With long-term success in mind, the primary goal of Canada’s Drug Strategy with respect to MMT programs in federal prisons “is to reduce the harm associated with injection drug use, including outbreaks of HIV and overdose deaths” (NIDA 1999:6). Notwithstanding the fact that this and comparable policies have played a leading role “in the use and expansion of [federal MMT programs], cost factors also have played an important role. Authoritative studies have demonstrated that methadone-maintenance is cost effective” (Stoller and Bigelow 1999). Accordingly, the balance of this article will explore the cost/benefit ratio of MMT programs, with specific reference to the expansion of existing programs in Canadian federal prisons.

COST/BENEFIT RATIO OF MMT IN FEDERAL PRISONS IN CANADA

Denying Methadone Maintenance Therapy in Prison: A Case Study

To properly determine if there is a positive cost/benefit ratio to expanding MMT in federal prisons in Canada, it is perhaps helpful to consider the consequences of denying such treatment. Following is a discussion regarding one federal inmate who was denied access to MMT.

Prior to his admission to prison, Jason Pothier had never used heroin and only became addicted to the drug while incarcerated. Through injecting himself with heroin using dirty needles, Mr. Pothier contracted both HIV and Hepatitis C in the federal penitentiary in which he has been housed for the last five years. He had repeatedly asked to receive MMT before he contracted HIV, “but was refused because he was not eligible for methadone under CSC’s policy guidelines [Phase I]: he had not been treated with methadone outside the prison system and was deemed not to be a serious enough user of heroin.” (Jürgens 2002:39)

Mr. Pothier commenced legal action against CSC in 2001, alleging that CSC must be held responsible for his contraction of HIV, its failure to provide him with MMT prior to his infection and its denial of sterile injection equipment (Kloeze 2002). In support of his allegations, Mr. Pothier is specifically relying on section 86 of the CCRA (see above).

In particular, “Mr. Pothier argues that CSC:

• acted negligently because the health care he received while in prison did not meet acceptable standards of care;
• owed him a fiduciary duty to ensure his safety and well-being, and breached this duty (CSC has a special responsibility to ensure that inmates are receiving necessary health care, since they clearly cannot provide for their own health care); and
• infringed his rights under the Charter (sections 7, 12, and 15) (Jürgens 2002:40).

Now 25 years of age, Mr. Pothier, whose lawsuit still remains before the Ontario Superior Court of Justice, is seeking both monetary compensation for the serious loss of health he has suffered, as well as institutional change with respect to the manner in which inmates with HIV are treated during incarceration (Kloeze 2002).