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Substance use and risk of death in young offenders: A prospective data linkage study

Authors

  • Stuart A. Kinner,

    Corresponding author
    1. Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
    2. Centre for Adolescent Health, Murdoch Childrens Research Institute, Melbourne, Australia
    3. School of Medicine, University of Queensland, Brisbane, Australia
    4. School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
    • Correspondence to Associate Professor Stuart A. Kinner, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Carlton Vic. 3010 Australia. Tel: +61 3 9035 7598; Fax: +61 3 9348 1174; E-mail: s.kinner@unimelb.edu.au

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  • Louisa Degenhardt,

    1. Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
    2. Centre for Adolescent Health, Murdoch Childrens Research Institute, Melbourne, Australia
    3. National Drug and Alcohol Research Centre, University of New South Wales Australia, Sydney, Australia
    4. Department of Global Health, School of Public Health, University of Washington, Seattle, USA
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  • Carolyn Coffey,

    1. Centre for Adolescent Health, Murdoch Childrens Research Institute, Melbourne, Australia
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  • Stephen Hearps,

    1. Centre for Adolescent Health, Murdoch Childrens Research Institute, Melbourne, Australia
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  • Matthew Spittal,

    1. Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
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  • Susan M. Sawyer,

    1. Centre for Adolescent Health, Murdoch Childrens Research Institute, Melbourne, Australia
    2. Department of Paediatrics, University of Melbourne, Melbourne, Australia
    3. Centre for Adolescent Health, Royal Children's Hospital Centre for Adolescent Health, Melbourne, Australia
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  • George C. Patton

    1. Centre for Adolescent Health, Murdoch Childrens Research Institute, Melbourne, Australia
    2. Department of Paediatrics, University of Melbourne, Melbourne, Australia
    3. Centre for Adolescent Health, Royal Children's Hospital Centre for Adolescent Health, Melbourne, Australia
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  • Stuart A. Kinner PhD, Principal Research Fellow, Louisa Degenhardt PhD, NHMRC Principal Research Fellow, Carolyn Coffey PhD, Senior Research Officer, Stephen Hearps PGDipPsyc, Data Coordinator, Matthew Spittal PhD, Senior Research Fellow, Susan M. Sawyer MD, Director, George C. Patton MD, Director of Research.

Abstract

Introduction and Aims

Young offenders are at increased risk of preventable death after release from custody, but risk factors for death in this population are poorly understood. Despite their poor health profiles, no studies have examined mortality outcomes in young people who have served community-based orders. The aims of this study were to describe the causes and identify risk factors for death in a cohort of young offenders in Victoria, Australia.

Design and Methods

We interviewed young people serving a custodial (n = 273) or community-based order (n = 242) in Victoria, Australia in 2002–2003. Measures included demographics and family history, offence history, experience of victimisation, mental illness, self-harm and substance use. Deaths up to 31 December 2011 were identified through a probabilistic linkage with the National Death Index.

Results

The all-cause crude mortality rate was 4.2 (95% confidence interval 2.7–6.8) per 1000 person years and was not significantly different for those who had served custodial and community-based orders. Most deaths were due to drug overdose, traffic accidents or suicide. Adjusting for age, sex and order type, risk factors for death from the baseline interview included weekly use of opioids, sleeping pills or painkillers, polydrug use and injecting drug use.

Discussion and Conclusions

Young people who have served community-based and custodial orders are at an increased risk of preventable death. Those engaging in risky substance use, particularly injecting drug use and use of multiple central nervous system depressants, are at greatest risk. There is an urgent need to develop and rigorously evaluate preventive interventions. [Kinner SA, Degenhardt L, Coffey C, Hearps S, Spittal M, Sawyer SM, Patton GC. Substance use and risk of death in young offenders: A prospective data linkage study. Drug Alcohol Rev 2015;34:46–50]

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