Non-Fatal Overdose Incidents in Federal Custody - 2020-2021

What we did

An incident search was conducted of CSC’s administrative database to identify all reported non-fatal overdose incidents in Fiscal Year 2020-2021 (April 1^st, 2020 to March 31^st, 2021). Incidents were manually screened to identify cases in which the consumption of drugs precipitated medical intervention (e.g., administration of NARCAN) and/or resulted in a designation of Serious Bodily Injury. Information was recorded pertaining to incident circumstances and victim characteristics.

What we found

In 2020-2021, there were 131 non-fatal overdose incidents in federal custody, a roughly 25% decrease from 2019-2020 (see Table 1). There was an increase in the number of incidents in the Atlantic region, and overall, regional distribution was more diffuse relative to prior years. The number of incidents in Ontario decreased 62% from the previous year. This decrease was likely associated with restrictions and measures in place during the COVID-19 pandemic.

Shifts in substances were evident in 2020-2021. While opioids remained the most common identified substance (38%; compared to 36% in 2019-2020), there was a shift in the type of opioids identified in incidents. Fentanyl was suspected or confirmed in 15% of cases (compared to 24% in 2019-2020), while methadone or suboxone were suspected or confirmed in 18% of cases (compared to 5% in 2019-2020).

In addition, there was a notable increase in cases involving non-opioid, non-stimulant prescription medications (34%; compared to 19% in 2019-2020). While less pronounced, there was also an increase in cases involving stimulants, such as methamphetamine (15%; compared to 7% in 2019-2020). Note that no substance was documented in 18% of cases.

In a majority of cases (i.e., 84%), the incident appeared to be accidental (i.e., there was no evidence of intentionality). The vast majority of incidents occurred at men’s institutions (97%) and involved medium security offenders (69%). Offenders involved in incidents were typically White (50%) or Indigenous (41%), in their twenties to forties (84%), and serving time for a violent index offence (74%), such as a Robbery or Homicide offence. Complex profile considerations were often at play, including histories of substance misuse issues (85%) or self-injurious behaviours (60%). Around one-quarter had arrived at the institution of incident within the last 60 days.

What it means

Trends in overdose incidents in federal custody were marked by shifts during the full Fiscal Year of the COVID-19 pandemic. Incidents were less concentrated to particular institutions or regions. Shifts in substance patterns were notable, including a decrease in the number of Fentanyl cases, and increase in cases involving institutionally available opioid and non-opioid medications. Such shifts likely reflect restrictions associated with the COVID-19 pandemic that reduced the inflow of illicit substances, resulting in different substance use patterns.

CSC continues to undertake measures to mitigate substance-related harms, including health interventions, harm reduction services, substance misuse programs, and preventative strategies. Ongoing tracking of overdose incidents remains key to informing approaches to improve offender health outcomes and enhance the safety and security of institutions.

For more information

Please email the Research Branch. You can also visit the Research Publications section for a full list of reports and one-page summaries.

Prepared by: Jessica Lundy, Dirk Boon, Falu Gaye, and Laura McKendy