Jail forces inmates off methadone

The Whitehorse Correctional Centre is denying some inmates their prescription drugs. As of March 2012, the jail no longer had staff qualified to administer methadone.

The Whitehorse Correctional Centre is denying some inmates their prescription drugs.

As of March 2012, the jail no longer had staff qualified to administer methadone.

Because of this, anyone on methadone when they are admitted is being taken off of it and put into a medical detox program.

Dr. Rao Tadepalli, president of the Yukon Medical Association, called the practice “inhumane.”

Some of the symptoms of withdrawal include high heart rate, restlessness, pacing like a caged animal, excessive sweating, vomiting, increasing rage, confusion, anxiety, dehydration, self-harm behaviour, and decreased appetite, he said.

Justice Minister Mike Nixon said the medical detox program is an appropriate alternative to methadone treatment.

The detox involves taking patients through withdrawal under medical supervision, and some drugs can be administered to ease the symptoms.

“Dr. Tadepalli is free to provide his thoughts on this, but we’re running a correctional centre up there,” said Nixon. “We use a detox model that is humane.”

Methadone is typically used to treat individuals who are addicted to opiates like heroin and morphine, but it can also be used to treat chronic pain.

Under the right dosage, it does not produce a narcotic effect, but allows the individual to avoid symptoms of withdrawal from opiate drugs, according to a research report prepared by the Correctional Service of Canada.

According to Health Canada’s best practices document for methadone, keeping patients on methadone should be the goal of treatment, not getting them off of it.

“Rather than emphasizing abstinence from all drugs – including eventual tapering from methadone – as the primary goal of treatment, methadone maintenance programs should focus instead on maintaining clients/patients on methadone for as long as they continue to benefit from treatment,” the document states.

Patricia Bacon, executive director of Blood Ties Four Directions Centre, said forcing people off of methadone will create a revolving door of people in and out of jail.

“They’re going to get out of jail, and they’re going to probably run across the things that had triggered their addictions to begin with, and then, what are they going to do? You’re setting them up for a very good likelihood that they’re going to want to acquire the opiate drug again. And then they may engage in acquisition crime to get the money to get the drug, and then when you commit crimes, you wind up in jail.”

She also called the practice of forcing people off methadone “inhumane.”

“If somebody was HIV positive, and they became incarcerated, we would give them their meds. If they’re on methadone, why aren’t we giving them their meds? It is the same. It’s their medication. We are denying them access to their medication.”

A number of reports prepared for the Correctional Service of Canada indicate that inmates on methadone do better than those with opiate addictions but not on methadone, especially if treatment and counselling is continued following release.

Methadone is available in federal prisons across the country, both to people coming in on the treatment and those wishing to start after being admitted.

According to a 2011 report prepared for the Canadian Executive Council for Addictions, almost all of the provinces will administer methadone when inmates come in on the treatment.

The only exception is Quebec, and in that case the report does not specify if the treatment would or would not be continued.

A spokesperson for Ontario’s ministry of correctional services this week told the News that treatment decisions are between doctors and patients, and methadone is treated like any other medication.

A spokesperson for the N.W.T. Department of Justice said that it has never had an inmate come in on methadone, but if that were to occur, the jail would support that treatment.

Yukon had a methadone program between 2008 and 2012, said Dan Cable, spokesperson for Justice.

Only five individuals used the program during that time, he said.

The decision to switch to a medical detox model was made in consultation with medical staff at the institution, said Minister Nixon.

Now, the institution does not have staff qualified to administer methadone, he said. And there are other complications and safety concerns, said Nixon.

“It’s a health and safety issue on the floor, where the inmates are living. It becomes a currency, it puts a lot of pressure under the other inmates to bring the methadone back onto the floor and use it for other purposes rather than the detox.”

Methadone is taken orally in solution, like a drink of water. This can be done under supervision, but the fear is that someone could later attempt to vomit and retrieve the substance.

Since the methadone program has been cancelled, an average of three individuals per year have arrived at the correctional centre already on methadone, wrote Cable in an email.

“Of these clients, the institutional physician reported that all of the cases she has seen are poly-substance abusers and therefore are not following the program as they should. In short, the inmates in the jail, as a rule, are not compliant individuals in adhering to the (methadone) program and therefore from a risk perspective are not suitable for continuing in a methadone program.”

Yukon’s methadone program is administered out of the River Valley Medical Clinic in Whitehorse.

Doctors and nurses require special training and accreditation to participate in the program.

None of the medical professionals involved responded to requests for comment.

There were approximately 32 patients in 2011, according to the Canadian Executive Council on Addictions report.

“Methadone treatment works,” said Bacon with Blood Ties. “We have a good methadone program. It’s not perfect, but overall we have a good methadone program, we have people who are using the methadone program and it’s saving their lives. And it’s making a difference, not just keeping them alive, but it’s making a difference in terms of the quality of that life and what it means for them having a life where they have stability. They’re not constantly worrying about where their next fix is going to come from.”

Contact Jacqueline Ronson at