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Opioid agonist therapy teams give incarcerated clients hope

“I love it here,” says Letitia Trevelyan, a nurse who works with incarcerated clients at the Prince George Regional Correctional Centre. “It’s like a big family.”
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​Tish Trevelyan is an opioid agonist therapy nurse at the Prince George Regional Correctional Centre.

​Letitia, or Tish, has worked in corrections for more than eight years, and it has become her unexpected dream job. She loves the opportunity to be part of lasting change with her patients. “It’s not like in a hospital where you see them for a day and then move on,” she says. 

Early this year, Tish was waiting in line to buy groceries when she heard a familiar voice behind her say hello. She turned to see the smiling face of a former client, and she immediately returned his friendly grin. “Wow! How are you?” 

The former client excitedly introduced Tish to his girlfriend and told her all about his new job — and about his sobriety. It was something he attributed to completing a drug treatment program with Tish while he was incarcerated at the correctional centre.

Tish is part of a team that supports clients who are on opioid agonist therapy, which uses medication-assisted treatments such as Suboxone and methadone to treat substance-use disorders. It can stabilize people who live with opioid addiction, reduce their reliance on opioids, and help them sustain their recovery.

The client had wanted to quit the program more than once, but Tish persuaded him to keep going. 

“He was so thankful, and so eager,” Tish recalls. “It was amazing to see how excited he was — and he hasn’t been back in here since.”

Stories like this client’s help Tish through some of the more challenging days, she says. 

“I like being able to help the clientele who are vulnerable and who need it more…They do struggle with things. They’ve had a harder upbringing. Some really want to make changes in their lives, but when they’re out in the general public, they don’t know how to get there. So in here, we’re able to help them.”

The Provincial Health Services Authority assumed responsibility for health care in B.C. correctional centres in 2017, expanding access to OAT and implementing a big-picture approach to helping people who use substances — a large part of B.C.’s incarcerated population. In addition to providing opioid agonist therapy, Tish and her colleagues work to help make sure clients can stay on treatment after going home. 

Nurses help clients connect with community health-care services upon their release. Additionally, a doctor at the centre’s OAT clinic writes a prescription for up to two weeks of Suboxone or methadone — long enough to last until the client can see a doctor on the outside. 

As a backup, if a client is released on short notice, staff can provide a brochure with all the information clients need to find a doctor who can help them stay on OAT — and on the road to recovery.

OAT services are offered at all of B.C.’s correctional facilities, and roughly a third of all incarcerated clients across the province participate. Clients who enter the facility while on OAT continue on their treatment without interruption, and there is no waiting list for clients who want to begin. 

Clients at risk of experiencing or witnessing an overdose after their release also receive Take Home Naloxone kits and training so they can reverse an overdose if they need to. The kits, provided by the BC Centre for Disease Control, include ampules of naloxone, a drug that reverses the effects of an opioid overdose, as well as syringes for administering it.

To date, Tish has given out about 400 Take Home Naloxone kits, and she has heard many stories about them saving lives. “It’s a good feeling,” she says.

Andrew MacFarlane, the provincial executive director of Correctional Health Services, has been working with clients with complex mental health and substance-use issues for his entire career. He believes health care team members like Tish are heroes.

“I have no doubt that the work our team does every day saves lives,” he says. “Not just because OAT helps prevent overdose in the correctional centres — but because getting people the treatment they need while they’re with us and a connection to the medical system upon their release makes a world of difference. Our clients have faced multiple challenges. If we can set them up to stay healthy, they’re less likely to repeat the decisions that brought them to us — and more likely to go on to participate in their communities.”

addiction; BC Mental Health & Substance Use Services; overdose; Substance use
SOURCE: Opioid agonist therapy teams give incarcerated clients hope ( )
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