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The danger beyond the prison gates
Ex-prisoners face a heightened risk of fatal overdose upon their release, and advocates say officials aren't doing enough to prevent it

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Saturday, December 1, 2018 – Page A15

In his short life, Scott Sirman caused a world of trouble for his mom, Karen Bell. He started stealing cars when he was in his teens. A drug user, he was in and out of jail in his 20s. The family had to move when they found out he was dealing methamphetamine from their house in Calgary. He told them: My suppliers are looking for me and they know where you live.

In spite of it all, mother and son were tight. Sometimes they played cards when he was around, usually poker or blackjack. They shared a taste for horror movies, especially the old slasher flicks like the "Freddy" series.

They had some epic blowouts, but she could never stay angry. "I called him my silver-tongued devil. No matter how mad I was at him he would turn it around."

When Mr. Sirman finished his most recent jail stint this past summer, Ms. Bell says her 27-yearold son wanted to stay clean and spend time with his two children, a boy and a girl. Instead, on Sept.

20, just four weeks after his release from a jail in Calgary, he got hold of some crystal meth and smoked it at a friend's place. The friend found him dead on the couch the next morning.

Police suspect the meth was laced with fentanyl, the synthetic opioid that has killed thousands in the past few years. An officer told Ms. Bell that after Mr. Sirman's time in prison, the drug probably hit his system like a brick.

Men and women just released from prison are especially vulnerable to drug overdose. The forced break from drug use while they are behind bars lowers their tolerance. Even if they found and used drugs in jail, the drugs they encounter afterward are often more potent. Advocates say prisoners are not getting the treatment and support they need to avoid a fatal overdose once they come out of the prison gates.

A study on overdose deaths in Ontario showed that, between 2006 and 2013, one in 10 happened within a year of release from a provincial jail. The deaths come especially thick in the days right after release, when many exprisoners struggle with the transition to life outside. Another Ontario study found that in the first two weeks after release, ex-prisoners face a death rate from overdose that is 56 times that of the general population.

They are dying at such a pace that authorities are studying their deaths in detail to find a way to turn the problem around. This fall, the coroners office of Ontario began looking case by case at the deaths of recently released prisoners. Most of them are men between the ages of 22 and 48. "We are just starting to drill down more deeply," Chief Coroner Dirk Huyer said.

In British Columbia, ground zero of the overdose crisis, the coroners service has been examining the problem, too. It says that based on figures from 2016 and 2017, about two-thirds of those who die of drug overdose have spent time in jail at some point in their lives or were under correctional supervision outside prison. Of the 1,233 fatalities in that category, 18 per cent, or 333, occurred within 30 days of release. Twenty-five percent, or 470, died within a year.

The revolving-door nature of the justice system means many go in and out, in and out, often spending just a few days or weeks behind bars. When they emerge, many are at loose ends and easily exploited.

You can see it happening in places such as Barrie, Ont., an hour's drive north of Toronto. The provincial prison at Penetanguishene delivers released prisoners to the Barrie bus station to catch a ride home. Many drift into the rough parts of downtown just around the station, where drugs are readily available and overdoses common.

Drug dealers sometimes approach them even as they stand in line to get a bus ticket.

Dr. Stephen Hwang of Toronto's St. Michael's Hospital says that often prisoners "just walk out the door and that's it, they're on their own. We should at least be giving them a chance to survive."

Many prisoners are thrown into drug withdrawal by brief stays in prison, emerging with an uncontrollable craving. Emergency doctor Aaron Orkin of Toronto's Mount Sinai Hospital says they are like men crawling across desert sands, finding an oasis and gulping from a dirty puddle. "It is as profound, if not more profound, than deep thirst." He says putting drug users in jail without access to the drug they need is the same as depriving a diabetic of insulin. He and many other health professionals argue that authorities should be helping addicted prisoners get on regulated substitute drugs and stay on them once they get out.

Some jurisdictions are waking up to the problem and following that advice.

Jails in Rhode Island have been screening inmates for opioid use and giving them ready access to substitutes. A recent study led by a Brown University professor suggested the approach is significantly reducing the death toll among released prisoners.

Prison officials in Ontario say they are helping inmates manage their withdrawal by getting on substitutes such as methadone or Suboxone, which tame drug cravings and withdrawal symptoms.

When "at-risk" inmates are released, they get naloxone kits and training about how to use the lifesaving, overdose-reversal drug.

All departing inmates are supposed to get a wallet card on how to avoid an opioid overdose.

But the families of victims say it is not nearly enough. Anne Keszely of Orillia, Ont., 90 minutes north of Toronto, lost her son Dorian to overdose last year. He got out of jail Sept. 28 and died on Oct. 4 after injecting cocaine in the washroom of a waterfront bar, Studabakers. He was 31. When police came to her door, she asked, "What has he done now?" assuming it was just another theft. They told her to sit down.

She says there is a lack of treatment programs or beds for people like her son, a "very bright, very funny" man who liked superloud techno music and the comedy of Russell Peters.

Another mother, Corinne Chapman, told a Toronto inquest this week that her son Bradley wanted to straighten out and find a place to live after a stint behind bars in 2015. He was released on a weekend with no phone and no bank account, and ended up living on the streets, as he had before. He was found collapsed in the doorway of a Toronto store.

He had been out of jail for two weeks.

Calgary's Karen Bell, mother of Scott Sirman, says her son needed help finding housing and coping with his depression and other mental-health issues. He should have gone straight into a treatment centre, but "they just let him go. He literally just got bailed out and they let him go," even though "the courts absolutely knew he was addicted."

Those like her son suffer from a double stigma: drug user and convict, she says. She wishes the world would learn to see them as human beings, with personalities and passions, such as a taste for scary movies.

Associated Graphic

Karen Bell, seen at her home in Calgary on Tuesday, lost her son Scott Sirman to a drug overdose in September.



This was the last time Mr. Sirman saw his daughter, Isabella, in February. Mr. Sirman died just four weeks after his release from jail.

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