Characteristics, institutional behaviour, and post-release success of Opioid Agonist Treatment participants: Examining differences across Opioid Agonist Treatment options

Research Highlights: Understanding the differences across OAT treatment options highlights areas of need for on-going OAT enhancements.

Ensuring that offenders have access to interventions that will assist them in addressing their substance use issues allows the Correctional Service of Canada (CSC) to support the safe reintegration of offenders into society. For offenders who misuse opioids, CSC offers Opioid Agonist Treatment (OAT). Methadone has been offered in CSC institutions since 1998 and more recently, Suboxone has been added to the medication roster. Previous CSC research focused on methadone maintenance treatment exclusively. The current study examines both methadone and Suboxone based treatment.

Study cohorts consisted of 2,325 men federal offenders, and 273 women federal offenders, who participated in the CSC's OAT while incarcerated between October 2016 and 2018. Cohorts were further divided into three treatment type groups: methadone only (M-OAT), Suboxone only (S-OAT), and a group that changed medication types during the study period (Cx-OAT). Non-OAT comparison groups were also included. Men and women were examined separately. Demographics, offence, and sentence characteristics of these three groups were compared, and indicators of institutional behaviour and post-release success were examined.

Results indicated that men non-OAT offenders were younger, more likely to be classified as minimum security and more likely to be serving their first federal sentence. In contrast, men offenders in the Cx-OAT group were more likely to be classified as maximum security and serving a longer sentence.

Women offenders in the non-OAT and M-OAT groups were more often classified as minimum security while those in the Cx-OAT and S-OAT groups were more often classified as maximum security. Women in the non-OAT group were also most likely to be serving their first federal sentence.

Across all risk related indicators, the non-OAT men offenders were the least likely to be high risk or need.

The Cx-OAT group were the most likely to have positive urinalysis tests, disciplinary charges or institutional incidents, and flagged with mental health concerns. Interestingly, the S-OAT group was most likely to have an institutional incident recorded for diverting OAT medications.

The women S-OAT and Cx-OAT groups were more likely to be high risk than the M-OAT or non-OAT groups. The women S-OAT group was also most likely to be high need, across all indicators examined.

Among study groups and regardless of gender, the S-OAT groups were least likely to be released. The Cx-OAT groups were most likely to have a release suspension and were also the most likely to have a return to custody. Most returns to custody were due to technical revocations of release.

This study provides information about a group of offenders that have not been extensively examined within a Canadian context. Findings suggest that OAT treatment groups have varying characteristics, institutional adjustment, and post-release success. Capacity and modality enhancements, as well as continued research will further improve OAT provisions and support to participants.

Farrell MacDonald, S. & Beauchamp, T. Characteristics, Institutional Behaviour, and Post-release Success of Opioid Agonist Treatment (OAT) Participants: Examining Differences across OAT Options (Research Report R-436). Ottawa, ON: Correctional Service of Canada.

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