The study examines the risk of death among former inmates of Washington State prisons immediately after their release. The researchers conducted a retrospective cohort study of 30,237 inmates released from the Washington State Department of Corrections between July 1999 and December 2003. The overall mortality rate among these former inmates was 777 deaths per 100,000 person-years, significantly higher than the rate for other state residents (223 deaths per 100,000 person-years). The adjusted risk of death among former inmates was 3.5 times higher than that of other state residents. During the first 2 weeks after release, the risk of death was particularly high, at 12.7 times that of other state residents, with a marked elevation in deaths from drug overdose (129 times higher). The leading causes of death among former inmates were drug overdose, cardiovascular disease, homicide, and suicide. The study highlights the need for interventions to reduce the risk of death after release from prison, particularly during the critical first few weeks.The study examines the risk of death among former inmates of Washington State prisons immediately after their release. The researchers conducted a retrospective cohort study of 30,237 inmates released from the Washington State Department of Corrections between July 1999 and December 2003. The overall mortality rate among these former inmates was 777 deaths per 100,000 person-years, significantly higher than the rate for other state residents (223 deaths per 100,000 person-years). The adjusted risk of death among former inmates was 3.5 times higher than that of other state residents. During the first 2 weeks after release, the risk of death was particularly high, at 12.7 times that of other state residents, with a marked elevation in deaths from drug overdose (129 times higher). The leading causes of death among former inmates were drug overdose, cardiovascular disease, homicide, and suicide. The study highlights the need for interventions to reduce the risk of death after release from prison, particularly during the critical first few weeks.