ArticleInternational journal of prison health2025
Overall and substance use-specific healthcare utilization among individuals with and without criminal justice involvement in Ontario, Canada.
Article in International journal of prison health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeCorrectional populations have higher rates of substance use disorders and related healthcare visits relative to the general population. However, limited evidence on substance use-related healthcare visits exists among this population. Using population data for Ontario, Canada, this study aims to examine overall and substance use-specific healthcare visits for individuals with and without known provincial criminal justice system involvement (CJI versus non-CJI, respectively). DESIGN/METHODOLOGY/APPROACH: This retrospective study compared overall and substance use-related healthcare visits between April 1, 2015 and March 31, 2020 among provincially-incarcerated individuals (CJI group) versus those without criminal justice involvement (non-CJI group). Both groups were identified through available health administrative data and were individually matched by age, sex and material deprivation.
findingsThe authors identified and matched 208,188 individuals (59.9% male) with and without CJI and a healthcare visit. Compared to the non-CJI group, those with CJI had approximately 20 times the rate of healthcare visits for alcohol use, drug use and illicit drug-related overdoses. Among those with CJI, females had a higher prevalence of overall healthcare visits, whereas males had a higher prevalence of substance use-specific visits. RESEARCH LIMITATIONS/IMPLICATIONS: Findings highlight the high number of healthcare visits for substance use-related needs among individuals with CJI in Ontario. These results can inform efforts to enhance correctional release planning, improve access to community-based treatment and strengthen substance use prevention and treatment interventions for this high-risk population. PRACTICAL IMPLICATIONS: Results can inform efforts to enhance correctional release planning, improve access to community-based treatment, and strengthen substance use prevention and treatment interventions for this high-risk population. ORIGINALITY/VALUE: To the best of the authors' knowledge, this study is the first in Canada to draw on population-level administrative health data to identify and match a large sample of individuals with and without CJI and examine substance use-specific healthcare utilization, longitudinally.
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