Case Report
Initiation of opiate addiction in a Canadian prison: a case report
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* Corresponding author: Evan Wood ewood@cfenet.ubc.ca
1 British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608 – 1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada
2 Department of Medicine, University of British Columbia, 950 West 10th Avenue, Vancouver, BC V5Z 4E3, Canada
3 Addiction Centre, University of Calgary, 6th Floor, North Tower, 1403 – 29 Street NW, Calgary AB T2N 2T9, Canada
Harm Reduction Journal 2006, 3:11 doi:10.1186/1477-7517-3-11
Published: 16 March 2006Abstract
Background
In North America, the harms of illicit drug use have been responded to primarily through law enforcement interventions. This strategy has resulted in record populations of addicted individuals being incarcerated in both Canada and the United States. The incarceration of non-violent drug offenders has become increasingly controversial as studies demonstrate the harms, including elevated HIV risk behavior, of incarcerating injection drug users. Other harms, such as the initiation of illicit drug use by prison inmates who previously did not use drugs, have been less commonly described.
Case Presentation
We report on the case of an individual who initiated non-injection opiate use in a Canadian prison and developed an addiction to the drug. Upon release into the community, the individual continued using opiates and sought treatment at a clinic. The patient feared that he might initiate injection use of opiates if his cravings could not be controlled. The patient was placed on methadone maintenance therapy.
Conclusion
While anecdotal reports indicate that initiation in prison of the use of addictive illicit substances is frequent, documentation through clinical experience is rare, and the public health implications of this behavior have not been given sufficient attention in the literature. Strategies of incarcerating non-violent drug offenders and attempting to keep illicit drugs out of prisons have not reduced the harms and costs of illicit drug use. Effective, practical alternatives are urgently needed; expanded community diversion programs for non-violent drug offenders deserve particular attention.