title: Psychostimulant-related deaths among former inmates.
abstract: OBJECTIVE
  Psychostimulants are highly addictive and their use is increasing. Little is known about psychostimulant-related deaths. This study identified characteristics, risk factors, and contributing substances reported upon death among former prison inmates who died from a psychostimulant-related death.
  
  
  METHODS
  This retrospective cohort study of released inmates from 1999 to 2003 (N = 30,237) linked data from the Washington State Department of Corrections with the National Death Index. We examined characteristics of individuals who died with psychostimulants listed among their causes of death. These were categorized into 3 groups: (1) noncocaine psychostimulants, (2) cocaine only, and (3) all psychostimulants. Cox proportional hazards regression determined risk factors for death in each group, and the risk of death in the first 2 weeks after release from prison
  
  
  RESULTS
  Of the 443 inmates who died, 25 (6%) had noncocaine psychostimulants listed among their causes of death. Six of these 25 deaths had both noncocaine psychostimulants and cocaine listed among their causes-of-death. Most of the former inmates who died with noncocaine psychostimulants were male (n = 21, 84%) and non-Hispanic white (88%, n = 22). Cocaine only was listed among the causes-of-death for 49 former inmates; most were male (n = 35, 71%) and non-Hispanic white (n = 27, 55%). Longer length of incarceration was associated with a reduced risk of death from any psychostimulant use (hazard ratio = 0.76, confidence interval = 0.63-0.920 for each additional year of incarceration) and from use of noncocaine psychostimulants (hazard ratio = 0.42, 95% CI = 0.22-0.80). Risk of death was highest during the first 2 weeks postrelease for cocaine only-related deaths (incidence mortality ratio = 1224.0, confidence interval = 583-1865).
  
  
  CONCLUSIONS
  Former prisoners have a significant risk of death from psychostimulants, especially within the first 2 weeks postrelease.
authors: Division of General Internal Medicine, University of Colorado School of Medicine, Denver, CO 80045, USA. Susan.Calcaterra@ucdenver.edu
authors: Susan
authors: S
authors: Calcaterra
authors: Patrick
authors: P
authors: Blatchford
authors: Peter D
authors: PD
authors: Friedmann
authors: Ingrid A
authors: IA
authors: Binswanger
mesh_terms: D000328:Adult; D002423:Cause of Death; D000697:Central Nervous System Stimulants / Q000506:poisoning*; D003042:Cocaine / Q000506:poisoning*; D015331:Cohort Studies; D004347:Drug Interactions; D005260:Female; D006801:Humans; D008297:Male; D011329:Prisoners; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000401:mortality*; D016019:Survival Analysis; D014861:Washington
chemical_list: D000697:Central Nervous System Stimulants; D003042:Cocaine