Pubdate: Thu, 07 Jul 2016
Source: Globe and Mail (Canada)
Page: A5
Copyright: 2016 The Globe and Mail Company
Contact:  http://www.theglobeandmail.com/
Details: http://www.mapinc.org/media/168
Author: Karen Howlett

STUDY REVEALS EX-INMATE OVERDOSE RISKS

Research boosts calls for naloxone distribution in finding deaths are 
almost 12 times higher for ex-convicts than Ontarians in general

One in 10 people who died of a drug overdose in Ontario over a 
seven-year period had been released from a provincial prison within 
the previous 12 months, lending new urgency to calls to distribute 
the opioid antidote naloxone to inmates returning to the community.

A study by researchers at St. Michael's Hospital and the University 
of Toronto - the first in Canada to match coroner reports with 
records for incarcerated individuals - found that the risk of inmates 
dying of a drug overdose after they are released is almost 12 times 
higher than that for Ontarians over all.

"We were surprised at how high the fatal overdose rate was among 
those who were recently released from provincial custody," said Nav 
Persaud, a family physician and scientist with the Li Ka Shing 
Knowledge Institute at St. Michael's Hospital.

The World Health Organization recommends that individuals who are 
likely to witness an opioid overdose should have access to naloxone, 
says the study published on Wednesday in the medical journal PLOS 
ONE. The study found that the majority of overdose deaths involved 
opioids and that someone was present who could have intervened in 
more than half of the cases. Naloxone reverses the effects of an 
overdose within minutes.

Public-health doctors in Ontario have called on the province to hand 
out take-home naloxone kits to inmates, who can be in particular 
danger of overdosing on opioids after they leave prison.

This week, Ontario Health Minister Eric Hoskins overruled his 
bureaucrats and ordered them to immediately begin distributing 
naloxone to newly released inmates. His directive followed a Globe 
and Mail report about a turf battle between two provincial ministries 
that stalled efforts to distribute the life-saving antidote to 
prisons in Ontario.

"To my mind, this is a relatively easy solution to a very complex 
problem," said Fiona Kouyoumdjian, a prison physician and lead author 
of an earlier research paper, which found that jail time is 
frequently a precursor to an early death by preventable means. Nearly 
14 per cent of the 50,000 former prisoners studied died of an overdose.

"It's very clear that this population is at very high risk and is 
contributing to the overall burden of overdose deaths 
disproportionately," she said.

The weeks immediately after release are a precarious time for former 
inmates. Job and housing prospects are usually bleak and drug 
tolerances are generally at a low point because of the relative 
scarcity of drugs in prison.

The new study found that just under 7,000 people across Ontario died 
of drug overdoses between 2006 and 2013. Of those, 702 people died of 
an overdose who had been released from prison in the year prior to their death.

Nine per cent of the overdose deaths occurred in the first two days 
after release and 20 per cent within the first week, the study found.

Correctional facilities in Ontario house inmates serving sentences of 
less than two years and those detained before and during a trial. The 
vast majority of overdose victims in the study had been remanded in custody.

Stephanie Massey, provincial program co-ordinator at PASAN, which 
provides support services for former inmates, said methadone therapy 
used to treat opioid addiction is not widely available behind bars in 
Ontario, leaving drug users at high risk of overdosing after their 
release. As well, she said, a loss of housing and a safe place to 
inject adds to the risk of overdosing.

Clare Graham, spokesperson for Minister of Community Safety and 
Correctional Services David Orazietti, responded to the study by 
noting that the government has expanded access to naloxone.

"We fully support any discussion around making our correctional 
facilities safer," Ms. Graham said.
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MAP posted-by: Jay Bergstrom