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Twice a year, Oslo University Hospital awards a prize to just six outstanding research articles with key authors from the hospital. In December, the PriSUD project had the pleasure of receiving this award for the article "The association of prison security level with mortality after release from prison: a retrospective national cohort study (2000–16)"where we find high mortality after release among those who have been incarcerated in a high security prison. The article was written by Anne Bukten, Ingeborg Skjærvø and Marianne R. Stavseth. The prize was NOK 50 000, intended to fund further research.

Bukten, Anne; Skjærvø, Ingeborg; Stavseth, Marianne Riksheim. The association of prison security level with mortality after release from prison: a retrospective national cohort study (2000–16). The Lancet Public Health, Volume 7, Issue 7, 2022, Pages e583-e592, ISSN 2468-2667, https://doi.org/10.1016/S2468-2667(22)00107-4. Background Incarceration might contribute to increased mortality in an already marginalised population. A better understanding of the prison-related factors that are associated with mortality is important for preventing the negative health consequences of incarceration. We aimed to investigate all-cause and cause-specific mortality following release from high-security and low-security prisons. Methods In this retrospective national cohort study, we used data from the Norwegian Prison Release study (nPRIS), which includes complete national register data for 96 859 individuals from the Norwegian Prison Register linked to the Norwegian Cause of Death Register from Jan 1, 2000, to Dec 31, 2016. The study cohort included all people in Norway released from a high-security or low-security prison unit. Cause of death was categorised into internal causes (infectious, cancerous, endocrine, circulatory, respiratory, digestive, nervous system diseases, and mental health disorders) and external causes (accidents, suicides, and homicides) according to the 10th revision of the International Classification of Diseases. We calculated crude mortality rates (CMR) and estimated Cox proportional-hazards models. Findings There were 151 790 releases in the study period (68·4% from low-security and 31·6% from high-security prisons) from 91 963 individuals. The overall CMR was 854·4 [95% CI 834·7–874·2] per 100 000 person-years (436·2 [422·1–450·3] per 100 000 person-years for internal causes and 358·3 [345·5–371·1] per 100 000 person-years for external causes). The overall post-release mortality rate was higher in those released from high-security prisons (1142·5 [95% CI 1102·6–1182·5] per 100 000 person-years) than in those released from low-security prisons (714·6 [692·6–736·6] per 100 000 person-years). Our results suggest an association between release from high-security prisons and elevated mortality due to both external causes (adjusted hazard ratio [aHR] 1·75 [95% CI 1·60–1·91]) and internal causes (1·45 [1·33–1·59]), compared to release from low-security prisons. Interpretation Imprisonment and the post-release period can be an important point for public health interventions. Particular attention to health is warranted for individuals incarcerated in and released from high-security prisons. The potential impact of both individual-level characteristics of people incarcerated in high-security facilities, and of the prison environment itself, on mortality outcomes, should be investigated further.

The PriSUD project is a large research project that aims to improve health among inmates with substance use disorders. But how do you do that, and why is it so important? In order to explain this complex project in a simple way, we got the Danish research dissemination company madeclear to create a so-called 'explainer'; a film that shows what the PriSUD project is all about. Watch it here! made by madeclear.dk

Scientific articles Tverborgvik, Torill., Stavseth, Marianne Riksheim & Bukten, Anne. The association between drug use and mortality in a norwegian prison cohort: a prospective cohort study . Health Justice 11, 22 (2023). https://doi.org/10.1186/s40352-023-00223-y ​ Lokdam, Nicoline; Stavseth, Marianne Riksheim & Bukten, Anne. "Drug use and re-imprisonment: A prospective study of the Norwegian Offender Mental Health and Addiction (NorMA) cohort". Drug and Alcohol Dependence Reports (2022) . doi: 10.1016/j.dadr.2022.100127 . ​ Bukten, Anne; Skjærvø, Ingeborg; Stavseth, Marianne Riksheim. "The association of prison security level with mortality after release from prison: a retrospective national cohort study (2000–16)". The Lancet Public Health, Volume 7, Issue 7 (2022) , Pages e583-e592, doi: 10.1016/S2468-2667(22)00107-4 . ​ Hilde Pape, Philipp Lobmaier, Anne Bukten. "An evaluation of eight short versions of the Drug Use Disorder Identification Test (DUDIT). A prison population study". Drug and Alcohol Dependence Reports, Volume 3 (2022) .doi: 10.1016/j.dadr.2022.100043 . ​ Bukten A, Lokdam NT, Skjærvø I, Ugelvik T, Skurtveit S, Gabhelík R, Skardhamar T, Lund IO, Havnes IA, Rognli EB, Chang Z, Fazel S, Friestad C, Hesse M, Lothe J, Ploeg G, Dirkzwager AJE , Clausen T, Tjagvad C, Stavseth MR "PriSUD-Nordic—Diagnosing and Treating Substance Use Disorders in the Prison Population: Protocol for a Mixed Methods Study". JMIR Res Protoc, 11(3):e35182 (2022). doi: 10.2196/35182 ​ Pape, Hilde, Rossow, Ingeborg, and Bukten, Anne. "Are Short Audit Screeners Effective in Identifying Unhealthy Drinking of Varying Severity? A Prison Population Study." Drug and Alcohol Dependence 229 (2021) .https://doi.org/https://doi.org/10.1016/j.drugalcdep.2021.109153 . Toresen Lokdam, Nicoline, Riksheim Stavseth, Marianne, and Bukten, Anne. "Exploring the External Validity of Survey Data with Triangulation: A Case Study from the Norwegian Offender Mental Health and Addiction (Norma) Study." Research Methods in Medicine & Health Sciences 2, no. 4 (2021) : 140-47.https://doi.org/10.1177/26320843211061298 . ​ Lindstad, Marianne, Skurtveit, Svetlana, and Bukten, Anne. "Too Much or Too Little Medicines? A National Study of Prescribed Psychotropic Drugs Among Inmates in Norwegian Prisons." Norwegian Epidemiology 29, no. 1-2 (2021) .https://doi.org/10.5324/nje.v29i1-2.4049 . ​ Pape, Hilde, Rossow, Ingeborg, and Bukten, Anne. "Alcohol Problems among Prisoners: Subgroup Variations, Concurrent Drug Problems, and Treatment Needs." European Addiction Research 27, no. 3 (2021) : 179-88.https://doi.org/10.1159/000511253 . ​ Bukten, Anne, and Stavseth, Marianne Riksheim. "Suicide in Prison and after Release: A 17-Year National Cohort Study." European Journal of Epidemiology 36, no. 10 (2021) : 1075-83.https://doi.org/10.1007/s10654-021-00782-0 . ​ Havnes, Ingrid Amalia, Bukten, Anne, Rognli, Eline Borger, and Muller, Ashley Elizabeth. "Use of Anabolic-Androgenic Steroids and Other Substances Prior to and During Imprisonment - Results from the Norwegian Offender Mental Health and Addiction (Norma) Study." Drug and Alcohol Dependence 217 (2020) : 108255.https://doi.org/https://doi.org/10.1016/j.drugalcdep.2020.108255 . ​ Bukten, Anne, Lund, Ingunn Olea, Kinner, Stuart A., Rognli, Eline Borger, Havnes, Ingrid Amalia, Muller, Ashley Elizabeth, and Stavseth, Marianne Riksheim. "Factors Associated with Drug Use in Prison – Results from the Norwegian Offender Mental Health and Addiction (Norma) Study." Health & Justice 8, no. 1 (2020) : 10.https://doi.org/10.1186/s40352-020-00112-8 . ​ Borschmann, Rohan, Tibble, Holly, Spittal, Matthew J., Preen, David, Pirkis, Jane, Larney, Sarah, Rosen, David L., et al. "The Mortality after Release from Incarceration Consortium (Maric): Protocol for a Multi-National, Individual Participant Data Meta-Analysis." International Journal of Population Data Science 5, no. 1(2020) .https://doi.org/10.23889/ijpds.v5i1.1145 . ​ Muller, Ashley Elizabeth, and Bukten, Anne. "Measuring the Quality of Life of Incarcerated Individuals." International Journal of Prisoner Health 15, no. 1 (2019) : 1-13.https://doi.org/10.1108/IJPH-02-2018-0005 . ​ Muller, Ashley Elizabeth, Havnes, Ingrid Amalia, Rognli, Eline Borger, and Bukten, Anne. "Inmates with Harmful Substance Use Increase Both Exercise and Nicotine Use during Incarceration." International Journal of Environmental Research and Public Health 15, no. 12 (2018) : 2663.https://doi.org/10.3390/ijerph15122663 . ​ Rognli, Eline Borger, Bramness, Jørgen G, Skurtveit, Svetlana, and Bukten, Anne. "Substance Use and Sociodemographic Background as Risk Factors for Lifetime Psychotic Experiences in a Non-Clinical Sample." Journal of Substance Abuse Treatment 74 (2017) : 42-47.https://doi.org/10.1016/j.jsat.2016.12.007 . ​ Bukten, Anne, Stavseth, Marianne Riksheim, Skurtveit, Svetlana, Tverdal, Aage, Strang, John, and Clausen, Thomas. "High Risk of Overdose Death Following Release from Prison: Variations in Mortality During a 15‐Year Observation Period." Addiction (2017) .https://doi.org/10.1111/add.13803 . ​ Bukten, Anne, Lund, Ingunn Olea, Rognli, Eline Borger, Stavseth, Marianne Riksheim, Lobmaier, Philipp, Skurtveit, Svetlana, Clausen, Thomas, and Kunøe, Nikolaj. "The Norwegian Offender Mental Health and Addiction Study–Design and Implementation of a National Survey and Prospective Cohort Study." Substance abuse: research and treatment 9, no. Supplement 2 (2015) : 59.https://doi.org/10.4137/SaRt.S23546 . Publications Here you can find all our scientific articles in peer-reviewed journals, as well as reports . Vitenskapeelige artikler Reports Bukten, A; Lokdam, NT; Clausen, T; Skærvø I. Use, possession and driving under the influence of drugs among inmates in Norwegian prisons 2000-2019 [Norwegian] SERAF report, 3/2021 (pdf) ​ Lindstad, M; Bukten, A & Clausen, T. Prisoners and patients in drug treatment with connections to Oslo [Norwegian] SERAF report 4/2019 (pdf) ​ Bukten, A; Stavseth, MR; Skurtveit, S, Lund, IO; Clausen, T. Intoxication and Health situation among inmates in the penal care [Norwegian] SERAF report, 2/2016 (pdf) Rapporter

Illness and mortality People who have been in prison are a marginalized group who have a high incidence of morbidity and an increased risk of premature death. The group has a particularly increased risk of dying from external causes such as accidents, overdoses and suicide, but research also finds an increased risk of dying from somatic diseases such as various forms of cancer and heart and lung diseases. Knowledge of these risks is important in order to offer good and correct treatment and to prevent premature death. In the PriSUD project, we look at inmates' morbidity using patient registers, and we investigate the prevalence of various somatic diseases among inmates in Norwegian, Danish and Swedish prisons in the period 2010 to 2020. Mortality is also examined in all three countries, with special focus on deaths related to intoxication and addiction. ​ Publications on the topic Tverborgvik, Torill., Stavseth, Marianne Riksheim & Bukten, Anne. The association between drug use and mortality in a norwegian prison cohort: a prospective cohort study . Health Justice 11, 22 (2023). https://doi.org/10.1186/s40352-023-00223-y ​ Bukten, Anne; Skjærvø, Ingeborg; Stavseth, Marianne Riksheim. "The association of prison security level with mortality after release from prison: a retrospective national cohort study (2000–16)". The Lancet Public Health, Volume 7, Issue 7 (2022), Pages e583-e592, doi: 10.1016/S2468-2667(22)00107-4 . ​ Bukten, Anne, and Stavseth, Marianne Riksheim. "Suicide in Prison and after Release: A 17-Year National Cohort Study." European Journal of Epidemiology 36, no. 10 (2021): 1075-83.https://doi.org/10.1007/s10654-021-00782-0 . ​ Borschmann, Rohan, Tibble, Holly, Spittal, Matthew J., Preen, David, Pirkis, Jane, Larney, Sarah, Rosen, David L., et al. "The Mortality after Release from Incarceration Consortium (Maric): Protocol for a Multi-National, Individual Participant Data Meta-Analysis." International Journal of Population Data Science 5, no. 1 (2020).https://doi.org/10.23889/ijpds.v5i1.1145 . ​ Bukten, Anne, Stavseth, Marianne Riksheim, Skurtveit, Svetlana, Tverdal, Aage, Strang, John, and Clausen, Thomas. "High Risk of Overdose Death Following Release from Prison: Variations in Mortality During a 15‐Year Observation Period." Addiction (2017).https://doi.org/10.1111/add.13803 . ​ Bukten, A; Stavseth, MR; Skurtveit, S, Lund, IO; Clausen, T. Drug and health situation among inmates in correctional facilities. SERAF report, 2/2016 (pdf)

PriSUD has been established at the Norwegian Center for Addiction Research (SERAF) at the University of Oslo. The main goal of PriSUD is to improve mental and physical health, as well as quality of life for people with substance abuse problems in prison. PriSUD researches: Alcohol, drugs and treatment Mental Health Illness and mortality Young people and the elderly Women in prison Health and lifestyle News from the project PriSUD article received an award for outstanding research! The association of prison security level with mortality after release from prison A movie about the project Post.doc scholarship to evaluate drug treatment in Sweden What is PriSUD? Prison inmates are a marginalized group with an accumulation of social vulnerability related to mental health and substance abuse. As a result, overdose death, suicide and relapse to drug use are very high. At PriSUD, we map, evaluate and examine outcomes related to the treatment of drug and mental disorders in prison. Over time, the project has increased in scope to include studies related to both the Norwegian and the Nordic prison population. For more detailed information about the project, read here . ​ PriSUD began in 2019 and is led by Anne Bukten . In addition, the project has several full-time and part-time team members: postdoctoral fellow Marianne Riksheim Stavseth , postdoctoral fellow Ingeborg Skjærvø , postdoctoral fellow Torill Tverborgvik , PhD candidate Nicoline Lokdam , PhD candidate Rose Elizabeth Boyle , PhD candidate Vegard Svendsen , as well as Katja Nilsen who represents WayBack . The project also has an interdisciplinary approachresearch group . ​ PriSUD has been developed and is led by the Norwegian Centre for Addiction Research (SERAF ) at the University of Oslo (UiO). PriSUD is financed by South-Eastern Norway Regional Health Authority (HSØ ), the Research Council of Norway ( NFR ) and The Ministry of Justice and Public Security.