A drag that can lead to the black market

2024-04-10 09:00:00

“That fucks my whole journey. Instead of helping me, it harms me,” says Steve Brisebois, who has been going back and forth between prison and the street since 2017. Suffering from chronic pain since a fall of around forty feet that occurred 15 years ago , he obtained prescriptions for opiates “to be able to function,” he summarizes. “If I don’t have painkillers, I’m not able to walk in the morning. »

Published yesterday at 5:00 a.m.

Zoé Arcand Special collaboration

During Steve Brisebois’ last visit to the Saint-Jérôme Provincial Detention Facility (EDSJ), the infirmary staff allegedly changed his medication, suspecting an allergic reaction. From a cocktail of fentanyl, oxycodone and codeine, in particular, he moved to hydromorphone, a synthetic derivative of morphine. “They gave me a big cleaning,” says Steve.

But everything has changed since his return to freedom last September: no general practitioner, nurse practitioner or pharmacist wanted to renew this long-term prescription.

For three months, I went to the emergency room to get my opiates refilled because I didn’t have a doctor and there, I was stuck on the street.

Steve Brisebois, ex-inmate

Sometimes unable to get his hands on his painkillers, Steve says he was forced to self-medicate by obtaining them on the black market.

A recurrent issue

Steve is not the only one to suffer from gaps in the continuity of health care upon release from prison. The issue is giving a hard time to an organization in the region and its users experiencing residential instability, like Éric Grégoire and Alain Laliberté, who have similar stories.


Alain Laliberté

They too regularly go from the street to prison. When they left the EDSJ this winter, a few weeks apart, neither had any medication. “It happens all the time,” laments the first, who reportedly spent several days without antiplatelets, prescribed in detention after he suffered a heart attack there.

The second must take antidepressants, which he always ends up getting his hands on outside the prison walls, he assures. That said, he spends several days without having access to it when his prescription is renewed during his stay in prison, specifies Rachel Lapierre, president of the Humanitarian Book and nurse.


Rachel Lapierre, president of the Humanitarian Book and nurse

If the prison prescribed it, it stays at the prison. It’s like it’s a country within a country.

Rachel Lapierre, president of the Le Book Humanitarian organization and nurse

“It’s not just the people who stay in Saint-Jérôme who have a problem, it’s all those who go through the prison [de Saint-Jérôme] », Worries Rachel Lapierre, who has seen the problem growing for three years.

“It very often happens that someone coming out of detention spends several days in their community without having their medication,” confirms the general director of the Association of Social Rehabilitation Services of Quebec (ASRSQ), David Henri.

Health professionals sometimes renew the prescriptions of ex-inmates at very short notice, “to help out,” explains Rachel Lapierre. The ex-inmates concerned must continually restart their efforts to get their hands on their medication while they find themselves in “a disturbed mental state” and in withdrawal, saddens Mr. Henri.

Several ex-inmates thus find themselves on the street, wandering around the city or leaving it, underlines Ms. Lapierre. They are not always able to cope with the delays between their release from prison and obtaining their medication.

Ex-inmates therefore often fall back on emergencies, “whose mandate is not to assess an emergency situation without having a file,” laments the addiction expert, researcher at the CHUM and professor in the department of medicine. of family and emergency from the University of Montreal Julie Bruneau.

People brought to justice – often stigmatized – find themselves “in a system where they do not have access to the first line”, she criticizes. And this, although they have the same right to health care as the rest of the population.

All this occurs in the context of a homelessness crisis that persists in the Saint-Jérôme region, where homeless people are victims of a serious lack of services and systemic and organizational mistreatment, according to a report from the Center assistance and support for complaints (CAAP) in the Laurentians, which local radio CIME reported last September.

At that time, Saint-Jérôme only had six emergency beds, while the Humanitarian Book counted around a hundred people experiencing residential instability in this Laurentian town. Since 2022, the camps there have been systematically dismantled. The Montreal Traveling Justice Clinic recently filed a complaint against the City of Saint-Jérôme to contest these dismantlings which, according to it, contravene the fundamental rights of the homeless, who find themselves without an alternative solution.

An obstacle to rehabilitation

The health as well as the path towards rehabilitation of those mainly concerned is at stake, explains Mr. Henri, also a criminologist.

During this time, they are not looking for housing, they are not looking for a job and above all, during this time, the temptation to self-medicate can be great.

David Henri, general director of the Association of Social Rehabilitation Services of Quebec (ASRSQ)

And it is not without risk to venture into the black market with the opioid crisis wreaking havoc across the country. In 2023, in the MRC de la Rivière-du-Nord, where Saint-Jérôme is located, 4.77% of deaths have the “probable cause” of an overdose, compared to 3.7% in 2019.


When they cannot get their hands on their medication, ex-prisoners turn to the black market.

David Henri is convinced that the issue weighs on the health system and on the shoulders of groups helping ex-prisoners. Community partners are “essential allies to Correctional Services in the supervision and monitoring of offenders,” assures the Ministry of Public Security (MSP).

“There are prisons and penitentiaries that do better jobs than others,” believes Julie Bruneau, emphasizing that not all prison establishments manage releases in the same way.

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