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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)

Ingeborg Skjærvø Ingeborg Skjærvø is employed as a postdoctoral fellow on the PriSUD project, and has been involved since December 2020. ​ Ingeborg has a background in psychology, with a bachelor's degree (London Metropolitan University) and a master's degree (UiO) with a focus on cognitive psychology and the biological aspects of behavior. This interest led to the topics for both bachelor's and master's theses being triggers for alcohol and nicotine use. ​ Ingeborg completed her doctorate as part of the NorComt project at SERAF in 2018. NorCOMT is a follow-up study of patients starting LAR or obstetric treatment. The theme of her dissertation was the extent to which the patients themselves committed crime in the time before and after treatment, and the extent to which they themselves were exposed to criminal acts during the same periods. ​ In addition to intoxication and health in prison, Ingeborg has an interest in PTSD and chronic pain among patients in treatment for drug addiction, and parent-led trauma treatment for children. Email: ingeborg.skjarvo@nkvts.no

Evaluation of overdose prevention measures in prison care As part of the national overdose strategy (2014-2017) under the auspices of the Norwegian Directorate of Health, the Prison and Probation Service is implementing a project to reduce the risk of overdose after release from prison. The purpose of the project is to increase knowledge and improve the practice of reentry, so that overdose deaths can be prevented. The Norwegian Prison and Probation Service's college and education center KRUS conducts training based on the prison departments learning networks. Will the measures save lives? In order to be able to answer whether the measures will save lives, SERAF and KRUS established a collaborative project in January 2019. To evaluate the measures, we have designed an electronic questionnaire that the participant can answer themselves. The study will eventually use data from two different sources: data from questionnaires and national register data. Participants who agree to participate in the study, and who provide their social security number, will be followed up prospectively with data obtained from national registers with measures of mortality and treatment status. In addition to providing updated information about the measures, the survey will provide important information about post-release life for this vulnerable group. The project includes Nalokson nasal spray for inmates, and the prisons thus work closely with SERAF and the Naloxone project . Naloxone is an opioid antidote and can reverse an opioid overdose potentially saving lives.

Levekår, rus og psykisk helse blant domfelte Takk for din interesse for denne spørreskjemaundersøkelsen! ​ ​ ​ ​ ​ ​ ​ På oppdrag fra Justis- og beredskapsdepartementet og i samarbeid med WayBack har vi utarbeidet en undersøkelse for å kartlegge domfeltes egen vurdering av behov for, og tilbud om oppfølging, behandling og aktivitet under og etter straffegjennomføring. ​ Alle som har sonet i fengsel, friomsorg, hjemmesoning eller annet er velkomne til å svare. Trykk her for å komme til spørreskjemaet. Det tar ca.15 minutter å svare på spørreskjemaet. Deltagelsen er helt anonym og selvfølgelig frivillig. Det er viktig at du kun svarer en gang. Del gjerne med ditt nettverk – jo flere svar vi får inn, jo bedre kan vi beskrive situasjonen for straffedømte i Norge. Undersøkelsen er en del av prosjektet «Levekår, rus og psykisk helse blant domfelte» som PriSUD-gruppen ved Seraf (UiO) gjennomfører på oppdrag fra Justis- og beredskapsdepartementet. Les mer om prosjektet her . Resultatene fra prosjektet vil presenteres for departementet i en rapport som skal lanseres sommeren 2024. Undesøkelsen gjennomføres i samarbeid med WayBack-kontorene i Oslo, Bergen, Kristiansand og Tromsø. ​ ​Tusen takk for ditt bidrag - din stemme er viktig! Ansvarlig for spørreskjemaundersøkelsen er forsker Torill Tverborgvik . Ta gjerne kontakt hvis det er noe du lurer på!

NorMA: Alcohol research Psychologist and senior researcher, Hilde Pape (KRUS & FHI) has worked with issues related to alcohol use and alcohol problems among inmates using NorMA data. ​ Hilde Pape has for many years researched drug use among young people. She has otherwise been concerned with related topics such as alcohol policy, drug prevention, alcohol and drug problems among prisoners and alcohol-related crime, as well as partner violence. In recent years, she has collaborated with us on the PriSUD project, which has had a major impact on the knowledge base related to alcohol use among prisoners. Read more about the research results below: ​ Article focusing on alcohol problems among inmates: Differences between subgroups, concomitant drug problems and treatment needs ​ The article focuses on the following questions: How widespread are alcohol problems among those imprisoned in Norway? Are the problems often combined with drug problems, and what proportion of the inmates have a drug-related treatment need? ​ ​ The NorMA study includes inmates in almost all Norwegian prisons. The study included the Alcohol Use Disorder Identification Test (AUDIT). ​ ​ - The responses of the inmates showed that just over half (55%) had alcohol problems of a certain severity when they were imprisoned, says KRUS researcher Hilde Pape. ​ ​ The results also showed that barely one in five (18%) were probably addicted to alcohol, in need of specialized drug treatment. The incidence was about the same among women and men. In younger age groups, and among former convicts and those who were convicted of violent crimes or driving under the influence of drugs, the proportion with alcohol problems was significantly increased. ​ ​ A solid majority (68%) of inmates with alcohol problems also had drug problems. The more serious the alcohol problems, the higher the proportion with drug problems. Prisoners with addictions related to both alcohol and drugs had particularly serious alcohol problems. Of all the inmates in the study, three out of four (75%) had alcohol and / or drug problems, while almost half (45%) were probably drug addicts. ​ ​ - There is obviously a great unmet need for treatment, says Pape. The substance abuse units in Norwegian prisons only have the capacity to receive three to four percent of the prison population. ​ ​ - It is also a paradox that alcohol problems among the inmates have received so little attention, both in the professional and research literature and in the penal care system. ​ ​ ​ ​ Hilde Pape (KRUS / FHI), Ingeborg Rossow (FHI) and Anne Bukten contributed to this article, which was recently published in the journal European Addiction Research. Read the article here. ​ ​

NorMA: Anabolic steroids Ingrid Amalie Havnes researches the use of anabolic steroids and has, among other things, used data from the NorMA study to look at the use of anabolic steroids in the prison population. ​ Background: The use of anabolic steroids is often related to various health problems and use of other drugs. Drug use is more frequent among the prison population compared to the rest of the population. Therefore, it was relevant to look at how many people in prisons have used anabolic steroids and what characterizes those who have used anabolic steroids. Findings: The study found, among other things, that over 30% of men and 6% of women had used anabolic steroids at least once in their lives. Few, however, had used steroids immediately before imprisonment. For most, its use ceased during imprisonment. ​ Read the whole publication: "Use of anabolic-androgenic steroids and other substances prior to and during imprisonment - Results from the Norwegian Offender Mental Health and Addiction (NorMA) study" ​

Research topics In the PriSUD project, we work with a number of different topics related to drug use, treatment, physical and mental disorders among prisoners. We are fortunate to have many partners who contribute with a number of exciting research questions. Read more about the different research topics below. Substance use disorders Mental health disorders Mortality and morbidity Young people and the elderly Women in prison Isolation and prison conditions

Katya Stavelie Khouri Selvkontroll blant innsatte i fengsel. Katya skriver hovedoppgave basert på NorMA-kohorten, og går siste året på profesjonsstudiet i psykologi ved Universitet i Oslo. Hun har tidligere hatt fag innen fengselspsykiatri og helse fra Glasgow Caledonian University. Der ble Katya interessert i psykisk helse og soninigsvilkår blant fengselsinnsatte, som bidro til at hun søkte hovedpraksis til et norsk fengsel. Der jobbet Katya som terapeut i et halvt år, som videre økte interessen for feltet. Katya er spesielt interessert i minoriteters opplevelse av opphold i fengsel og hvilke helsemessige behov som dukker opp i møte med ulike mennesker både i og utenfor fengsel. Videre interesserer Katya seg for hva som kan drive mennesker til å begå kriminelle handlinger. Dette er noe av fokuset for hovedoppgaven hennes, som utforsker selvkontroll og rusbruk i forbindelse med kriminalitet blant innsatte i norske fengsler.

Suvi Virtanen Suvi Virtanen is a postdoctoral researcher with the PriSUD project, and she works at the Department of Medical Epidemiology and Biostatistics at the Karolinska Institutet in Sweden. Suvi is a licensed clinical psychologist. She obtained her PhD in Psychology from the University of Helsinki in 2021. In her doctoral dissertation, she investigated the comorbidity of substance misuse with anxiety and depressive disorders using Swedish register data and longitudinal twin cohort data. Her current research interests include causes and consequences of externalizing psychopathology across the lifespan; psychopathology characterized by compulsivity (such as addictions and OCD), and applied research (pharmacoepidemiological studies, effectiveness studies, etc.). Email: suvi.maria.virtanen@ki.se

Torill Tverborgvik Torill started as a postdoctoral researcher in the PriSUD project in the summer of 2021. In addition to collaborating with the Nordic research groups in PriSUD-Nordic , Torill works on studies focusing on older individuals in prison and groups with various mental health diagnoses . Torill is responsible for a new research and development project on corrections and welfare services in Norway, commissioned by the Ministry of Justice and Public Security. ​ Torill obtained her Ph.D. in epidemiology from the Department of Public Health Sciences at the University of Copenhagen. Her study was a register-based investigation that explored intergenerational transmission of educational attainment and labor market attachment in the Danish population born between 1930 and 2002. She also has experience in research on overdose mortality, sickness absence, substance abuse, and forensic toxicology. ​ Furthermore, Torill has several years of experience as a facilitator and mentor in rehabilitation companies, providing support and assistance to individuals seeking help through the Norwegian Labour and Welfare Administration (NAV) to enter or reintegrate into the job market. She has worked extensively with mental health and life skills, gaining significant experience in motivational interviewing (MI) and holding certifications in Supported Employment (SE) and Career Tools. ​ ​ Publications: 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). 10.1186/s40352-023-00223-y Email: torill.tverborgvik@medisin.uio.no

Isolation and prison conditions Th is text is under review This text is under review

WOMPRIS There is a significant need for more knowledge about women in prison . WOMPRIS is a collaborative project between PRISONHEALTH and PriSUD, with the aim of shedding light on challenges and issues that are particularly relevant to female inmates and women who have previously been incarcerated in Norway. ​ The project's data foundation consists of linkages between the nPRIS cohort and various other national registers (such as the patient register, cause of death register, and living conditions data from Statistics Norway). You can read more about the background of the project here. ​ So far, one article has been published in the project, which deals with the prevalence of mental health diagnoses in prison . The next article will focus on mortality among women after release from prison. Like all other articles in the project, it will also be disseminated via the PriSUD website as soon as it has undergone peer review and been published.