Information for offenders: Opioid use disorder and Opioid Agonist Treatment

The Correctional Service of Canada (CSC) has been working with health experts, Prisoners' Legal Services, and the Canadian Human Rights Commission to improve services for people in CSC's custody who have Opioid Use Disorder (OUD). CSC is committed to continuing efforts to better support those with OUD during their sentences. CSC has an Opioid Agonist Treatment (OAT) program that is available to you.

CSC is committed to offering timely access to the OAT program for everyone diagnosed with OUD. The treatment program is offered according to the Guidance on Opioid Agonist Treatment. This guidance document is available to you at any time in the institution library or by requesting a copy through Health Services. The OAT program is guided by the following principles:

• OAT is a health treatment program and is delivered by health care professionals who are required by legislation and their licensing body to provide treatment based on independent clinical decisions.
• Health Services staff will not be involved in disciplinary decision-making or other restrictive measures. They are required to keep your medical information confidential, including urinalysis testing, unless this information must be disclosed in accordance with the law.
• The approach to your care is trauma-informed and culturally appropriate.
• Timely access to the program is key and patients already on OAT will continue without interruption.
• Health Services recognizes that among those in treatment there may be recurrence of substance use and you may not meet your treatment goals. Health Services will work with you to help you engage in treatment that is right for you. If you are benefiting from OAT you will not be discontinued.
• Discharge planning is an essential component of the OAT program. Health care staff will help you find health care supports in the community, with your consent.
• If you decide to discontinue treatment, you will be tapered gradually unless you choose otherwise. Unless it is medically necessary, you will not have to end treatment abruptly without a taper against your wishes. Your physician or nurse practitioner will discuss this with you.
• Any withdrawal symptoms you have will be treated urgently.
• Health Services will ensure that OAT participants are offered psychosocial support and treatment interventions in a timely manner. The SMART Recovery program, is being implemented at all institutions for everyone with problematic substance use. Additional or different treatment will be offered when clinically indicated.
• Health Services is committed to providing care that keeps up to date with developments in the field of addiction medicine.

Other important information you should be aware of:

• Positive urine drug screens for opioids are not required to be eligible to participate in the OAT program.
• Your OAT treatment team will only include health care staff. Elders can be part of your treatment team if you wish.
• CSC recognizes the importance of medical advice and guidance for the treatment of people with OUD. CSC works with health experts and has recently hired an expert in addictions medicine to oversee the program and provide guidance and advice to CSC.
• If your OAT is discontinued against your wishes, the decision will be reviewed by the National OAT Medical Advisor in collaboration with your treatment team. You will get a copy of the review if you ask for it.
• We are working hard to reduce wait times for access to this program. CSC has established a working group to monitor wait lists for the program to work on strategies to eliminate the waitlist, to support education for CSC health care staff, and to improve the quality of care to people on OAT.
• Since the outset of the opioid crisis in communities across Canada, CSC has increased access to OAT for individuals in custody by 185%.
• You have a right to access your medical records, including documentation and reviews relating to OAT. CSC is working with a medical records specialist to help us respond more efficiently to patient requests for medical records.
• CSC is committed to providing psychosocial treatment to all patients and will consult with experts to ensure that psychosocial treatment and support is culturally appropriate. Please provide feedback to Health Services if you have ideas about this.
• CSC has updated policy (Commissioner's Directive 580 - Discipline of Inmates) to incorporate Good Samaritan principles. This is to encourage you to seek medical attention for yourself or others in the event of a potential overdose without fear of disciplinary action.

Please note that if there are any inconsistency between this fact sheet and the Guidance on Opioid Agonist Therapy (as it may be amended from time to time), the Guidance document prevails.

To learn more about support available to you, please speak to a staff member in Health Services.