experts, health care providers, insurers and others is critical. There isn't one off-the-shelf solution to curb the epidemic, but policymakers are taking action to address the crisis and save lives. This handbook will detail those efforts and outline other steps policymakers can take to help mitigate the opioid crisis. Details: California: Governing Institute, 2017. 28p. Source: Internet Resource: Accessed November 1, 2018 at: file:///C:/Users/AuthUser/Downloads/GOV17_HANDBOOK_BCBS_V.PDF Year: 2017 Country: United States URL: http://www.governing.com/papers/Confronting-a-Crisis-A-Practical-Guide-for-Policymakers-to-Mitigate-the-Opioid-Epidemic-81958.html Shelf Number: 153137 Keywords: Drug-Related DeathsIllegal DrugsOpioid CrisisOpioid EpidemicPolicy RecommendationsPrescription MedicationPublic Health CrisisSubstance Abuse |
Author: Kilmer, Beau Title: Considering Heroin-Assisted Treatment and Supervised Drug Consumption Sites in the United States Summary: Current levels of opioid-related morbidity and mortality in the United States are staggering. Data for 2017 indicate that there were more than 47,000 opioid-involved overdose deaths, and one in eight adults now reports having had a family member or close friend die from opioids. Increasing the availability and reducing the costs of approved medications for those with an opioid use disorder (OUD) is imperative; however, jurisdictions addressing OUDs and overdose may wish to consider additional interventions. Two interventions that are implemented in some other countries but not in the United States are heroin-assisted treatment (HAT; sometimes referred to as supervised injectable heroin treatment) and supervised consumption sites (SCSs; sometimes referred to as overdose prevention sites). Given the severity of the opioid crisis, there is urgency to evaluate tools that might reduce its impact and save lives. In this mixed-methods report, the authors assess evidence on and arguments made about HAT and SCSs and examine some of the issues associated with implementing them in the United States. Key Findings -- Evidence from randomized controlled trials of HAT in Canada and Europe indicates that supervised injectable HAT - with optional oral methadone - can offer benefits over oral methadone alone for treating OUD among individuals who have tried traditional treatment modalities, including methadone, multiple times but are still injecting heroin. Although heroin cannot be prescribed in the United States because it is a Schedule I drug, it would be legal to conduct a human research trial on HAT. The literature on treating OUD with hydromorphone (e.g., Dilaudid) is less extensive than the literature on HAT; however, the existing results are encouraging. Hydromorphone trials in the United States would face fewer barriers than HAT trials. The scientific evidence about the effectiveness of SCSs is limited in quality and the number of locations evaluated. Many SCSs have been around for 15 to 30 years. Persistence does not imply effectiveness, but it seems unlikely that these SCSs - which were initially controversial in many places - would have such longevity if they had serious adverse consequences for their clients or communities. For drug consumption that is supervised, SCSs reduce the risk of a fatal overdose, disease transmission, and harms associated with unhygienic drug use practices; however, there is uncertainty about the size of the population-level effects of SCSs. There are significant legal issues surrounding the implementation of SCSs in the United States.. Both HAT and SCSs, as currently implemented, serve only a small share of people who use heroin. It is important to have a sense of potential scale limitations and costs when discussing HAT and SCSs. It might be constructive to view HAT and SCSs as exemplars of broader strategies, not as the only option within their class. Recommendations -- Given (1) the increased mortality associated with fentanyl, (2) the fact that some people who use heroin may not respond well to existing medications for OUD, (3) HAT's successful implementation abroad, and (4) questions concerning whether the success would carry over to the United States, HAT trials should be conducted in some of the U.S. jurisdictions that already provide a spectrum of social services and good accessibility to medication treatments for OUD. Conducting trials with HAT and hydromorphone are not mutually exclusive, and it may make sense to include both in the same study, as was done in Canada. Assessing the impact of injectable hydromorphone via clinical trials (with or without a HAT arm) would inform future regulatory decisions about using it as a medication treatment for OUD. Some researchers and advocates believe that, during an emergency like the present opioid crisis, the absence of a large downside risk for an intervention that has strong face validity (e.g., SCSs) may be sufficient for some decisionmakers to proceed, rather than waiting for further evidence. Nevertheless, if attempts to implement SCSs in the United States are successful, a strong research component should be incorporated into these efforts. Details: Santa Monica, CA: RAND, 2018. 93p. Source: Internet Resource: Accessed Dec. 6, 2018 at: https://www.rand.org/pubs/research_reports/RR2693.html?utm_source=WhatCountsEmail&utm_medium=Drug%20Policy%20Research%20Center%20(DPRC)+AEM:%20%20Email%20Address%20NOT%20LIKE%20DOTMIL&utm_campaign=AEM:363632650 Year: 2018 Country: United States URL: https://www.rand.org/pubs/research_reports/RR2693.html?utm_source=WhatCountsEmail&utm_medium=Drug%20Policy%20Research%20Center%20(DPRC)+AEM:%20%20Email%20Address%20NOT%20LIKE%20DOTMIL&utm_campaign=AEM:363632650 Shelf Number: 153920 Keywords: Drug Abuse and AddictionDrug Consumption FacilitiesDrug-Related DeathsFentanylOpioid EpidemicOpioidsPrescription Drug AbuseSubstance Abuse Treatment |
Author: McKendy, Laura Title: Overdose Incidents in Federal Custody, 2012/2013 - 2016/2017 Summary: The rise of drug overdose incidents, specifically those involving opioids, is a growing concern for Canadian society (British Columbia Coroners Service Death Review Panel, 2018; Special Advisory Committee on the Epidemic of Opioid Overdoses, 2018; Health Canada, 2017). While numerous reports have documented trends in the community, limited detailed data is available on trends in overdose incidents among custodial populations. This report furthers knowledge on this topic by examining all overdose incidents in federal custody over a five-year period (2012/2013 - 2016/2017), identifying the prevalence and nature of overdose incidents, the circumstances under which overdose incidents occur, the characteristics of offenders who experience overdose incidents, and patterns in the nature of staff and medical responses. Over the five-year period under examination, 330 incidents were identified for analysis. Most of these overdose incidents were unintentional and non-fatal. More specifically, over three-quarters of cases (77%) were identified as unintentional non-fatal overdose incidents, 15% were intentional non-fatal overdose incidents, and 7% were identified as fatal overdose incidents, either intentional or non-intentional. Overdose incidents have seen a notable increase in the Prairie region; in 2016/2017, 48% (42) of all overdose incidents occurred in this region, compared to 20% (8) in 2012/2013. In terms of the substances involved in overdose incidents, differences were observed across incident types. Opioids were most common in fatal overdoses and unintentional non-fatal overdose incidents, accounting for 91% and 57% of incidents respectively. Contrastingly, intentional nonfatal overdose incidents seldom involved opioids and most often involved prescription medications (e.g., anticonvulsants, antidepressants, cardiovascular medications), identified in 85% of cases. Over the five-year period examined, overdose incidents involving opioids increased in raw numbers (from 19 in 2012/2013 to 50 in 2016/2017), with a moderate increase as a percentage of all overdose incidents (from 48% to 57%). Notably, the percentage of those involving fentanyl increased from 3% (1) in 2012/2013, to 26% (23) in 2016/2017. At the same time, the percentage of overdose incidents involving heroin decreased from 25% (10) in 2012/2013, to 13% (11) in 2016/2017. When it came to fatal overdose incidents, fentanyl was the most common substance found, noted in 36% (8) of cases across the five-year period. While variation exists, certain characteristics were common among offenders who overdosed. They tended to be male (92%), Caucasian (58%) or Indigenous (36%), aged 25-34 (39%), classified as medium security (72%), serving relatively short (under 4 year) sentences (41%), with a major index offence of robbery (31%). Offenders typically had institutional histories riddled with security and discipline incidents, particularly incidents involving drugs, other contraband (excluding tobacco), and disobedience. Indigenous offenders were involved in 119 (36%) of overdose incidents over the five-year period examined. Indigenous representation was highest in the Pacific region (46%) and was higher The rise of drug overdose incidents, specifically those involving opioids, is a growing concern for Canadian society (British Columbia Coroners Service Death Review Panel, 2018; Special Advisory Committee on the Epidemic of Opioid Overdoses, 2018; Health Canada, 2017). While numerous reports have documented trends in the community, limited detailed data is available on trends in overdose incidents among custodial populations. This report furthers knowledge on this topic by examining all overdose incidents in federal custody over a five-year period (2012/2013 - 2016/2017), identifying the prevalence and nature of overdose incidents, the circumstances under which overdose incidents occur, the characteristics of offenders who experience overdose incidents, and patterns in the nature of staff and medical responses. Over the five-year period under examination, 330 incidents were identified for analysis. Most of these overdose incidents were unintentional and non-fatal. More specifically, over three-quarters of cases (77%) were identified as unintentional non-fatal overdose incidents, 15% were intentional non-fatal overdose incidents, and 7% were identified as fatal overdose incidents, either intentional or non-intentional. Overdose incidents have seen a notable increase in the Prairie region; in 2016/2017, 48% (42) of all overdose incidents occurred in this region, compared to 20% (8) in 2012/2013. In terms of the substances involved in overdose incidents, differences were observed across incident types. Opioids were most common in fatal overdoses and unintentional non-fatal overdose incidents, accounting for 91% and 57% of incidents respectively. Contrastingly, intentional nonfatal overdose incidents seldom involved opioids and most often involved prescription medications (e.g., anticonvulsants, antidepressants, cardiovascular medications), identified in 85% of cases. Over the five-year period examined, overdose incidents involving opioids increased in raw numbers (from 19 in 2012/2013 to 50 in 2016/2017), with a moderate increase as a percentage of all overdose incidents (from 48% to 57%). Notably, the percentage of those involving fentanyl increased from 3% (1) in 2012/2013, to 26% (23) in 2016/2017. At the same time, the percentage of overdose incidents involving heroin decreased from 25% (10) in 2012/2013, to 13% (11) in 2016/2017. When it came to fatal overdose incidents, fentanyl was the most common substance found, noted in 36% (8) of cases across the five-year period. While variation exists, certain characteristics were common among offenders who overdosed. They tended to be male (92%), Caucasian (58%) or Indigenous (36%), aged 25-34 (39%), classified as medium security (72%), serving relatively short (under 4 year) sentences (41%), with a major index offence of robbery (31%). Offenders typically had institutional histories riddled with security and discipline incidents, particularly incidents involving drugs, other contraband (excluding tobacco), and disobedience. Indigenous offenders were involved in 119 (36%) of overdose incidents over the five-year period examined. Indigenous representation was highest in the Pacific region (46%) and was higher The rise of drug overdose incidents, specifically those involving opioids, is a growing concern for Canadian society (British Columbia Coroners Service Death Review Panel, 2018; Special Advisory Committee on the Epidemic of Opioid Overdoses, 2018; Health Canada, 2017). While numerous reports have documented trends in the community, limited detailed data is available on trends in overdose incidents among custodial populations. This report furthers knowledge on this topic by examining all overdose incidents in federal custody over a five-year period (2012/2013 - 2016/2017), identifying the prevalence and nature of overdose incidents, the circumstances under which overdose incidents occur, the characteristics of offenders who experience overdose incidents, and patterns in the nature of staff and medical responses. Over the five-year period under examination, 330 incidents were identified for analysis. Most of these overdose incidents were unintentional and non-fatal. More specifically, over three-quarters of cases (77%) were identified as unintentional non-fatal overdose incidents, 15% were intentional non-fatal overdose incidents, and 7% were identified as fatal overdose incidents, either intentional or non-intentional. Overdose incidents have seen a notable increase in the Prairie region; in 2016/2017, 48% (42) of all overdose incidents occurred in this region, compared to 20% (8) in 2012/2013. In terms of the substances involved in overdose incidents, differences were observed across incident types. Opioids were most common in fatal overdoses and unintentional non-fatal overdose incidents, accounting for 91% and 57% of incidents respectively. Contrastingly, intentional nonfatal overdose incidents seldom involved opioids and most often involved prescription medications (e.g., anticonvulsants, antidepressants, cardiovascular medications), identified in 85% of cases. Over the five-year period examined, overdose incidents involving opioids increased in raw numbers (from 19 in 2012/2013 to 50 in 2016/2017), with a moderate increase as a percentage of all overdose incidents (from 48% to 57%). Notably, the percentage of those involving fentanyl increased from 3% (1) in 2012/2013, to 26% (23) in 2016/2017. At the same time, the percentage of overdose incidents involving heroin decreased from 25% (10) in 2012/2013, to 13% (11) in 2016/2017. When it came to fatal overdose incidents, fentanyl was the most common substance found, noted in 36% (8) of cases across the five-year period. While variation exists, certain characteristics were common among offenders who overdosed. They tended to be male (92%), Caucasian (58%) or Indigenous (36%), aged 25-34 (39%), classified as medium security (72%), serving relatively short (under 4 year) sentences (41%), with a major index offence of robbery (31%). Offenders typically had institutional histories riddled with security and discipline incidents, particularly incidents involving drugs, other contraband (excluding tobacco), and disobedience. Indigenous offenders were involved in 119 (36%) of overdose incidents over the five-year period examined. Indigenous representation was highest in the Pacific region (46%) and was higher The rise of drug overdose incidents, specifically those involving opioids, is a growing concern for Canadian society (British Columbia Coroners Service Death Review Panel, 2018; Special Advisory Committee on the Epidemic of Opioid Overdoses, 2018; Health Canada, 2017). While numerous reports have documented trends in the community, limited detailed data is available on trends in overdose incidents among custodial populations. This report furthers knowledge on this topic by examining all overdose incidents in federal custody over a five-year period (2012/2013 - 2016/2017), identifying the prevalence and nature of overdose incidents, the circumstances under which overdose incidents occur, the characteristics of offenders who experience overdose incidents, and patterns in the nature of staff and medical responses. Over the five-year period under examination, 330 incidents were identified for analysis. Most of these overdose incidents were unintentional and non-fatal. More specifically, over three-quarters of cases (77%) were identified as unintentional non-fatal overdose incidents, 15% were intentional non-fatal overdose incidents, and 7% were identified as fatal overdose incidents, either intentional or non-intentional. Overdose incidents have seen a notable increase in the Prairie region; in 2016/2017, 48% (42) of all overdose incidents occurred in this region, compared to 20% (8) in 2012/2013. In terms of the substances involved in overdose incidents, differences were observed across incident types. Opioids were most common in fatal overdoses and unintentional non-fatal overdose incidents, accounting for 91% and 57% of incidents respectively. Contrastingly, intentional nonfatal overdose incidents seldom involved opioids and most often involved prescription medications (e.g., anticonvulsants, antidepressants, cardiovascular medications), identified in 85% of cases. Over the five-year period examined, overdose incidents involving opioids increased in raw numbers (from 19 in 2012/2013 to 50 in 2016/2017), with a moderate increase as a percentage of all overdose incidents (from 48% to 57%). Notably, the percentage of those involving fentanyl increased from 3% (1) in 2012/2013, to 26% (23) in 2016/2017. At the same time, the percentage of overdose incidents involving heroin decreased from 25% (10) in 2012/2013, to 13% (11) in 2016/2017. When it came to fatal overdose incidents, fentanyl was the most common substance found, noted in 36% (8) of cases across the five-year period. While variation exists, certain characteristics were common among offenders who overdosed. They tended to be male (92%), Caucasian (58%) or Indigenous (36%), aged 25-34 (39%), classified as medium security (72%), serving relatively short (under 4 year) sentences (41%), with a major index offence of robbery (31%). Offenders typically had institutional histories riddled with security and discipline incidents, particularly incidents involving drugs, other contraband (excluding tobacco), and disobedience. Indigenous offenders were involved in 119 (36%) of overdose incidents over the five-year period examined. Indigenous representation was highest in the Pacific region (46%) and was higher among women (52%) relative to men (35%). Overdose incidents involving Indigenous offenders were somewhat less likely to involve opioids compared to incidents involving non-Indigenous offenders (45% versus 56%). Over the five-year period examined, 21 overdose incidents occurred involving women; all were non-fatal and most (71%) were unintentional. Overdose incidents involving women typically involved prescription medications (86%), while none involved opioids. Overdose incidents involving women were most common in the Ontario and Pacific regions; nine incidents (43% of all cases) occurred in both of these regions. All women involved in overdose incidents had an identified mental health disorder, while 95% (20) had histories of substance abuse. Overall, overdose incidents tended to occur when offenders were well into their sentence. At the time of incident, offenders had served, on average, 41% of their current sentence, or an average of 4.9 years. The average length of time between the most recent admission date and incident date was 3.2 years. However, variation was observed across incident type; those involved in fatal incidents had served more time (7.8 years) and had been out of the community longer (4.5 years) compared to those involved in non-fatal incidents. In terms of potential risk factors, offenders involved in overdose incidents often had histories of substance misuse and mental illness. More specifically, 95% of offenders had issues related to drugs, while 54% had issues with alcohol. In 81% of cases, substance misuse was identified as a factor linked to criminal offending. Mental illness was particularly common among those involved in intentional non-fatal overdose incidents; 92% had at least one mental health disorder identified, while 89% had histories of self-injurious/suicidal behaviour. A disproportionate number of incidents occurred at a single medium security men's institution in the Prairie region, Drumheller Institution. An institutional-level analysis suggests that the experience of Drumheller is more closely tied to the opioid crisis in the community; over threequarters (77%) of overdose incidents at Drumheller Institution involved opioids, compared to 47% at all other institutions. Fentanyl was identified in 34% of overdose incidents at Drumheller, compared to 8% at all other institutions. Overall, the number of overdose incidents at Drumheller increased from five incidents in 2012/2013, to 25 in 2016/2017. Despite a higher number of overdose incidents, Drumheller had a smaller percentage of deaths (i.e. 2%) and much higher usage of naloxone. The medication, which can temporarily reverse an opioid overdose, was used in 91% of cases at Drumheller, compared to 34% at all other institutions. The findings outlined in this report suggest that the community opioid crisis may be paralleled in custodial settings. As this crisis continues to affect the federal offender population, CSC remains committed to efforts to curb prison drug use and reduce the likelihood of overdose incidents. The widespread availability of naloxone in institutions, as well as CSC's take-home naloxone kit program, Opioid Substitution Treatment (OST) program, substance misuse programs, and the Prison Needle Exchange Program (PNEP), constitute efforts to reduce the potential harms associated with drug use and improve offender health outcomes. This report will further assist in CSC's goal of achieving safe custodial environments by contributing to knowledge on recent trends surrounding fatal and non-fatal drug overdose incidents in custody. Details: Ottawa: Correctional Service of Canada, 2018. 62p. Source: Internet Resource: No. SR-28-02: Accessed April 2, 2019 at: https://www.csc-scc.gc.ca/research/092/sr-18-02-en.pdf Year: 2019 Country: Canada URL: https://www.csc-scc.gc.ca/research/092/sr-18-02-en.pdf Shelf Number: 155268 Keywords: Drug Abuse and AddictionDrug OffendersDrug OverdoseDrug-Related DeathsIn-Custody DeathsOpioid EpidemicOpioidsPrison Deaths |