Examining Experiences of Federal Offenders on Opioid Agonist Treatment (OAT) During Incarceration in Ontario, Canada: A Pre-Release Report
Research Highlights: The provision of opioid agonist therapy (OAT) to incarcerated individuals with opioid use disorder (OUD) prior to community release is an important public health intervention. OAT is available to federal offenders in Canada, yet access barriers exist and individuals express apprehension regarding OAT treatment transitions during community reintegration periods.
Why we did this study
Opioid agonist treatment (OAT) is an effective treatment for opioid use disorder (OUD) as it prevents withdrawal symptoms, reduces cravings, and has been associated with beneficial outcomes such as reductions in illicit drug use and related harms (e.g., overdose, mortality, etc.).
In Canada, OAT has been available in federal institutions for over two decades, and an increasing number of offenders with OUD have accessed this intervention. While research studies have shown positive outcomes among offenders who receive OAT while incarcerated, not much is known regarding federal offenders' experiences with institutional OAT in Canada, including any barriers to accessing the intervention as well as perspectives related to treatment transitions during their impending community reintegration period. To better understand OAT-related experiences and release-related perspectives among federal offenders with OUD, we conducted the current longitudinal mixed-methods study.
Publication
R-449
2023
A full PDF is also available for download on the Government of Canada Publications.
ISBN: 978-0-660-45938-7
Cat. No.: PS83-5/R449E-PDF
Research at a Glance - PDF
Examining Experiences of Federal Offenders on Opioid Agonist Treatment (OAT) During Incarceration in Ontario, Canada: A Pre-Release Report
What we did
This study focuses on the pre-release assessment that occurred with 46 offenders incarcerated across seven federal Ontario-based institutions, engaged in OAT, and scheduled to be released into the community within six months. Short surveys and one-on-one interviews were conducted on site between January and March 2019. Survey data were linked with administrative Correctional Service of Canada (CSC) data, and interview data were thematically analyzed for common themes and experiences.
What we found
- Participants had complex histories with opioid use, yet most were familiar with OAT, and many had received it within the community before incarceration. Participants found OAT beneficial in terms of improving their lives and preventing drug use-related harms.
- Experiences with institutional OAT were divergent and provision was not standardized; those with OAT engagement pre-admission did not experience many challenges, whereas those initiating OAT during incarceration experienced barriers such as extensive treatment waitlists.
- Most participants were on methadone, yet expressed a strong preference for Suboxone; however, some participants described specific challenges accessing their preferred OAT formulation and dosage.
- Participants expressed the need for additional substance-use related support services during incarceration, as well as greater access to a variety of OAT medications, and more agency in treatment decisions.
- Participants also expressed concerns regarding their upcoming release and community reintegration period, including specific apprehension related to OAT treatment transitions.
What it means
Federal offenders in Ontario with OUD reported positive health outcomes as a result of engaging in institutional OAT. However, there were challenges related to the administration of OAT within federal correctional institutions, and access to OAT during the study period was less than optimal 1. Streamlining and quality-improving correctional OAT provision and more comprehensive release planning as it relates to treatment transitions may be essential for treatment retention and outcomes.
1 It should be noted that post baseline data collection for this study, CSC accelerated the roll-out and expansion of Suboxone®-based OAT, with numbers now outpacing those on methadone at many institutions (Correctional Service Canada, 2021). These changes included a substantial reduction in waitlists and practical limitations (e.g., wait until release time, etc.) which had previoulsy impeded offenders' ability to receive treatment.
For more information
Russell, C., Pang, M., Malta, M., Douardo, L.M.B, & Fischer, B. (2023). Examining experiences of federal offenders on Opioid Agonist Treatment (OAT) during incarceration in Ontario, Canada:A pre-release report.
(Research Report R-449).Ottawa, Ontario: Correctional Service of Canada.
To obtain a PDF version of the full report, or for other inquiries, please e-mail the Research Branch.
You can also visit the Research Publications section for a full list of reports and one-page summaries.