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Date: April 30, 2024 Tue

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Results for in-custody deaths

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Author: McKendy, Laura

Title: Overdose Incidents in Federal Custody, 2012/2013 - 2016/2017

Summary: The rise of drug overdose incidents, specifically those involving opioids, is a growing concern for Canadian society (British Columbia Coroners Service Death Review Panel, 2018; Special Advisory Committee on the Epidemic of Opioid Overdoses, 2018; Health Canada, 2017). While numerous reports have documented trends in the community, limited detailed data is available on trends in overdose incidents among custodial populations. This report furthers knowledge on this topic by examining all overdose incidents in federal custody over a five-year period (2012/2013 - 2016/2017), identifying the prevalence and nature of overdose incidents, the circumstances under which overdose incidents occur, the characteristics of offenders who experience overdose incidents, and patterns in the nature of staff and medical responses. Over the five-year period under examination, 330 incidents were identified for analysis. Most of these overdose incidents were unintentional and non-fatal. More specifically, over three-quarters of cases (77%) were identified as unintentional non-fatal overdose incidents, 15% were intentional non-fatal overdose incidents, and 7% were identified as fatal overdose incidents, either intentional or non-intentional. Overdose incidents have seen a notable increase in the Prairie region; in 2016/2017, 48% (42) of all overdose incidents occurred in this region, compared to 20% (8) in 2012/2013. In terms of the substances involved in overdose incidents, differences were observed across incident types. Opioids were most common in fatal overdoses and unintentional non-fatal overdose incidents, accounting for 91% and 57% of incidents respectively. Contrastingly, intentional nonfatal overdose incidents seldom involved opioids and most often involved prescription medications (e.g., anticonvulsants, antidepressants, cardiovascular medications), identified in 85% of cases. Over the five-year period examined, overdose incidents involving opioids increased in raw numbers (from 19 in 2012/2013 to 50 in 2016/2017), with a moderate increase as a percentage of all overdose incidents (from 48% to 57%). Notably, the percentage of those involving fentanyl increased from 3% (1) in 2012/2013, to 26% (23) in 2016/2017. At the same time, the percentage of overdose incidents involving heroin decreased from 25% (10) in 2012/2013, to 13% (11) in 2016/2017. When it came to fatal overdose incidents, fentanyl was the most common substance found, noted in 36% (8) of cases across the five-year period. While variation exists, certain characteristics were common among offenders who overdosed. They tended to be male (92%), Caucasian (58%) or Indigenous (36%), aged 25-34 (39%), classified as medium security (72%), serving relatively short (under 4 year) sentences (41%), with a major index offence of robbery (31%). Offenders typically had institutional histories riddled with security and discipline incidents, particularly incidents involving drugs, other contraband (excluding tobacco), and disobedience. Indigenous offenders were involved in 119 (36%) of overdose incidents over the five-year period examined. Indigenous representation was highest in the Pacific region (46%) and was higher The rise of drug overdose incidents, specifically those involving opioids, is a growing concern for Canadian society (British Columbia Coroners Service Death Review Panel, 2018; Special Advisory Committee on the Epidemic of Opioid Overdoses, 2018; Health Canada, 2017). While numerous reports have documented trends in the community, limited detailed data is available on trends in overdose incidents among custodial populations. This report furthers knowledge on this topic by examining all overdose incidents in federal custody over a five-year period (2012/2013 - 2016/2017), identifying the prevalence and nature of overdose incidents, the circumstances under which overdose incidents occur, the characteristics of offenders who experience overdose incidents, and patterns in the nature of staff and medical responses. Over the five-year period under examination, 330 incidents were identified for analysis. Most of these overdose incidents were unintentional and non-fatal. More specifically, over three-quarters of cases (77%) were identified as unintentional non-fatal overdose incidents, 15% were intentional non-fatal overdose incidents, and 7% were identified as fatal overdose incidents, either intentional or non-intentional. Overdose incidents have seen a notable increase in the Prairie region; in 2016/2017, 48% (42) of all overdose incidents occurred in this region, compared to 20% (8) in 2012/2013. In terms of the substances involved in overdose incidents, differences were observed across incident types. Opioids were most common in fatal overdoses and unintentional non-fatal overdose incidents, accounting for 91% and 57% of incidents respectively. Contrastingly, intentional nonfatal overdose incidents seldom involved opioids and most often involved prescription medications (e.g., anticonvulsants, antidepressants, cardiovascular medications), identified in 85% of cases. Over the five-year period examined, overdose incidents involving opioids increased in raw numbers (from 19 in 2012/2013 to 50 in 2016/2017), with a moderate increase as a percentage of all overdose incidents (from 48% to 57%). Notably, the percentage of those involving fentanyl increased from 3% (1) in 2012/2013, to 26% (23) in 2016/2017. At the same time, the percentage of overdose incidents involving heroin decreased from 25% (10) in 2012/2013, to 13% (11) in 2016/2017. When it came to fatal overdose incidents, fentanyl was the most common substance found, noted in 36% (8) of cases across the five-year period. While variation exists, certain characteristics were common among offenders who overdosed. They tended to be male (92%), Caucasian (58%) or Indigenous (36%), aged 25-34 (39%), classified as medium security (72%), serving relatively short (under 4 year) sentences (41%), with a major index offence of robbery (31%). Offenders typically had institutional histories riddled with security and discipline incidents, particularly incidents involving drugs, other contraband (excluding tobacco), and disobedience. Indigenous offenders were involved in 119 (36%) of overdose incidents over the five-year period examined. Indigenous representation was highest in the Pacific region (46%) and was higher The rise of drug overdose incidents, specifically those involving opioids, is a growing concern for Canadian society (British Columbia Coroners Service Death Review Panel, 2018; Special Advisory Committee on the Epidemic of Opioid Overdoses, 2018; Health Canada, 2017). While numerous reports have documented trends in the community, limited detailed data is available on trends in overdose incidents among custodial populations. This report furthers knowledge on this topic by examining all overdose incidents in federal custody over a five-year period (2012/2013 - 2016/2017), identifying the prevalence and nature of overdose incidents, the circumstances under which overdose incidents occur, the characteristics of offenders who experience overdose incidents, and patterns in the nature of staff and medical responses. Over the five-year period under examination, 330 incidents were identified for analysis. Most of these overdose incidents were unintentional and non-fatal. More specifically, over three-quarters of cases (77%) were identified as unintentional non-fatal overdose incidents, 15% were intentional non-fatal overdose incidents, and 7% were identified as fatal overdose incidents, either intentional or non-intentional. Overdose incidents have seen a notable increase in the Prairie region; in 2016/2017, 48% (42) of all overdose incidents occurred in this region, compared to 20% (8) in 2012/2013. In terms of the substances involved in overdose incidents, differences were observed across incident types. Opioids were most common in fatal overdoses and unintentional non-fatal overdose incidents, accounting for 91% and 57% of incidents respectively. Contrastingly, intentional nonfatal overdose incidents seldom involved opioids and most often involved prescription medications (e.g., anticonvulsants, antidepressants, cardiovascular medications), identified in 85% of cases. Over the five-year period examined, overdose incidents involving opioids increased in raw numbers (from 19 in 2012/2013 to 50 in 2016/2017), with a moderate increase as a percentage of all overdose incidents (from 48% to 57%). Notably, the percentage of those involving fentanyl increased from 3% (1) in 2012/2013, to 26% (23) in 2016/2017. At the same time, the percentage of overdose incidents involving heroin decreased from 25% (10) in 2012/2013, to 13% (11) in 2016/2017. When it came to fatal overdose incidents, fentanyl was the most common substance found, noted in 36% (8) of cases across the five-year period. While variation exists, certain characteristics were common among offenders who overdosed. They tended to be male (92%), Caucasian (58%) or Indigenous (36%), aged 25-34 (39%), classified as medium security (72%), serving relatively short (under 4 year) sentences (41%), with a major index offence of robbery (31%). Offenders typically had institutional histories riddled with security and discipline incidents, particularly incidents involving drugs, other contraband (excluding tobacco), and disobedience. Indigenous offenders were involved in 119 (36%) of overdose incidents over the five-year period examined. Indigenous representation was highest in the Pacific region (46%) and was higher The rise of drug overdose incidents, specifically those involving opioids, is a growing concern for Canadian society (British Columbia Coroners Service Death Review Panel, 2018; Special Advisory Committee on the Epidemic of Opioid Overdoses, 2018; Health Canada, 2017). While numerous reports have documented trends in the community, limited detailed data is available on trends in overdose incidents among custodial populations. This report furthers knowledge on this topic by examining all overdose incidents in federal custody over a five-year period (2012/2013 - 2016/2017), identifying the prevalence and nature of overdose incidents, the circumstances under which overdose incidents occur, the characteristics of offenders who experience overdose incidents, and patterns in the nature of staff and medical responses. Over the five-year period under examination, 330 incidents were identified for analysis. Most of these overdose incidents were unintentional and non-fatal. More specifically, over three-quarters of cases (77%) were identified as unintentional non-fatal overdose incidents, 15% were intentional non-fatal overdose incidents, and 7% were identified as fatal overdose incidents, either intentional or non-intentional. Overdose incidents have seen a notable increase in the Prairie region; in 2016/2017, 48% (42) of all overdose incidents occurred in this region, compared to 20% (8) in 2012/2013. In terms of the substances involved in overdose incidents, differences were observed across incident types. Opioids were most common in fatal overdoses and unintentional non-fatal overdose incidents, accounting for 91% and 57% of incidents respectively. Contrastingly, intentional nonfatal overdose incidents seldom involved opioids and most often involved prescription medications (e.g., anticonvulsants, antidepressants, cardiovascular medications), identified in 85% of cases. Over the five-year period examined, overdose incidents involving opioids increased in raw numbers (from 19 in 2012/2013 to 50 in 2016/2017), with a moderate increase as a percentage of all overdose incidents (from 48% to 57%). Notably, the percentage of those involving fentanyl increased from 3% (1) in 2012/2013, to 26% (23) in 2016/2017. At the same time, the percentage of overdose incidents involving heroin decreased from 25% (10) in 2012/2013, to 13% (11) in 2016/2017. When it came to fatal overdose incidents, fentanyl was the most common substance found, noted in 36% (8) of cases across the five-year period. While variation exists, certain characteristics were common among offenders who overdosed. They tended to be male (92%), Caucasian (58%) or Indigenous (36%), aged 25-34 (39%), classified as medium security (72%), serving relatively short (under 4 year) sentences (41%), with a major index offence of robbery (31%). Offenders typically had institutional histories riddled with security and discipline incidents, particularly incidents involving drugs, other contraband (excluding tobacco), and disobedience. Indigenous offenders were involved in 119 (36%) of overdose incidents over the five-year period examined. Indigenous representation was highest in the Pacific region (46%) and was higher among women (52%) relative to men (35%). Overdose incidents involving Indigenous offenders were somewhat less likely to involve opioids compared to incidents involving non-Indigenous offenders (45% versus 56%). Over the five-year period examined, 21 overdose incidents occurred involving women; all were non-fatal and most (71%) were unintentional. Overdose incidents involving women typically involved prescription medications (86%), while none involved opioids. Overdose incidents involving women were most common in the Ontario and Pacific regions; nine incidents (43% of all cases) occurred in both of these regions. All women involved in overdose incidents had an identified mental health disorder, while 95% (20) had histories of substance abuse. Overall, overdose incidents tended to occur when offenders were well into their sentence. At the time of incident, offenders had served, on average, 41% of their current sentence, or an average of 4.9 years. The average length of time between the most recent admission date and incident date was 3.2 years. However, variation was observed across incident type; those involved in fatal incidents had served more time (7.8 years) and had been out of the community longer (4.5 years) compared to those involved in non-fatal incidents. In terms of potential risk factors, offenders involved in overdose incidents often had histories of substance misuse and mental illness. More specifically, 95% of offenders had issues related to drugs, while 54% had issues with alcohol. In 81% of cases, substance misuse was identified as a factor linked to criminal offending. Mental illness was particularly common among those involved in intentional non-fatal overdose incidents; 92% had at least one mental health disorder identified, while 89% had histories of self-injurious/suicidal behaviour. A disproportionate number of incidents occurred at a single medium security men's institution in the Prairie region, Drumheller Institution. An institutional-level analysis suggests that the experience of Drumheller is more closely tied to the opioid crisis in the community; over threequarters (77%) of overdose incidents at Drumheller Institution involved opioids, compared to 47% at all other institutions. Fentanyl was identified in 34% of overdose incidents at Drumheller, compared to 8% at all other institutions. Overall, the number of overdose incidents at Drumheller increased from five incidents in 2012/2013, to 25 in 2016/2017. Despite a higher number of overdose incidents, Drumheller had a smaller percentage of deaths (i.e. 2%) and much higher usage of naloxone. The medication, which can temporarily reverse an opioid overdose, was used in 91% of cases at Drumheller, compared to 34% at all other institutions. The findings outlined in this report suggest that the community opioid crisis may be paralleled in custodial settings. As this crisis continues to affect the federal offender population, CSC remains committed to efforts to curb prison drug use and reduce the likelihood of overdose incidents. The widespread availability of naloxone in institutions, as well as CSC's take-home naloxone kit program, Opioid Substitution Treatment (OST) program, substance misuse programs, and the Prison Needle Exchange Program (PNEP), constitute efforts to reduce the potential harms associated with drug use and improve offender health outcomes. This report will further assist in CSC's goal of achieving safe custodial environments by contributing to knowledge on recent trends surrounding fatal and non-fatal drug overdose incidents in custody.

Details: Ottawa: Correctional Service of Canada, 2018. 62p.

Source: Internet Resource: No. SR-28-02: Accessed April 2, 2019 at: https://www.csc-scc.gc.ca/research/092/sr-18-02-en.pdf

Year: 2019

Country: Canada

URL: https://www.csc-scc.gc.ca/research/092/sr-18-02-en.pdf

Shelf Number: 155268

Keywords:
Drug Abuse and Addiction
Drug Offenders
Drug Overdose
Drug-Related Deaths
In-Custody Deaths
Opioid Epidemic
Opioids
Prison Deaths