Evaluating the impact of pharmaceutical interventions to reduce overdose among people with criminal justice system involvement in British Columbia

People who have been incarcerated (i.e. in prison) are more likely to use illicit substances (e.g. heroin, methamphetamine) compared to the general population and are at higher risk of negative outcomes including overdose and more rapid and/or frequent return to prison. Efforts to address overdose, both in prisons and in the community, have been focused on treatment for people with opioid addiction, by prescribing medications that have been shown to help people to stop their illicit opioid use. This alone may not be sufficient to reduce illicit opioid use, particularly among people who also use other substances. In March 2020, in the context of COVID-19, British Columbia's Ministry of Health took a significant step to expand access to prescription medications for people with substance use disorders (i.e. drug addictions), by providing doctors with new guidelines and permissions for prescribing opioids, stimulants, benzodiazepines, and alcohol withdrawal management medications to people at risk of overdose. The goal of this study is to investigate whether these guidelines have been effective at reducing overdose and criminal justice system involvement. Provincial health and criminal justice system records will be examined to identify how many people with and without criminal justice system involvement have substance use disorder diagnoses (and which type of diagnosis) in British Columbia. Trends of overdose and criminal justice system involvement will be examined to identify changes since prescription medication programs were expanded. Findings will highlight gaps in substance use services in British Columbia, and will inform policies and programs that can reduce overdose in both criminal justice and community health systems.