Question Period Note: Harm Reduction in CSC's Institutions

Media is reporting on concerns raised by the Correctional Investigator pertaining to progress being made by the Correctional Service of Canada (CSC) to expand harm reduction services in Canada’s federal penitentiaries.

•Canadians across the country have been impacted by the tragic and ongoing opioids crisis, and those living within our federal institutions are no exception.
•One of the Correctional Service of Canada’s top priorities is ensuring that incarcerated offenders have access to quality, safe, patient-centred health care.
•To help save lives and prevent the spread of infectious diseases, over the last number of years, CSC has introduced a number of harm reduction measures to better support those living with problematic substance use challenges.
•This includes the Opioid Agonist Treatment, the expansion of the Prison Needle Exchange Program, and the establishment of the world’s only prison-based Overdose Prevention Service.
•Mental health and problematic substance use is first-and-foremost a health issue, and we continue to work to break down stigma, while providing effective and appropriate treatments.
•CSC’s provision of these services continued throughout the COVID-19 pandemic and efforts have resumed to continue the implementation of Prison Needle Exchange Program and Overdose Prevention Service at additional sites across the country.

Over the past decade, 46 inmates across Canada have died from suspected drug overdoses at federal institutions. Another 728 people have non-fatally overdosed between April 2011, and March 2022.

CSC's treatment and harm reduction initiatives include:
•Programs to address problematic substance use;
•Access to the Opioid Agonist Treatment (OAT) program;
•Access to Prison Needle Exchange Program (PNEP) and Overdose Prevention Service (OPS),
•Access to naloxone in living units;
•Self-Management and Recovery Training (SMART);
•Programming and trained peer support for inmates with opioid addictions;
•Referrals to community-based Narcotics Anonymous programs; and
•Access to take-home naloxone kits when released to the community.

To date, the Prison Needle Exchange Program (PNEP) has been implemented at nine federal institutions: Grand Valley Institution, Atlantic Institution, Fraser Valley Institution, Edmonton Institution for Women, Nova Institution, Joliette Institution, Joyceville Institution (minimum security), Mission Institution (medium security), and Dorchester Penitentiary.

Additionally, CSC implemented the Overdose Prevention Service (OPS) in June 2019 at Drumheller Institution, which is the only existing prison-based supervised consumption site known worldwide.

Warkworth Institution, Bowden Institution, Collins Bay Institution and Springhill Institution had been identified as potential sites for expansion of PNEP and OPS but further implementation of these program were impacted by the COVID-19 pandemic. CSC continued to provide PNEP and OPS throughout the COVID-19 pandemic and has since resumed work, including ongoing consultations, for implementation of PNEP and OPS at additional sites across the country.

Before an individual can participate in the PNEP program, CSC must complete a Threat Risk Assessment (TRA), to confirm that it is suitable to allow the individual to possess a needle, similar to the one currently being used for EpiPens and needles for insulin use.

CSC remains committed to the further implementation of both the PNEP and OPS across the country in comprehensive consultation with patients, employees and labour partners. To date, we have updated health promotion information for the PNEP and OPS and we have provided training to CSC health staff to increase understanding of substance use and stigma. By implementing multiple targeted initiatives to our inmate population to prevent and manage drug use, including opioid use, we have shown that we are committed to the individuals under our care.

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