Prisoners struggling with opiate addictions in British Columbia jails have gained the same right to medical treatment as people outside the corrections system.
B.C. Corrections has implemented a new policy after four men who alleged they were denied opiate replacement therapy launched a charter challenge last month.
The men, who are addicted to opiates and range in age from their 20s to late 40s, are now under the care of doctors after a settlement that will also give other prisoners access to timely therapy.
"We know, regrettably, there are drugs in provincial and federal institutions," their lawyer Adrienne Smith said Friday. "The fentanyl epidemic doesn't stop at the prison gate."
"This is a step in the right direction to keep people well, particularly when they're at a good place being able to ask for medical support."
The new policy comes as the province's medical health officer Dr. Perry Kendall declared Thursday that B.C. is facing a public health emergency involving overdoses involving drugs such as the opioid-based pain killer fentanyl.
Dr. M-J Milloy, of the B.C. Centre for Excellence in HIV/AIDS, said that under Canadian law, health care must be equivalent for people inside and outside corrections facilities.
"Anything that moves us closer to that being the reality ... is a good thing," said the infectious-disease epidemiologist.
Opioid addicts who have been released from prison are at greater risk of suffering a fatal overdose, Milloy said. A Washington state-based study in The New England Journal of Medicine found opioid dependent people were 12 times more likely to face that risk in the two weeks following release, he said.
B.C. Corrections' current policy follows the same guidelines for administering suboxone or methadone treatment to opioid addicts as set out by the College of Physicians and Surgeons of B.C.
That means any addicted prisoner seeking help can request therapy during an appointment with a jail doctor.
Suboxone, which is now listed in the policy as the first line of treatment for prisoners, can be dissolved under the tongue in tablet form. Methadone is administered as a liquid that's usually mixed with orange juice.
An application for injunction and notice of civil claim was filed on March 18 as the four prisoners sought therapeutic prescriptions but alleged they were repeatedly told they were required to be in custody for at least three months before being eligible for treatment.
B.C. Corrections spokeswoman Cindy Rose said in a statement that methadone has been available in jails since 2002 and Suboxone since 2010.
Rose declined to dicuss the process leading to the settlement or the terms, and said B.C. Corrections was working on updating the opiate addiction treatment policy before the prisoners' legal challenge.
"B.C. Corrections will continue to offer treatment in conjunction with substance abuse management programs," she said, adding that the department is pleased that the matter has been settled.
B.C.'s Ministry of Public Safety has said there is no minimum time or length of custodial sentence to start treatment but did not explain why the four prisoners were refused therapy.
The ministry did not immediately respond to a request for comment on Friday.
Milloy said there is evidence that opioid-addictions therapy not only prevents overdoses, but protects against HIV infections and helps people living with HIV stay on their drugs.
"There's an awful lot of benefits tied up into one relatively inexpensive medication," he said.
One of Smith's clients, Shawn Gillam, overdosed on illicit drugs at North Fraser Pretrial Centre in Port Coquitlam after repeatedly being refused treatment, according to his affidavit.
"There are lots of drugs in this jail," he said. "I've seen MDMA, acid, heroin, cocaine and oxys. I don't want to overdose again."
Smith said 33-year-old Gillam "will be safer now."