In Canada, methadone is a controlled substance which means that its use is governed by the Controlled Drugs and Substances Act (CDSA). As such, Health Canada applies strict rules and guidelines to its use in each of the territories and provinces, except in British Columbia and Ontario where such rules and guidelines are applied through their respective Colleges of Physicians & Surgeons and Colleges of Pharmacy (NIDA 1999). Importantly, and with respect to the criminal justice system, the Correctional Service Canada (CSC) is legally obligated to ensure that these rules and guidelines are followed within its institutions. More specifically, CSC must adhere to the provisions of the CDSA with respect to accessing, dispensing, recording, storing, handling and distributing methadone from pharmacies to institutions to prisoners (CSC 1998b).

In addition, operations at CSC are governed by the xCorrections and Conditional Release Act (CCRA) with relevant policies being sections 70, 86 and 87. These sections read as follows:

 

70

The Service shall take all reasonable steps to ensure that penitentiaries, the penitentiary environment, the living and working conditions of inmates and the working conditions of staff members are safe, healthful and free of practices that undermine a person’s sense of personal dignity.

1992, c. 20, s. 70; 1995, c. 42, s. 17(F).

 

86.(1)

The Service shall provide every inmate with

  1. essential health care; and
  2. reasonable access to non-essential mental health care that will contribute to the inmate’s rehabilitation and successful reintegration into the community.
 

(2) 

The provision of health care under subsection (1) shall conform to professionally accepted standards.
 

87

87. The Service shall take into consideration an prisoner’s state of health and health care needs

  1. in all decisions affecting the prisoner, including decisions relating to placement, transfer, administrative segregation and disciplinary matters; and
  2. in the preparation of the prisoner for release and the supervision of the prisoner.

Further to CSC’s statutory obligations, the National Institute on Drug Abuse (1999) points out that:

While the CCRA does not directly identify any specific therapeutic treatment, MMT is a clinically accepted treatment towards effective management of opiate addiction that contributes to the health and safety of prisoners, staff and the public. CSC should consider the obligations set forth by the CCRA when evaluating inmates for methadone maintenance treatment (p. 6).

In fact, CSC’s statutory obligations have become even more significant as MMT has taken on an expanded role due to the proliferation of HIV, AIDS and Hepatitis C. Since methadone is orally ingested, IDU’s who are treated with methadone are able to significantly reduce or eliminate entirely the injection of illicit substances. As inmates often use “dirty” injection equipment, the provision of MMT in prison fosters a marked decrease in the spread of HIV, AIDS and Hepatitis C among inmates. In fact, “there is ample data supporting methadone as an effective measure in reducing high risk injecting behaviour and thereby reducing the risk of transmission of blood-borne pathogens,” such as HIV, AIDS and Hepatitis C (NIDA 1999:6).

On December 1, 1997 the Solicitor General of Canada announced that a National MMT program would be implemented in all federal institutions as a proactive step to prevent HIV, AIDS and Hepatitis C from spreading among incarcerated inmates (CSC 1998a). CSC’s MMT program has been implemented in two phases, with the first phase commencing in January 1998 (CSC 2001) and the second phase commencing in May 2002 (CSC 2002).