Examining Experiences of Federal Offenders on Opioid Agonist Treatment (OAT) During Release from Incarceration in Ontario, Canada: A Post-Release Report
Research Highlights: Many offenders with opioid use disorder (OUD) who receive opioid agonist therapy (OAT) in Canadian federal institutions remain engaged in OAT post-release, yet report a variety of facilitators and barriers to continuous OAT engagement that have important implications for positive community reintegration experiences.
Why we did this study
Correctional populations experience high levels of opioid use disorder (OUD) and increased risks for related harms upon the high-risk period of community release and reintegration, including overdose and premature mortality. Opioid agonist therapy (OAT) is an effective treatment for OUD and its provision is associated with a reduction in these and other related risks during the community transition period. However, OAT engagement and treatment retention remain key challenges among this population, and many individuals experience detrimental treatment disruptions that can result in negative impacts on their health and reintegration prospects and experiences. Numerous factors determine whether an offender remains engaged in OAT upon community release, yet not much is known regarding these influences, particularly in the Canadian context. We conducted the current study to address this knowledge gap.
Publication
R-450
2023
A full PDF is also available for download on the Government of Canada Publications.
ISBN: 978-0-660-45940-0
Cat. No.: PS83-5/R450E-PDF
Research at a Glance- PDF
What we did
We completed this longitudinal, mixed-methods study among a small sample of federally incarcerated offenders engaged in OAT who underwent two separate assessments: baselineFootnote 1 (during incarceration, within six months prior to release) and follow-up (post-incarceration, within one year post-release). This report focuses on the follow-up assessment which occurred with 35 individuals who were retained from the initial baseline sample (of 46), and had been released into the community. The assessments included a short survey and a one-on-one interview, carried out within Southern Ontario-based community locations between October 2019 and March 2020. 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
- The majority (77%) of the study participants remained engaged in OAT treatment after release. A number of facilitators and barriers to positive community reintegration experiences and OAT continuity and access were identified.
- Key facilitators included personal motivation and coping mechanisms, familial support, employment, and the specific benefits of OAT programs (e.g., ability to alleviate pain, flexibility to choose formulation and dose, structure of treatment adherence, positive staff rapport, etc.).
- Key barriers included challenges with correctional discharge planning, fragmented OAT transitions, financial issues, balancing OAT and other release requirements, logistical challenges, and inaccessibility of take-home OAT doses.
What it means
Canadian federal correctional populations with OUD need continued access to educational and correctional programming opportunities to increase motivation and coping skills. Linkages to community employment and work placements should be strengthened. Additionally, correctional discharge planning requires improvements to support consistent and seamless linkage to community-based OAT, and policies, including those at the provincial level, should be amended to ensure offenders on release have adequate financial and prescription coverage and access to take-home OAT doses. These and additional recommendations to ensure effective community transitions for this high-risk population are proposed in light of the study results.
For more information
Russell, R., Pang, M., Nafeh, F., Rehm, J., & Fischer, B. (2023). Examining experiences of federal offenders on Opioid Agonist Treatment (OAT) during release from incarceration in Ontario, Canada: A post-release report. (Research Report R-450).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.