Stimulant use disorder diagnosis and opioid agonist treatment dispensation following release from prison: a cohort study

Stimulant use disorder (StUD) diagnoses are linked to reduced access to opioid agonist treatment (OAT) right after prison release, especially for people who also have mental illness. A BC cohort study used linked health and corrections records for 13,380 prison releases between January 1, 2015 and December 29, 2018 to examine whether having StUD affects whether people receive OAT within two days after release. About 25% of releases resulted in OAT dispensation within that two day window. In adjusted analyses, the relationship between StUD and OAT dispensation depended on mental illness status: with mental illness present, StUD was associated with lower odds of obtaining OAT (OR 0.73, 95% CI 0.64-0.84). Without mental illness, the association was not evident. The study concludes that treatment and harm reduction services need scaling and adaptation to reach people facing concurrent StUD and mental illness upon release.