Steve Pelland overdosed the morning after he was released from the Surrey pretrial centre. The public health emergency had just been declared and he remembered seeing a poster in the jail warning about fentanyl.
“I thought, you know, it’s not gonna affect me, I’ve never overdosed,” he said. “But sure enough, I took one hit of this stuff and it knocked me out.
“They had to ‘Narcan’ me six times to bring me back.”
The period of time following release from jail is especially high risk for overdose, even more so for people with substance-use disorders.
A new study from the sa国际传媒 Centre for Disease Control and sa国际传媒 Mental Health and Substance Abuse Services quantifies just how much higher that risk is.
It found that people with both opioid- and stimulant-use disorder diagnoses were more than twice as likely to overdose following a release from jail than others.
The study also found that the more often someone entered custody, the more likely they were to overdose upon release.
“Our research has shown that when people get out they are at a seriously increased risk of having an overdose because their tolerance has been diminished,” said Amanda Slaunwhite, a senior scientist with sa国际传媒 CDC.
“They’re detoxing while they’re in custody, and then their tolerance for the fentanyl in the illicit drug supply is diminished,” Slaunwhite said.
The findings suggest that more needs to be done to meet the needs of people with substance-use disorders who come into contact with the criminal justice system, according to the report, which highlighted the “urgent need to scale up access to interventions to reduce overdoses.”
“That period of release back to the community is an especially high-risk period,” said Heather Palis, a post-doctoral fellow at UBC and lead author of the study.
“If we’re not doing anything to make sure that the intervention that might have been started in prison has continued, then people are at risk,” she said.
Pelland, who is now a peer support worker with Mental Health and Substance Use Services, agreed the transition back into the community is an important period.
“It’s time when there’s an opportunity to carry a message to people and to help them get better,” he said. “But at a minimum, we can keep them safe.”
He’s part of a recently expanded program of community transition teams that support people upon release from sa国际传媒’s 10 provincial jails. The teams consist of social workers, nurses, peer support workers and Indigenous patient navigators. Teams work with clients to create a release plan that can include help finding housing, connecting them to substance-use treatment, getting prescriptions filled or simply giving them rides.
Palis said it is important to have peer workers with shared experiences, noting they can often build trusting relationships that aren’t possible with someone who hasn’t lived through such experiences.
“That can bring people to care who otherwise would not come to health care,” she said.
Pelland said the intervention work he does isn’t necessarily complicated. Sometimes it’s as simple as a ride or a coffee.
“My role is to provide peer support and that’s kind of my advantage over the clinicians because I was a client of the program myself,” he said. “I know what it feels like.”
“It was really huge just to have people walk beside me and to be willing to physically pick me up, take me to where I needed to go and continue to engage with me,” Pelland said of his time as a community transition team client.
“They did it in a way that was respectful and I just felt accepted and I felt like they were just doing it because they cared about me and that’s what I needed,” he said.
