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Browsing by master's degree program "Tilastotiede"

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  • Laine, Riku (2021)
    People with a drug use disorder have a high risk of death following release from criminal sanctions due to increased risk of overdose. Time in prison has been associated with increased mortality from natural causes of death and suicides. In this thesis, the association of criminal sanctions with the mortality and causes of death of Finnish treatment-seeking individuals with substance use disorder was studied. Prior research on the topic is scarce and old. The data was the Register-based follow-up study on criminality, health and taxation of inpatients and outpatients entered into substance abuse treatment (RIPE, n = 10 887). The patients had been clients of A-Clinic Foundation between 1990 and 2009. Mortality was the modelled with logistic regression from 1.1.1992 to 26.8.2015. The time was divided into one-week episodes. For each client it was marked whether they were free, in prison or serving a community service, and whether they had died during the episode. Causes of death were studied using death records from 1992 to 2018. There was a 2,5-fold increase in overall mortality during the first two weeks after sentences. The risk stayed elevated even after the first 12 weeks (odds ratio 1,20; 95% confidence interval 1,08-1,32). The risk of a drug-related death (DRD) was almost 8,5-fold during the first two weeks. Poisonings excl. alcohol poisoning and assaults were more likely causes of death for patients with criminal history. DRD was over three times more likely among patients with criminal records. After validations, 33 individuals who had died during their sentence were identified from the data, of whom 14 (42,4%) had committed suicide. Approximately 10 percent of other deaths were suicides. Thus, it can be concluded that Finland has similar increased risk of death after sentences as has been observed in other countries despite frequent use of buprenorphine. Sentences affect causes of death for 2-5 years after the last sentence. Additionally, first signs of elevated mortality during community sanctions was observed, but further studies are required to confirm the finding.