About the authors: is a Frontline Harm Reduction Worker & Health Promotion Research Assistant at 国民彩票. is an Associate Professor in the Schulich School of Law at 国民彩票. is Resident Physician in the Department of Family Medicine at McMaster University.
The opioid overdose crisis has .
One flashpoint of this crisis is Canada鈥檚 correctional facilities. among incarcerated people. Post-release, their prospects are even worse: in the two weeks after release, a prisoner鈥檚 risk of overdose is than in the general population. is a prisoner released in the past year.
Despite this, our prisons and jails often delay or deny access to evidence-based treatments for opioid use disorder and fail to ensure appropriate supports on release.
Opioid agonist therapy
Governments have brought and . Canada鈥檚 federal government is .
But our divergent experiences as a physician, a legal academic and a formerly incarcerated harm reduction activist have taught us that much of the responsibility lies with government itself 鈥� specifically, its failure to provide prisoners with timely access to opioid agonist therapy (OAT) and ensure post-release continuity of treatment.
People incarcerated in Canada鈥檚 federal prisons and provincial-territorial jails are highly likely to have experienced , poverty and the corrosive effects of and . They are highly likely to struggle with and . Incarcerated people, like many on the outside, use drugs as a form of coping.
OAT provides a medication (usually buprenorphine/naloxone or methadone) to prevent drug cravings and withdrawal symptoms. It is the and the standard of community-based care across Canada. , , improves a host of social and psychological outcomes and is associated with a decreased risk of and .
Legal standards for health care
and law obliges prisons to provide incarcerated people with health care at community standards. But , and all tell a similar story: too often, people are not provided addictions treatment on admission, whether or not they were being treated in the community. This means they go into acute withdrawal and are at increased risk of use, relapse and overdose.