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. 2022 Dec;17(1):2094111.
doi: 10.1080/17482631.2022.2094111.

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

Cayley Russell  1 , Michelle Pang  1 , Frishta Nafeh  1 , Shanna Farrell Macdonald  2 , Dena Derkzen  2 , Jürgen Rehm  1   3   4   5   6   7   8 , Benedikt Fischer  3   9   10   11
Affiliations

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

Cayley Russell et al. Int J Qual Stud Health Well-being. 2022 Dec.

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.

Keywords: Addiction; Canada; community release; corrections; opioid agonist treatment; opioid use disorder; parole; prison; re-incarceration; re-integration; substance use.

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Conflict of interest statement

No potential conflict of interest was reported by the author(s).

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