The Impact of Injectable Opioid Agonist Treatment (iOAT) on Involvement in Criminalized Activities: A Secondary Analysis from a Clinical Trial in Vancouver, BC

Abstract

Purpose

A significant portion of the economic consequences of untreated Opioid Use Disorder (OUD) relate to individuals’ involvement in the criminal justice system. The present study uncovers if treatment with iOAT is related to the number of criminal charges amongst participants, what type of crime participants were involved in, and the frequency with which participants were victims of crime. This study contributes to the body of research on the effectiveness of iOAT reducing criminal involvement.

Patients and Methods

This is a secondary analysis of police record data obtained from the Vancouver Police Department over a three-year period during the Study to Assess Longer-term Opioid Medication Effectiveness clinical trial. The data was obtained from participants (N = 192) enrolled in the trial through a release of information form.

Results

During the three-year period, most charges (45.6%) were property offences, and 25.5% of participants were victims of crime. Participants with no treatment prior to randomization into the SALOME trial were 2.61 (95% CI = 1.64–4.14) more likely to have been charged with a crime than during the iOAT state.

Conclusion

IOAT can reduce individuals’ involvement with the criminal justice system and is thus a crucial part of the continuum of care. Addiction should be conceptualized as a healthcare rather than criminal issue.

Keywords:

• heroin assisted treatment
• diacetylmorphine
• hydromorphone
• crime
• charges
• police

Acknowledgments

The authors respectfully acknowledge the unceded and traditional territory of the Coast Salish Peoples, including the traditional territories of xʷməθkwəýəm (Musqueam), Sḵwxw ú7mesh (Squamish), and Səlí̓ lwətaɬ (Tsleil-Waututh) Nations, upon which this research took place. We graciously thank all the SALOME participants, and the research and clinical teams.

Disclosure

Dr Martin Schechter reports grants from Canadian Institutes for Health Research during the conduct of the study. The authors report no other conflicts of interest in this work.

Additional information

Funding

SALOME was funded by an operating grant from the Canadian Institutes of Health Research [MCT-103817] in partnership with Providence Health Care and financing from the InnerChange Foundation, Providence Health Care Research Institute, St. Paul’s Hospital Foundation, and Vancouver Coastal Health. Additional financial support was provided by the Michael Smith Foundation for Health Research Career Award and the Canada Institutes of Health Research New Investigator Award (EOJ) and the Canada Research Chairs Program (MTS). The funding sources were not involved in any aspect of the study or manuscript. The SALOME trial received ethical approval from the University of British Columbia and Providence Healthcare research ethics boards, and all participants provided informed written consent.