Seen from McIntyre Bluffs one February night, the Okanagan Correctional Centre is flooded with light, next to the darkness of empty land and the starlike twinkle of Oliver’s streetlights. Dustin Godfrey/Western News

okanagan incorrectional

In jail and in withdrawal: Inmates face long waits for opioid therapy in OCC

Provincial health body aims to erase waitlists in Okanagan’s jail, including for opioid replacement

While a nurse was taking an inmate’s blood pressure at the Okanagan Correctional Centre, the inmate grabbed a dose of methadone and ran away, according to a complaint filed by the nurse.

The Western News obtained the document as part of a freedom of information request for all staff and inmate complaints about OCC’s suboxone/methadone programs — often called opioid agonist therapy (OAT).

According to the complaint, staff attempted to grab onto the inmate as he ran away.

Related: Isolation likely factor in drugs, rule-breaking at Okanagan jail

The nurse and an officer present “yelled at the I/m (inmate) multiple times to return the bottle and (the inmate) responded by opening the bottle and drinking it,” the nurse wrote.

The inmate, who was not on the methadone program, reportedly sat down on a chair and waited for officers to arrive. Some of the methadone had spilled out of the bottle and some remained in the bottle afterward, staff wrote, noting concerns of an overdose.

“We take all incidents seriously and review our processes to see how we can improve,” the Provincial Health Services Authority said in a statement this week, noting “any opioid overdose is considered serious.”

Related: Correcting the Okanagan Correctional

It is not clear in the staff complaint why the inmate stole the methadone bottle.

When PHSA took over correctional health in October, they came with the intention of cutting down waitlists, including for OAT programs, which are intended to stave off withdrawal symptoms for those addicted to opioids.

Andrew MacFarlane, executive director of Correctional Health Services under the PHSA, acknowledged in a February interview the importance of the OAT system in an institution with high rates of opioid addictions.

At any given point, 30-35 per cent of the inmate population is on opioid replacements, but MacFarlane said the number of those addicted to opioids is likely higher than that.

Related: Remedying health care at Okanagan’s jail

MacFarlane said PHSA “inherited a really high-functioning system” from Chiron Health Services, the private body contracted to run health care in jails prior to Oct. 1, 2017.

“But we really thought we could get the waitlist down to zero,” MacFarlane said, noting PHSA has hired a number of new staff to help with all medical wait times at OCC.

For inmates seeking an opioid replacement who don’t come in on a Friday night or a weekend, “we’re going to be able to have no waitlist at all,” MacFarlane said.

While the goal is ambitious, it would not appear to have been achieved at this point, with only a moderate decrease in inmate complaints of wait times for the program.

Related: Ailing health care biggest hurdle for Okanagan jail

This year, PHSA received three written complaints regarding the program in April, six complaints in February and one complaint in January. Comparatively, in December last year the program received two complaints, with three complaints in November.

Okanagan Correctional: Suboxone/methadone complaints
Infogram

Of those complaints, most involved waiting days or weeks either to get into the OAT program or for altering their dosage.

“I am in active withdraw from heroin and I do not want to (go) back to using, and the only way to get s*** done is to freak out but I do not want to (go) back to (segregation),” one inmate wrote on Feb. 16.

“I spoke to the John Howard (Society) and they said I should (have) already been on the suboxone treatment by now, and I’ve been here for almost two weeks,” another inmate wrote on April 7.

Related: B.C.’s promising new jail grinds into motion

In February, two inmates wrote that they had been seeking increases to their methadone prescriptions, stating that they were still feeling the effects of opioid withdrawal.

“I am still having cold sweats at night, also still having trouble sleeping which is stressing me the f*** out because then I am tired all day,” one inmate wrote in February. “I don’t want to be tired because I want and mean to spend more time working on myself.”

Asked how wait times have improved since PHSA took over, the public health body said in an email statement this week, staffing at the jail has increased this year.

Between December last year and April this year, total health-care encounters increased by 72 per cent, according to PHSA figures.

Related: Okanagan Incorrectional: Dashboard

That, PHSA said, has translated into a greater volume of inmates being seen, from 2,237 total health care encounters for the final period of the 2017/18 fiscal year to 3,848 encounters in the first period of this fiscal year.

In another staff-reported incident, a member of staff found that the copies of a doctor’s order did not match what had been entered into the PHSA’s digital system, leading to a patient receiving 40-mg doses instead of 35 mg. The staff member in that complaint said there was not enough time in the mornings to compare doctors’ orders with what has been entered into the system.

In response to that incident, PHSA said a number of positions have been opened or filled to address the timing issues for staff, including two pharmacists and a pharmacy co-ordinator.

This article is a follow-up to our series Okanagan Incorrectional, which ran from March 30 to May 5 this year. Find our full series below.

Okanagan Incorrectional

Part 0: Okanagan Incorrectional: Dashboard
Part 1: B.C.’s promising, new jail grinds into motion
Part 2: ‘Honeymoon phase is over’ at Okanagan Correctional Centre
Part 3: OCC inmates face more violence than nearly any other jail
Part 4: Okanagan jail used solitary confinement as overflow: advocate
Part 5: Isolation likely factor in drugs, rule-breaking at Okanagan jail
Part 6: Ailing health care biggest hurdle for Okanagan jail
Part 6.5: Remedying health care at Okanagan’s jail
Part 7: Correcting the Okanagan Correctional
Column: When we fail inmates, we fail ourselves

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Dustin Godfrey | Reporter

@dustinrgodfrey

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