Theme: Epidemiology & Public Health Research Year: 2024
Background: British Columbia has been in an overdose public health emergency since 2016 from a toxic, unpredictable illicit drug supply. Overdose death risk is very high amongst people leaving incarceration, with the highest risk in the first two weeks post-release. The Unlocking the Gates program provides peer support to this population. The staff are also trained as researchers and conduct interviews and surveys with participants.
Methods: Peer researchers conducted surveys and interviews with 120 participants on the day of release. This project examined qualitative and quantitative data on access to Opioid Agonist Therapies (OAT), such as methadone, buprenorphine, and slow release oral morphine, relative to chronic opioid use prior to incarceration and overdose risk, to assess the availability of OAT medications prior, during, and post incarceration.
Results: Over half of participants experienced an overdose in the six months prior to their most recent incarceration and 57% used opioids chronically in two weeks prior, yet only 37% of participants had an active OAT prescription. While incarcerated, 61% percent received OAT, although rarely expediently. Most participants (72.6%) experienced withdrawal while incarcerated, due to OAT waitlists and lack of treatment for benzodiazepine dependence. Among persons who received OAT while incarcerated, 29% reported not being provided a prescription upon release.
Conclusion: OAT is an evidence-based treatment that has shown to reduce overdose risk, unsafe injection practices during incarceration, withdrawal, craving, and recidivism. The results of this project suggest that gaps in OAT access among persons incarcerated in the BC provincial prison system persisted in 2023, and that there are opportunities to strengthen the continuity of care among incarcerated persons at-risk of overdose. In the context of the ongoing toxic drug poisoning emergency in BC and the extreme risk of overdose death post-release, additional supports are needed to support continuity of OAT during community transition.