The opioid crisis is putting pressure on Canada’s federal prisons, as new data shows that nearly one in four inmates are receiving opioid agonist treatment like methadone or suboxone.
This comes from a recently answered order paper question on how many federal inmates are receiving that treatment and how many are using the prison needle exchange program.
In the response to B.C. Conservative MP Frank Caputo, Ontario Liberal MP Jennifer O’Connell wrote that as of Feb. 4, 2024, 3,129 of the 13,619 inmates in federal prisons were receiving the treatment, or 23 per cent. Of those on opioid agonist treatment, 45 were involved in the prison needle exchange program.
There’s been a steady increase in the number of inmates receiving opioid agonist treatment since Correctional Service Canada (CSC) began to really see the growth of the opioid epidemic in 2016. In December 2016, nine per cent of inmates were getting opioid agonist treatment, climbing to 15 per cent at the end of 2021.
“When the opioid overdose epidemic essentially started in 2016, 2017, both the health authorities, communities, prison services were quite challenged with the rapid increase,” said Dr. Nader Sharifi, CSC’s opioid use disorder medical advisor, in an interview with Global News.
“We did have a waitlist that was just over 400 a couple of years ago. And we’ve managed, with some very hard work and caring staff, to reduce that number to just under 100, which is basically a rolling waitlist. It’s people who come in and need to go on opioid agonist treatment. So, we’ve managed to sort of keep pace at this point.”
CSC says opioid agonist treatment is complemented by additional treatments to help inmates with addictions including counselling and other mental health services.
However, advocates in prisoner’s rights say more still needs to be done.
“Oftentimes, in my experience working in the prisons, the use of drugs goes up when there are fewer programs, when there are more restrictions, and basically less hope in the prisons,” said independent Senator Kim Pate said in an interview with Global News.
Much of Pate’s work as a senator and before her appointment revolves around prisoner’s rights. Shortly after her appointment in 2017, Pate challenged her colleagues to go to jail with her to document the conditions in federal prisons, resulting in the 2022 report Senators go to Jail.
The senator advocates for greater access to social programming and visits as a means of trying to help curb prison drug use.
“Whenever we relegate people who are suffering with addictions, especially when it’s linked to past trauma to prison, we’re basically reinforcing and increasing the risks to them in terms of their inability to be in the community,” she said.
“It corresponds with what most of us know who have been working in and around the prison system for many years, that when people have access to the things they need, what a big surprise, they’re less likely to anesthetize themselves with drugs.”
Jeff Wilkens, president of the Union of Canadian Correction Officers, said the societal increase in opioid use is reflected in the prison system, creating increased challenges for corrections workers.
“We’re seeing inmates divert those medications to give to other inmates to pay off debts, institutional debts, for example,” Wilkins said in an interview from Amherst, N.S.
“So, we have to monitor those inmates taking methadone or suboxone. And when we’re monitoring those inmates, when you have 100 of them in the institution on a given day, operationally in the morning to get that routine done is a nightmare.”
Wilkins, who has been a corrections officer for two decades, said, that he and his members are seeing more drugs in jails. With the increased drug supply, he said overdoses have “doubled” over the last year.
“This is a direct result of not only the programs that inmates are on and the misuse or abuse of those prescribed medications, but also the rapid influx of drugs that are being introduced through means like drones across the country,” Wilkins said.
“I’ve been a correctional officer for 21 years, and I’ve never seen this amount of drugs inside of our prison walls and fences. The crisis is alarming.”
According to the most recent publicly available CSC data, between 2017/2018 and 2019/2020, CSC reported 19 fatal overdoses. Among the 17 fatal overdoses with complete investigations, opioids were a contributing factor in 15 deaths.
In 2019/2020, CSC reported 174 non-fatal in-custody overdoses, a 58 per cent increase over the prior year.
Two-thirds of the time, contributing substances were not identified. When a drug is known, opioids were most frequently identified as the cause at 36 per cent, followed by prescription medication at 19 per cent.
When prisoners are released, Dr. Sharifi said overdose rates for former inmates who went through opioid agonist treatment are four to 50 times higher than the general population, depending on the study referenced.
“We want to make sure as they transition to the community that they’re being supported and we’re connecting them with resources in the community. So, they get that continuity of care and can get the treatment that they need as they’re released into the community,” said Ginette Clarke CSC director general of health programs and policies.
Still, Pate said more needs to be done. She said that in her experience, she has found that much of the time psychiatrists spend in the prison setting is conducting risk assessments, which is part of why she is sponsoring legislation that in part, would require CSC to contract community organizations to assist in addictions treatment programs.
“Most people are developing health and mental health issues because of the conditions to which they’re subjected when they go into prison, which is a vicious cycle of people becoming more likely to use drugs or other substances. And so, it is a compounding, very vicious cycle,” Pate said.
Senate Bill 230 is still at the committee stage in the red chamber and has not yet made its way to the House of Commons.
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