Human rights complaint filed over federal inmates' access to opioid treatment

A complaint filed with the Canadian Human Rights Commission (CHRC) claims federal prisoners face "inhumane" waiting lists for opioid addiction treatment — amounting to discrimination on the basis of a disability — and that inmates in Correctional Service Canada (CSC) institutions experience involuntary tapering or sudden termination of their medications as punishment.

The complaint has been filed by the B.C.-based Prisoners' Legal Services (PLS) on behalf of all federal inmates dealing with opioid use addiction, and follows a number of similar complaints to the CHRC from individual prisoners.

"We're really concerned that there's a real acute and urgent medical need that's just not being met," said PLS legal advocate Nicole Kief, who says he has personally talked to about 75 inmates who described struggles getting opioid substitution therapy (OST) like methadone or Suboxone to treat their addictions.

"There's really no access to quality harm reduction and there's very little access to mental health supports, to addictions counselling, that sort of thing," said Kief.

In May, CSC announced it would begin needle exchange pilot programs at two federal institutions, with plans to expand the program to other facilities next year.

"PLS has spoken to numerous prisoners who have waited months — and some more than a year for OST while in custody," the complaint claims.

"The inability to obtain treatment can compromise a person's ability to meet the goals of their correctional plan, achieve parole, and be successful upon release into the community," it continues.

"PLS has heard from prisoners who were released to the community without OST, only to find themselves returning to prison for reasons related to their addictions."

'Profoundly dangerous' withdrawal

According to Kief, the experience of prisoners whose OST medication is suddenly stopped can include painful and dangerous withdrawal, and even if it's carefully tapered off, the lack of treatment can lead inmates to turn to the illicit market, raising the risk of accidental poisoning from fentanyl-laced drugs, and HIV and hepatitis C infection.

Paul Quick, a lawyer with the Queen's Prison Law Clinic in Kingston, Ont., said his group wasn't involved in filing the human rights complaint, but he's familiar with it, and says from his experience in Ontario, "it is certainly well founded."

"Sadly, it seems to me that the ultimate source of this problem is that prisoners' lives are simply not valued as other lives are," Quick said in an email to CBC News.

"Our legal clinic is frequently contacted by prisoners who are in distress due to being removed from OST," he said.

"It is profoundly dangerous to cut a patient off OST, particularly given the current fentanyl crisis in Canadian prisons. Unfortunately, it appears that such choices are at times made for punitive reasons (to deter diversion) rather than health-related reasons."

'Persistent noncompliance'

CSC declined an interview request, but spokesperson Stephanie Stevenson provided a statement which says that since October 2016, there has been a 25 per cent increase in the number of inmates on opioid use disorder treatments.

"Involuntary tapering is not to be used as a form of discipline and is only to be considered as a last resort in situations of persistent noncompliance with the methadone/Suboxone Maintenance Treatment Agreement with the offender," said Stevenson.

Kief said that in the past year, there has been plenty of progress getting proper treatment for inmates, but engagement in the issue from CSC appears to have stalled, and outside B.C. the problem is still especially bad.

She said the Human Rights Tribunal doesn't hear many cases, and this complaint could be dismissed entirely, but her hope is it will lead to a meaningful conversation with CSC and improved access to treatment for inmates.

Follow Rafferty Baker on Twitter: @raffertybaker