More than 50 per cent of people in prison are estimated to be affected by problematic substance use — yet prison authorities across the country are increasingly restricting access to a key, evidence-based treatment option, resulting in a dramatic drop in people receiving this care.

Opioid Agonist Treatment (OAT) is a medication used to treat opioid use disorder. It provides a stable, regulated dose that aims to prevent withdrawal and reduce cravings. Decades of research have shown that people receiving OAT experience substantially lower rates of fatal drug toxicity and other health complications.

But for it to properly work, OAT must be low barrier, compassionate and individualized. In general, methadone, buprenorphine/naloxone (Suboxone) and injectable buprenorphine (Sublocade) are all considered first-line OAT options. They are not interchangeable. Abrupt discontinuation increases the risk of overdose, and changes in treatment require careful clinical oversight to avoid destabilization and other harms.