title: Characterization of drug overdoses in an Ohio incarcerated population.
abstract: BACKGROUND
  Literature exists about drug overdose following release of recently incarcerated individuals and mortality among prisoners in the United States, but little information exists about drug overdoses in the imprisoned population.
  
  
  OBJECTIVE
  This study aims to quantify and describe prisoner medication overdose requiring inpatient admission or assessment at a tertiary care facility and to assess the associated hospital charges.
  
  
  METHODS
  A single-center, retrospective cohort study was conducted on all Ohio Department of Rehabilitation and Correction inmates who presented to The Ohio State University Wexner Medical Center with drug overdose between 15 October 2011 and 14 October 2014. Demographic information, overdose substances, exposure reason, clinical effects, lengths of stay, outcomes, and hospital charges were collected.
  
  
  RESULTS
  Of the 130 patients included in the study, there were 100 intentional overdoses, 7 unintentional overdoses, 3 adverse drug reactions, and 20 unknown intentions. The most common drug in prisoner overdose was phenytoin (n = 29, 22%). While anticonvulsants were the most common drug class overall, anticonvulsants, antidepressants, and cardiovascular medications accounted for equal numbers of intensive care unit (ICU) admissions. Most patients exhibited multiple symptoms on arrival, most commonly neurologic, cardiovascular, and gastrointestinal symptoms. Patients were seen from 21 of the 28 Ohio Department of Rehabilitation and Correction facilities, of which five facilities, that largely house minimum and medium security prisoners, accounted for 61% of patients sent to our institution. The total sum of charges was $2,606,942 with 55% of charges from ICU stays.
  
  
  CONCLUSIONS
  Our study shows that drug overdoses within our incarcerated population were largely intentional overdoses of anticonvulsants, cardiovascular drugs, and antidepressants. Opportunities exist to target intentional drug overdoses that accounted for 80% of prisoner overdoses for potential cost-savings.
authors.affiliation: a Department of Pharmacy , Massachusetts General Hospital , Boston , MA , USA ;
authors.forename: Lanting
authors.initials: L
authors.lastname: Fuh
authors.affiliation: b Central Ohio Poison Center , Columbus , OH , USA ;|c Nationwide Children's Hospital , Columbus , OH , USA ;|d College of Medicine, The Ohio State University , Columbus , OH , USA ;
authors.forename: Hannah
authors.initials: H
authors.lastname: Hays
authors.affiliation: e Department of Biomedical Informatics , The Ohio State University , Columbus , OH , USA ;
authors.forename: Nicole
authors.initials: N
authors.lastname: Brown
authors.affiliation: f Department of Pharmacy , Wexner Medical Center, The Ohio State University , Columbus , OH , USA ;|g College of Pharmacy, The Ohio State University , Columbus , OH , USA.
authors.forename: Mary Beth
authors.initials: MB
authors.lastname: Shirk
mesh_terms: D000328:Adult; D000368:Aged; D000927:Anticonvulsants / Q000506:poisoning; D015331:Cohort Studies; D003422:Critical Care; D062787:Drug Overdose / Q000191:economics / Q000453:epidemiology*; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009820:Ohio / Q000453:epidemiology; D010672:Phenytoin / Q000506:poisoning; D011329:Prisoners / Q000706:statistics & numerical data*; D011330:Prisons; D012189:Retrospective Studies; D013406:Suicide, Attempted / Q000706:statistics & numerical data; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D010672:Phenytoin
keywords: Inmates; medication; overdose; prison; prisoner