Theme: Models of Care Year: 2024
Background: Drug poisoning (overdose) is the leading cause of death among persons leaving incarceration in British Columbia (BC) Canada. Persons who have been incarcerated are 3.5 times more likely to have a drug poisoning death in BC compared to persons who have not been incarcerated with most events occurring in the first two weeks post-release. In the context of the ongoing toxic drug crisis and continued stigma towards persons who have been incarcerated, a peer-led program was developed to support persons at-risk of overdose who were being released from incarceration which included cellular phones, care bundles, peer support, and harm reduction supplies.
Methods: Between February and August 2023, 120 men and women being released from provincial correctional centres were recruited through Unlocking the Gates (UTG) Society and enrolled in the PREVAIL project where they received peer support, a cellular phone with text, talk and data, harm reduction supplies, a care bundle, and First Nations medicines. Surveys and interviews were completed by peer mentors at UTG on the day of release and the two months following to evaluate the impact of the intervention and better understand the trajectories of substance use and overdose post-release, including access and uptake of prescribed safer supply and opioid agonist treatments.
Results: Among the 120 participants, 78% were male and with an average age of 37 years. Participants spent an average of 8 years in custody in their lifetime, and 78% were on parole/probation at enrollment. At baseline, 70% of participants had one or more overdose in their lifetime, and of these, 25% reported 5-10 overdoses and 14% reported 11+ overdoses in their lifetime. An estimated 96% of participants reported that they would recommend UTG to others, and that UTG staff had assisted them with meeting critical needs, such as transportation (50%), probation/parole (41%), clothing (24%), and mental health/substance use (19%). Over 70% of participants used their cellular phones daily, and they were commonly reported to be used by participants to increase social connectedness and to help stay busy, provide daily support, and facilitate communication with employers, housing, and substance use treatment services.
Conclusion: Peer-led programs in combination with technological, harm reduction, and basic necessities of daily life are important to strengthening the continuum of care for people leaving incarceration who are at disproportionate risk of overdose death.