Barriers and facilitators to opioid agonist treatment (OAT) engagement among individuals released from federal incarceration into the community in Ontario, Canada

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Cayley Russell - , University of Toronto (Author)
  • Michelle Pang - , University of Toronto (Author)
  • Frishta Nafeh - , University of Toronto (Author)
  • Shanna Farrell Macdonald - , Correctional Service of Canada (Author)
  • Dena Derkzen - , Correctional Service of Canada (Author)
  • Jürgen Rehm - , Chair of Behavioral Epidemiology, University of Toronto, TUD Dresden University of Technology, Sechenov First Moscow State Medical University (Author)
  • Benedikt Fischer - , University of Toronto, Simon Fraser University, The University of Auckland, Federal University of São Paulo (Author)

Abstract

Introduction: Correctional populations with opioid use disorder experience increased health risks during community transition periods. Opioid Agonist Treatment (OAT) can reduce these risks, but retention is a key challenge. This study addresses a knowledge gap by describing facilitators and barriers to OAT engagement among federal correctional populations released into the community in Ontario, Canada. Methods: This article describes results from a longitudinal mixed-methods study examining OAT transition experiences among thirty-five individuals released from federal incarceration in Ontario, Canada. Assessments were completed within one year of participants’ release. Data were thematically analyzed. Results: The majority (77%) of participants remained engaged in OAT, however, 69% had their release suspended and 49% returned to custody. Key facilitators for OAT engagement included flexibility, positive staff rapport, and structure. Fragmented OAT transitions, financial OAT coverage, balancing reintegration requirements, logistical challenges, and inaccessibility of ‘take-home’ OAT medications were common barriers. Conclusions: Post-incarceration transition periods are critical for OAT retention, yet individuals in Ontario experience barriers to OAT engagement that contribute to treatment disruptions and related risks such as relapse and/or re-incarceration. Additional measures to support community OAT transitions are required, including improved discharge planning, amendments to OAT and financial coverage policies, and an expansion of OAT options.

Details

Original languageEnglish
Article number2094111
JournalInternational Journal of Qualitative Studies on Health and Well-being
Volume17
Issue number1
Publication statusPublished - Dec 2022
Peer-reviewedYes

External IDs

PubMed 35787743

Keywords

Sustainable Development Goals

Keywords

  • Addiction, Canada, community release, corrections, opioid agonist treatment, opioid use disorder, parole, prison, re-incarceration, re-integration, substance use