» Applying therapeutic guidelines for acute
substance withdrawal.

Because of risk and liability, a needle exchange
program was not recommended. Although
some recommendations were only partially
implemented, improvements were still
achieved.

The committee discovered that the availability
of bleach varied across correctional centres.
Access and distribution of bleach was
subsequently improved. Similar policies with
respect to condoms and bleach were
implemented in youth custody facilities, after
consultation with the ministries of Health and
Social Services.

The report also called for security measures,
including:

» Anti-drug initiatives relating to visits;

» Drug detection dogs;

« Internal preventive security officers TPSO) at
all institutions;
» Security screening during the selection of

employees, contractors and volunteers in
contact with inmates;

» Effective inter-agency collaboration; and

a Severe sanctions for inmates found in
possession of illicit drugs.

As soon as Branch physicians were trained and
licensed for prescribing methadone, the
availability of methadone to inmates followed.
While the committee continued to meet
occasionally and provide updates to the
Assistant Deputy Minister about harm
reduction initiatives, the committee was
disbanded in 2001.

Methadone therapy policy

Prior to 1992, the Branch expected inmates on
methadone maintenance programs to withdraw
from methadone when they entered custody. In
1992, after becoming aware of the danger of
miscarriage if methadone was terminated, the
Branch allowed methadone maintenance
therapy for incarcerated pregnant women.

Medical literature suggested that persons with
AIDS, cardiac illness and hepatitis might also
be adversely affected if methadone was
withdrawn. In May 1996, the Branch allowed
methadone in cases when, in the opinion of the
centre’s physician, withdrawal would have
adverse affects. The policy of methadone
maintenance was expanded in September 1996
to include inmates were who were on a
recognized methadone maintenance program in
the community.

Following senior management’s endorsement
of the harm reduction committee
recommendations, the Branch reviewed
whether an inmate in custody could start a
methadone maintenance program. By 2000,
methadone induction was prescribed for
selected cases in most cotrectional centres,
provided resources were available.

A generally positive effect was noted for
inmates who continued established methadone
maintenance programs after admission.
According to Dr. Rothon, it “greatly reduced
drug withdrawal, drug seeking, treatment
compliance problems and needle use in jail.””°

26 Dr. Diane A. Rothon, “Update on Harm Reduction Strategies in B.C. Corrections,” British Columbia Ministry
of Attorney General, Corrections Branch, Health Services, 2000.

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