Work is underway to establish a site where inmates can use drugs under medical supervision at a prison in Kingston, Ont.
Collins Bay Institution’s Overdose Prevention Service (OPS) will be the third of its kind in Canada and the first in Ontario.
The goal is to save lives, limit needle sharing and prevent the spread of infectious diseases, according to Correctional Service Canada (CSC).
The drugs consumed on site will be self-supplied, that is, substances that are smuggled.
A ‘moral dilemma’ for prison staff
It’s an approach that’s supported by harm reduction advocates and the Union of Canadian Correctional Officers (UCCO), but it also leaves correctional staff with the question of whether they’re tolerating illicit drug use behind bars.
“It’s almost a moral dilemma for us,” said Chris Bucholtz, regional president of UCCO in Ontario.
“We’re supposed to keep drugs away… but we’re giving them the place to do it.”
There is no clear timeline for when OPS will be operational in Collins Bay. Bucholtz said it was supposed to be operational this month, but was delayed.
“Planning and consultation” for the Kingston location is underway, according to a statement from CSC, along with renovations. The goal is to open the site “as soon as possible.”
There were 23 overdoses or suspected overdoses in Collins Bay during the 2022-2023 fiscal year and 17 so far this year, the correctional service added, crediting staff with the fact that none of the incidents were fatal.
No fatal overdoses after OPS sites open
CSC’s first OPS site opened in June 2019 at the Drumheller Institution in Alberta. As of February 2023, 68 inmates had been approved for use of the facilities and 1,732 visits had been recorded.
A second location opened last July at Springhill Institution in Nova Scotia.
The correctional service said there have been no fatal overdoses in any of the prisons since an OPS was established.
“Mental health and problematic substance use are, first and foremost, a health issue, and we continue to work to end the stigma while providing effective and appropriate treatments,” the CSC statement reads.
Bucholtz recently toured the site in Collins Bay and said it will be in the health care section of the prison and will include a couple of rooms to give inmates privacy while they consume.
The union leader said the program ensures that medical staff, not correctional officers, are available when drugs are used and there is a risk of overdose, which he believes will be safer for both staff and inmates.
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Bucholtz also said the union considers OPS to be “the lesser of two evils” compared to the prison needle exchange program, which is currently in place at nine CSC facilities.
Needles can be used as a weapon, he said, and those who use them are unsupervised while injecting drugs, increasing the risk of overdose.
Timing and supply concerns
The move shows a “kind of evolution” from prison leadership toward recognizing substance use as a health issue, said Sandra Ka Hon Chu, co-executive director of the HIV Legal Network.
That change now needs to reach staff as the number of overdoses rises, he added.
“In the context of OPS, I would say that they do not support drug use, but rather fight against overdoses,” Ka Hon Chu said.
One problem with the sites is that they are a physical location, which will only be accessible during certain hours. For example, the Drumheller site is open from 7 a.m. to 7 p.m. seven days a week, according to a FAQ page on the CSC website.
Ka Hon Chu said people don’t use drugs on a schedule, referencing a 2020 report by University of Ottawa researcher Lynne Leonard, which found there had been two non-fatal overdoses in Drumheller since OPS was created. .
One occurred in 2019 and involved an OPS participant, but occurred outside of the site’s operating hours, according to its site assessment.
The setup also raised confidentiality issues, Ka Hon Chu said, noting that a person accessing an OPS will inevitably be seen by non-medical personnel while walking.
“A lot of people won’t want to present themselves as someone who uses drugs,” he said, adding that’s why the HIV Legal Network believes both an OPS and a needle exchange program are necessary.
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In its statement, the correctional service said participants will not face problems for using OPS, but using illicit substances outside of it could result in disciplinary or criminal charges.
Another concern that Ka Hon Chu shared is the illicit source of the drugs to be consumed, considering the current supply of toxic drugs.
“Even with the supervision of medical staff, which is fantastic, people are at risk of overdose.”