THE GOAL OF THE NORTH CAROLINA SURVEY OF INMATE DEATHS WAS TO IDENTIFY SPECIFIC PROBLEMS, VICTIM CHARACTERISTICS, AND THE CIRCUMSTANCES OF THE DEATHS, WITH THE AIM OF DEVISING WAYS TO REDUCE THE NUMBER OF INMATE DEATHS. DURING THE STUDY PERIOD, THE 110 COUNTY AND MUNICIPAL JAILS HAD AN AVERAGE DAILY CENSUS OF ABOUT 28,000 INMATES ; THE 80 STATE PRISON UNITS HAD AN AVERAGE DAILY POPULATION OF ABOUT 12,000. BY STATUTE AND CUSTOM, ALL DEATHS WHILE IN POLICE CUSTODY REQUIRE AUTOPSIES. DATA FOR THE STUDY WERE DERIVED FROM THE MEDICAL EXAMINER, AUTOPSY AND TOXICOLOGY REPORTS, AND INFORMATION FROM JAIL AND PRISON AUTHORITIES. OF THE 223 INMATES DEATHS THAT OCCURED BETWEEN 1972 AND 1976, NEARLY ONE-HALF (102) WERE FROM NATURAL DISEASE PROCESSES; 170 SUICIDES WERE A THIRD OF THE TOTAL; ACCIDENTS AND HOMICIDES COMPRISED A TENTH EACH, WITH NEARLY HALF OF THE LATTER RESULTING FROM A SINGLE ACT OF ARSON; AND IN 4 INSTANCES, LESS THAN 2 PERCENT, THE MANNER OF DEATH REMAINED OBSCURE, ALTHOUGH THE CAUSES WERE EVIDENT. IN THE CATEGORY OF NATURAL DEATHS, ALCOHOL WITHDRAWAL SYNDROME ACCOUNTED FOR 30 DEATHS IN TYPICALLY MIDDLE-AGED ALCOHOLICS; MOST OCCURRED WITHIN THE FIRST 3 DAYS OF INCARCERATION. OF THE 70 SUICIDES, 54 WERE WHITE MALES UNDER THE AGE OF 40, WITH MOST OCCURRING WITHIN THE FIRST DAY OF INCARCERATION. THE MAJORITY OF THE SUICIDE VICTIMS HAD BEEN ARRESTED ON ALCOHOL-RELATED CHARGES. OF THE 70 SUICIDE VICTIMS 65 HANGED THEMSELVES, WITH 27 OF THESE USING A BELT. IN THE 2 YEARS SINCE POLICY HAS REQUIRED THE REMOVAL OF BELTS FROM INMATES, THERE HAVE BEEN NO SUCCESSFUL SUICIDES. THUS, THE HIGHEST RISKS FOR INMATE DEATH RESULT FROM ALCOHOL WITHDRAWAL SYNDROME WHILE IN JAIL; FAILURE TO DISTINGUISH FEATURES OF ALCOHOL WITHDRAWAL FROM INTOXICATION; FATAL ALCOHOL OVERDOSE; AND SUICIDE IN RELATIVELY YOUNG, WHITE INTOXICATED MALES RECENTLY JAILED. MOST OF THESE SITUATIONS ARE EASILY REMEDIED. (RCB)