“…Nine percent of men and 16% of women in federal correctional institutions reported injecting opioids in the six months prior to incarceration (Zakaria et al, 2010) and similarly, in provincial correctional settings, 7.5% reported using heroin and 35.3% reported using other opioids in the year prior to incarceration (Kouyoumdjian et al, 2014). It is well documented that illicit opioid use persists in correctional facilities (Small, 2005; Wood et al, 2006a), with 10–20% of incarcerated persons testing positive for opioids on random urine drug screening (Kendall and Pearce, 2000). Release from correctional settings has been associated with an increased risk of overdose death in multiple settings (Binswanger et al, 2013; Binswanger et al, 2007; Bird and Hutchinson, 2003; Farrell and Marsden, 2008; Groot et al, 2016; Kouyoumdjian et al, 2016) presumably due to involuntary detoxification of opioid-dependent clients while incarcerated and resultant loss of tolerance (Binswanger et al, 2012; Strang et al, 2003; Tagliaro et al, 1998).…”