PI: PI rotates amongst leadership group depending on project

Leadership Group: Andrew MacFarlane (Correctional Health Services, BC); Fiona Kouyoumdjian (McMaster University, ON); Kevin Haggerty (University of Alberta, AB); Seonaid Nolan & Cheyenne Johnson (BCCSU, BC)

 Correctional populations are a standout vulnerable population with among the highest prevalence of substance use and mental health problems, and are at high risk for related morbidity and mortality (e.g., overdose). As many as 50% or more of correctional inmates, including in Canadian correctional systems feature opioid misuse and related problems. While some prevention and treatment interventions (e.g., opioid pharmacotherapy programs) for opioid misuse and harms have been selectively implemented for correctional settings, major intervention and knowledge gaps exist. A further challenge are post-release intervention and care, where care transition (e.g., addiction treatment) commonly break down, and released offenders return to substance use and other risk activities and are at highly elevated risks for (e.g., overdose) mortality, and other severe health and social problems, including re-offending).This EHT project will conduct several sub-projects focusing and generating evidence on opioid use related interventions for correctional systems/offenders in Canada.

  1. Scoping Review of Feasibility and Outcomes of Interventions for Opioids Misuse Among Correctional Populations

Objectives include:

  • Undertake a comprehensive/scoping review of existing evidence on the feasibility and outcomes of (prevention and treatment) interventions for opioid-related misuse and harms among correctional populations,
  • To distribute the findings for use among corrections-related policy and program officials
  1. Evaluating the Impact of Strategies to Prevent Opioid-Related Harms in People who Experience Imprisonment in Provisional Prisons in Ontario.

Objectives include:

  • Use available health administrative data to assess the impact of recent and current strategies to reduce opioid-related harms in persons who experience imprisonment in provincial prisons in Ontario,
  • Explore the impact of strategies to reduce opioid-related harms on the following outcomes over time:
  1. Follow-Up Study of Quebec Federal Offenders on Opioid Substitution Treatment (OST).

Objectives include:

  • Quebec Node to partner with Correctional Services Canada to jointly identify and implement feasible-interventions,
  • Increase effective service transition, and reduce overdose risk, among a sub-set of inmates to be released,
  • Examine treatment, health and criminogenic experiences and outcomes among federal (CSC) offenders with opioid disorders related to OST care, both institutionally and in the community upon release,
  • Examine the expectations of offenders as well as the role of contextual, systemic and environmental factors in influencing transition into OST-related community care,
  • Examine barriers to more successful transition into OST-related community upon release
  1. Examining the Opioid Landscape Within Federal Prisons in Alberta.

The project is concerned to examine: A). How has fentanyl/carfentanyl impacted policy responses to security concerns in Alberta’s prisons, and how does this development impact correctional officers and prisoners? B). Which measures might be most effective to address this problem in a prison environment? C). What is the level of appetite for different forms of harm reduction strategies in federal jails among correctional officers, prisoners and correctional staff? Which of these strategies are feasible from a security, legality, and safety perspective? D). What organizational, security, occupational or cultural barriers might have to be addressed in order to introduce measures to effectively reduce the assorted risks of opiates in prison.

  1. An evaluation of the use of Community Transition Teams to improve health outcomes for individuals recently released from British Columba Corrections.

The period following release from a correctional facility is one of heightened vulnerability, as individuals re-immerse into their communities, search for housing and employment and attempt to access health care services. Accordingly, many newly-released clients feel ill equipped to navigate this process and, in the absence of proper support, are at high-risk for relapse to substance use, recidivism and a host of other negative outcomes. To address this, PHSA Correctional Health Services (CHS) is planning on implementing and scaling-up the use of Community Transition Teams (CTTs). CTTs adopt a client-centred approach to care, whereby a case manager works closely with an individual to help them identify their priorities and subsequently takes an active role in supporting a client to achieve their treatment goals following release from provincial corrections.