Pubdate: Sat, 19 Mar 2016
Source: Globe and Mail (Canada)
Copyright: 2016 The Globe and Mail Company
Contact:  http://www.theglobeandmail.com/
Details: http://www.mapinc.org/media/168
Author: Andrea Woo
Page: S2

PRISONERS SEEK TO EXPEDITE ADDICTION-TREATMENT DRUGS

Four inmates file Charter challenge of BC Corrections policy they say
put them at risk of overdosing on illicit drugs behind bars

Four opioid-addicted prisoners are challenging a BC Corrections policy
they say impedes swift access to medication that could treat their
addictions, putting them at risk of overdose.

Lawyer Adrienne Smith, who is representing the men, says her clients
have received either limited access, or no access at all, to drugs
such as Suboxone and methadone, which are used to treat opioid
dependency. Fighting withdrawal, some have turned to illicit drugs
behind bars; one has overdosed for this reason, according to an affidavit.

According to BC Corrections' health-care services manual, inmates who
are on a methadone or Suboxone program at the time of admission are
eligible for continued treatment, while inmates who are qualified to
begin such a program should be considered.

This includes remanded individuals and inmates with short sentences,
according to the manual, but "the anticipated length of stay in
custody must be long enough to incrementally dispense a medically safe
dose and stabilize the maintenance dose." It does not specify how long
this is; the prisoners say they have been told it can be around three
months.

"They're being told that, until they know what their sentence is going
to be, whether they're getting federal or provincial time, whether
they're getting bail, they can't be started," Ms. Smith said.

The four men have each been held at provincial prisons for three or
four months. All were intoxicated or in withdrawal when they were
admitted; three were given Suboxone for a few days and then cut off,
Ms. Smith said.

They filed a Charter challenge on Friday in B.C. Supreme Court seeking
an injunction order suspending the policy and compelling BC
Corrections to bring them before a doctor authorized to prescribe
methadone and Suboxone.

Asked about this policy, BC Corrections said neither it nor its
health-care provider has a minimum time frame or length of custodial
sentences to initiate methadone or Suboxone treatment, despite the
language in its health-care services manual.

"To be clear, upon admission to a correctional centre, medical staff
can refer an inmate to either methadone or Suboxone treatment, or an
inmate can request it," the statement read. "A physician then assesses
the inmate and develops an individualized care plan, regardless of the
length of the inmate's sentence."

It did not clarify how that applies to the apparent requirement in the
health-care manual for a sentence long enough to reach a stable
maintenance dose.

Plaintiff Shawn Gillam, 33, said he overdosed snorting illicit
oxycodone obtained behind bars while waiting to see a doctor. "I saw
the jail doctor [after overdosing], who said they can't start me on
Suboxone because I'm getting out," he wrote in an affidavit. "That
makes no sense to me because being on Suboxone could make the
difference for me when I get out the door."

Keith Ahamad, an addiction physician at St. Paul's Hospital and the
B.C. Centre for Excellence in HIV/AIDS, said Suboxone, which has a
better safety profile than methadone, has recently become the
first-line treatment for opioid addiction.

"The amazing thing with Suboxone is that you can reach a stable dose,
for some patients, as early as one day," Dr. Ahamad said. What's more
complicated is ensuring patients have continued therapy upon discharge
from a correctional centre - but such discharge plans are already part
of BC Corrections policy, he said.

Using illicit drugs is more dangerous in jail because of a lack of
harm-reduction supplies.

"You can't get sterile rigs [syringes] in jail so people make their
own," plaintiff Nikola Skupnik, 34, wrote in an affidavit. "There is
lots of sharing. People can get diseases from that."
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MAP posted-by: Matt