Pubdate: Tue, 18 Jul 2017
Source: Globe and Mail (Canada)
Copyright: 2017 The Globe and Mail Company
Author: Patrick White
Page: A4


Correctional Service Canada vows to look into resources for inmates
with addictions following Vancouver-based group's call to action

Canada's prison agency said it will review the way it treats inmates
with opioid addictions in light of a series of accusations from
B.C.-based prisoners.

A letter sent to the Correctional Service Canada (CSC) on Monday - and
shared with The Globe and Mail - summarized the experiences of 33
prisoners held in the federal jailer's Pacific region who said they
couldn't access basic treatment for the highly addictive class of
drugs that includes fentanyl and oxycodone.

The Globe queried the CSC about the letter shortly after it was sent.
The response was immediate: "The Correctional Service of Canada takes
these allegations very seriously and will undertake a review of the
application of opiate substitution therapy policy."

Prisoners' Legal Services (PLS), a Vancouver-based law clinic devoted
to prison issues, brought the inmates' concerns forward in the 14-page
letter. Some prisoners reported waiting months and even years to
receive opiate substitution therapy, which generally consists of
methadone or Suboxone. "I'm very glad to hear that CSC is taking our
concerns seriously and will be undertaking a review," said PLS legal
advocate Nicole Kief. "We look forward to being consulted, and hope
that CSC will also consult with prisoners who have been directly
affected by these issues. And, given the urgency of the situation, we
hope the review will happen immediately and will result in all
prisoners who need treatment receiving it."

One prisoner, identified only as Joel, told PLS he was waiting three
years on a waitlist for Suboxone to treat his heroin addiction. "He is
set for release in mid-July and fears … becoming a victim in the
fentanyl crisis," the letter states.

Others fortunate enough to receive the treatments say prison staff
often cut them off cold-turkey, with devastating health effects.
Austin Curtin, an inmate at Matsqui Institution, told PLS he was
taking Suboxone successfully for three months when a nurse spotted
something white in his mouth and suspected him of diverting his
medication, a serious concern in prisons settings where prescription
medications fetch inflated black-market prices and are often acquired
by threat of violence. Mr. Curtin said the substance was not diverted
Suboxone but a piece of a hard-boiled egg he'd eaten before seeing the
nurse. His explanation did not allay the nurse's concerns, however,
and his Suboxone regimen was terminated without any kind of tapering.

"Mr. Curtin reports that he experienced heavy sweats, cold shakes,
diarrhea, stomach cramps, headaches, insomnia and restless arms and
legs, but despite numerous healthcare requests, he received no help
managing his withdrawal symptoms," the letter states.

Prisoners claim the decision to pull these medications is often based
on flimsy evidence and inmates are given "no meaningful opportunity to
defend themselves" - a violation of fundamental justice principles
enshrined in the Charter, according to Ms. Kief.

In an e-mailed response, CSC spokeswoman Sara Parkes said involuntary
tapering cannot be used as a form of discipline and must only be
carried out where an inmate doesn't comply with the treatment program
or presents a safety risk.

"Diversion of methadone or Suboxone … even in very small amounts may
lead to significant adverse effects, including respiratory depression
and even death," Ms. Parkes wrote.

Roughly 920 of the 14,639 inmates currently in CSC custody are
receiving opiate substitution therapy, up from 779 in the 201516
fiscal year. In the 2014-15 fiscal year, the most recent period for
which figures were available, there were six fatal overdoses in
federal prisons, an increase from two deaths the previous year.

"It's a difficult issue," correctional ombudsman Ivan Zinger said.
"I'm certainly of the view that there's an increased demand for
methadone and Suboxone. CSC has increased access but it is probably
insufficient to meet the demand."

In response to one inmate's grievance, a warden confirmed a supply
shortage exists, according to the letter. It states that one inmate,
who has been waiting a year for methadone, was informed the opiate
substitution therapy program is "significantly beyond capacity."
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