Improved health services for people with opioid use disorder in federal Institutions
The Correctional Service of Canada (CSC), the Canadian Human Rights Commission (CHRC), and Prisoners' Legal Services (PLS) have finalized a collaborative agreement that works to improve health services for people in CSC's custody with an opioid use disorder. These improvements were made in response to the opioid crisis, and to assist in resolving a complaint filed by PLS with the CHRC.
Building on the work the organizations have undertaken over the last several years, the agreement lists measures that will further support incarcerated people with an opioid use disorder in federal custody. More specifically, CSC will continue its efforts to provide timely access to Opioid Agonist Treatment (OAT) through the elimination of waitlists and a focus on continuity of care, including a focus on ensuring program discontinuation only when clinically appropriate or at the request of the patient.
Between December 2016 – at the outset of the opioid crisis – and May 2021, CSC has increased the number of individuals on OAT by 185%. Moreover, CSC continued to address opioid use disorder during the COVID-19 pandemic such that from the beginning of the pandemic in March 2020 until May 2021 the number of individuals on OAT increased by 21.86%.
CSC also recognizes the importance of psychosocial supports and treatment for patients with opioid use disorders and is implementing Self-Management and Recovery Training (SMART) at all institutions. SMART is currently available at 25 institutions.
Through this agreement, CSC affirms its commitment to:
- Publish waitlist information on CSC's website until waitlists are eliminated;
- Maintain the clinical independence of health care professionals;
- Further support a recovery orientation that is trauma-informed and culturally appropriate; and
- Transitions of care and discharge planning as essential components of OAT.
CSC recognizes the importance of expert medical advice and guidance for the treatment of patients in CSC's custody with opioid use disorders and that programs and practices incorporate changes in best practices and scientific evidence. As such, CSC is pleased to announce that Dr. Nader Sharifi, a recognized Canadian addiction specialist who brings extensive experience in both addiction medicine and correctional health care, will serve as CSC's National Medical Advisor for OAT.
In November 2019, CSC published a guidance document on the OAT program. The goal of the guidance is to ensure consistent, standardized, effective and evidence-based OAT for all patients across all sites operated by CSC. The guidance is available to people in CSC's custody and is publicly available on CSC's website. Updates to the guidance will be ongoing as appropriate in partnership with public health and addictions experts and will continue to be available on the CSC website.
CSC also appreciates the importance of patients being able to access their medical files in a timely manner. In recognition of this, CSC engaged a medical records specialist to provide advice on health records management, including how CSC could respond more efficiently to patients' requests for their medical records.
CSC has recently incorporated Good Samaritan Principles in policy in order to encourage people in CSC's custody to seek medical assistance for themselves or others in the event of a suspected overdose without fear of negative consequences.
For more information about the agreement, please see CSC's Fact Sheet: Opioid Use Disorder and Opioid Agonist Treatment.
All three organizations look forward to further collaboration and continuous support for people receiving OAT in federal correctional institutions.
Canadian Human Rights Commission:
“At the end of the day, this is about personal safety, public safety and human dignity. That is why the CHRC welcomes this agreement, and how well it has been informed by a human rights-based approach that puts the medical needs of the individual first. When we implement people-first changes like the ones set out in this agreement, we increase the chances of them being productive members of our society one day. That's why this issue should matter a great deal to all of us.”
— Marie-Claude Landry, Chief Commissioner, Canadian Human Rights Commission
Prisoners' Legal Services:
“We are pleased with the changes to CSC's administration of OAT, and the clear articulation that treatment of opioid use disorder is a health care service governed by the best interest of the patient. We are optimistic that these changes will save lives.”
— Jennifer Metcalfe, Executive Director, Prisoners' Legal Services
Correctional Service Canada:
“This agreement builds on CSC's work in providing quality care for those in federal custody with substance use disorders. We have been able to meet the needs of many more individuals in custody who require this support – since the onset of the opioid crisis, CSC has increased the number of people in the OAT program by 185%. We will continue to work closely with health care experts and partners to provide quality, person-centred health care that helps address the needs of those in federal custody.”
— Anne Kelly, Commissioner, Correctional Service Canada
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