{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T22:13:43Z","timestamp":1793744023346,"version":"4.6.1"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T00:00:00Z","timestamp":1775692800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T00:00:00Z","timestamp":1775692800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["FRN-193303"],"award-info":[{"award-number":["FRN-193303"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Can J Public Health"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Correctional Service Canada (CSC) recently revised its opioid agonist treatment (OAT) policy, designating extended-release injectable buprenorphine (XR-BUP; Sublocade) as the first-line treatment for opioid use disorder (OUD) in Canadian federal corrections. Methadone is now a second-line option, and buprenorphine\/naloxone is no longer available, raising concerns regarding access, clinical autonomy, and equivalence of care. CSC cited clinical evidence suggesting advantages of XR-BUP, including reduced diversion, simplified dosing, and superior efficacy. One of the primary sources referenced for the policy revisions was a systematic review examining the feasibility and effectiveness of XR-BUP among correctional populations. Here, we clarify the findings and limitations of this\u00a0review, and examine key implications of CSC\u2019s policy revision. While available evidence suggests that XR-BUP is a beneficial OAT option for incarcerated individuals, the literature remains preliminary, heterogeneous, and methodologically limited. It currently does not robustly support the use of XR-BUP as an exclusive replacement for established first-line OAT options. Restricting access to evidence-based OAT options among correctional populations risks undermining patient-centered care, continuity of treatment, and alignment with general clinical guidelines. Ideally, XR-BUP should be offered as a valuable addition, while preserving access to the full range of evidence-based OAT options.<\/jats:p>","DOI":"10.17269\/s41997-026-01186-x","type":"journal-article","created":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T13:58:13Z","timestamp":1775743093000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Clarifying the evidence and implications of prioritizing extended-release buprenorphine for opioid agonist treatment in Canada\u2019s federal correctional system"],"prefix":"10.17269","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9634-9554","authenticated-orcid":false,"given":"Cayley","family":"Russell","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tony P.","family":"George","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nitin","family":"Chopra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernard","family":"Le Foll","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flora I.","family":"Matheson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gillian","family":"Kolla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Wyman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedikt","family":"Fischer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikki","family":"Bozinoff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00fcrgen","family":"Rehm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shannon","family":"Lange","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,9]]},"reference":[{"key":"1186_CR1","unstructured":"BCCSU. (2022). Opioid use disorder: Practice update. https:\/\/www.bccsu.ca\/wp-content\/uploads\/2022\/02\/Opioid-Use-Disorder-Practice-Update-February-2022.pdf.\u00a0Accessed 15 Dec 2025"},{"issue":"10438","key":"1186_CR2","doi-asserted-by":"publisher","first-page":"1779","DOI":"10.1016\/S0140-6736(24)00344-1","volume":"403","author":"R Borschmann","year":"2024","unstructured":"Borschmann, R., Keen, C., Spittal, M. J., Preen, D., Pirkis, J., Larney, S., Rosen, D. L., M\u00f8ller, L., O\u2019Moore, E., Altice, F. L., Andrews, J. R., Binswanger, I. A., Bukten, A., Butler, T., Chang, Z., Chen, C.-Y., Clausen, T., Christensen, P. B., Culbert, G. J., \u2026 Young, J. T. (2024). Rates and causes of death after release from incarceration among 1 471 526 people in eight high-income and middle-income countries: An individual participant data meta-analysis. Lancet (London, England), 403(10438), 1779\u20131788.","journal-title":"Lancet (London, England)"},{"issue":"5","key":"1186_CR3","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2023-071867","volume":"13","author":"A Butler","year":"2023","unstructured":"Butler, A., Croxford, R., Bodkin, C., Akbari, H., Bayoumi, A. M., Bondy, S. J., Guenter, D., McLeod, K. E., Gomes, T., Kiefer, L. A., Orkin, A. M., Owusu-Bempah, A., Regenstreif, L., Kouyoumdjian, F., & Kanagalingam, T. (2023). Burden of opioid toxicity death in the fentanyl-dominant era for people who experience incarceration in Ontario, Canada, 2015\u20132020: A whole population retrospective cohort study. BMJ Open, 13(5), Article e071867.","journal-title":"BMJ Open"},{"key":"1186_CR4","unstructured":"CSC. (2024). Opioid Agonist Treatment: March 2024. Retrieved 28\/04\/2024 from https:\/\/www.canada.ca\/en\/correctional-service\/programs\/offenders\/health-services\/opioid-agonist-treatment\/2024-03.html#4.\u00a0Accessed 15 Dec 2025"},{"key":"1186_CR5","unstructured":"CSC. (2025a). Interim guidance on opioid use disorder program: Medication. https:\/\/drugdatadecoded.ca\/content\/files\/2025\/12\/01-Sublocade-Interim-Guidance.pdf.\u00a0Accessed 15 Dec 2025"},{"key":"1186_CR6","unstructured":"CSC. (2025b). Personal Communication; Meeting with HIV Legal Network and Prisoners' Legal Service"},{"key":"1186_CR7","unstructured":"Department of Justice Canada. (2023). Parliamentary committee notes: Overrepresentation of Indigenous offenders. https:\/\/www.publicsafety.gc.ca\/cnt\/trnsprnc\/brfng-mtrls\/prlmntry-bndrs\/20230720\/12-en.aspx.\u00a0Accessed 15 Dec 2025"},{"key":"1186_CR8","unstructured":"Keeler, A. (2025). This opioid addiction medication saves lives. So why has uptake been so slow?. Canadian Affairs. https:\/\/www.canadianaffairs.news\/2025\/03\/10\/opioid-addiction-medication-saves-lives-so-why-has-uptake-been-slow\/.\u00a0Accessed 15 Dec 2025"},{"key":"1186_CR9","unstructured":"Indivior UK Limited. (2025). Product monograph; patient medication information for SUBLOCADE\u00ae buprenorphine solution (extended-release) for injection (extended-release); . https:\/\/pdf.hres.ca\/dpd_pm\/00082639.PDF.\u00a0Accessed 15 Dec 2025"},{"key":"1186_CR10","unstructured":"META:PHI. (2025). Methadone as opioid agonist therapy: Guidance for prescribers. www.metaphi.ca\/wp-content\/uploads\/MethadoneGuidance.pdf .\u00a0Accessed 15 Dec 2025"},{"key":"1186_CR11","doi-asserted-by":"publisher","DOI":"10.1080\/00952990.2024.2360984","author":"C Russell","year":"2024","unstructured":"Russell, C., George, T. P., Chopra, N., Le Foll, B., Matheson, F. I., Rehm, J., & Lange, S. (2024). Feasibility and effectiveness of extended-release buprenorphine (XR-BUP) among correctional populations: A systematic review. American Journal of Drug and Alcohol Abuse. https:\/\/doi.org\/10.1080\/00952990.2024.2360984","journal-title":"American Journal of Drug and Alcohol Abuse"},{"issue":"1","key":"1186_CR12","doi-asserted-by":"publisher","DOI":"10.1080\/17482631.2022.2094111","volume":"17","author":"C Russell","year":"2022","unstructured":"Russell, C., Pang, M., Nafeh, F., Farrell Macdonald, S., Derkzen, D., Rehm, J., & Fischer, B. (2022). Barriers and facilitators to opioid agonist treatment (OAT) engagement among individuals released from federal incarceration into the community in Ontario, Canada. International Journal of Qualitative Studies on Health and Well-Being, 17(1), Article 2094111. https:\/\/doi.org\/10.1080\/17482631.2022.2094111","journal-title":"International Journal of Qualitative Studies on Health and Well-Being"},{"key":"1186_CR13","unstructured":"SAMHSA. (2021). Treatment improvement protocol 63: Medications for opioid use disorder. https:\/\/store.samhsa.gov\/sites\/default\/files\/SAMHSA_Digital_Download\/PEP21-02-01-002.pdf.\u00a0Accessed 15 Dec 2025"},{"key":"1186_CR14","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2021.0976","author":"T Santo","year":"2021","unstructured":"Santo, T., Clark, B., Hickman, M., Grebely, J., Campbell, G., Sordo, L., Chen, A., Tran, L. T., Bharat, C., Cousins, G., Dupouy, J., Kelty, E., Muga, R., Nosyk, B., Min, J., Pavarin, R., Farrell, M., Degenhardt, L., & Padmanathan, P. (2021). Association of opioid agonist treatment with all-cause mortality and specific causes of death among people with opioid dependence: A systematic review and meta-analysis. JAMA Psychiatry. https:\/\/doi.org\/10.1001\/jamapsychiatry.2021.0976","journal-title":"JAMA Psychiatry"},{"issue":"10","key":"1186_CR15","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2025.37319","volume":"8","author":"R Shiwach","year":"2025","unstructured":"Shiwach, R., Le Foll, B., Alho, H., Dunn, K. E., Strafford, S., Zhao, Y., & Dobbins, R. L. (2025). Rapid vs standard induction to injectable extended-release buprenorphine: A randomized clinical trial. JAMA Network Open, 8(10), Article e2537319. https:\/\/doi.org\/10.1001\/jamanetworkopen.2025.37319","journal-title":"JAMA Network Open"},{"issue":"9","key":"1186_CR16","doi-asserted-by":"publisher","first-page":"543","DOI":"10.5498\/wjp.v11.i9.543","volume":"11","author":"M Soyka","year":"2021","unstructured":"Soyka, M., & Franke, A. G. (2021). Recent advances in the treatment of opioid use disorders-focus on long-acting buprenorphine formulations. World Journal of Psychiatry, 11(9), 543\u2013552. https:\/\/doi.org\/10.5498\/wjp.v11.i9.543","journal-title":"World Journal of Psychiatry"},{"key":"1186_CR17","unstructured":"The College of Physicians and Surgeons of Manitoba. (2023). Manitoba opioid agonist treatment reccomended practice manual: Recommendations for sublocade and considerations for informed consent.\u00a0https:\/\/www.chrome-extension:\/\/efaidnbmnnnibpcajpcglclefindmkaj\/cpsm.mb.ca\/assets\/PrescribingPracticesProgram\/Buprenorphine%20Specific%20Guidance%20-%20Recommendations%20for%20Sublocade%20&%20Considerations%20for%20Informed%20Consent.pdf.\u00a0Accessed 15 Dec 2025"},{"issue":"5","key":"1186_CR18","doi-asserted-by":"publisher","first-page":"835","DOI":"10.1111\/add.16766","volume":"120","author":"A Woods","year":"2025","unstructured":"Woods, A., Foley, C., Conigrave, K. M., Asare-Doku, W., Shakeshaft, A., Settumba-Stolk, S., Farrell, M., & Doyle, M. (2025). Extended-release pharmacotherapies for substance use disorders in incarcerated populations: A systematic review. Addiction, 120(5), 835\u2013859. https:\/\/doi.org\/10.1111\/add.16766","journal-title":"Addiction"},{"issue":"38","key":"1186_CR19","doi-asserted-by":"publisher","first-page":"E1280","DOI":"10.1503\/cmaj.241173","volume":"196","author":"I Yakovenko","year":"2024","unstructured":"Yakovenko, I., Mukaneza, Y., Germ\u00e9, K., Belliveau, J., Fraleigh, R., Bach, P., Poulin, G., Selby, P., Goyer, M. \u00c8., Brothers, T. D., Rehm, J., Hodgins, D. C., Stewart, S. H., Wood, E., Bruneau, J., Canadian Research Initiative in Substance Matters guideline development team, Canadian Research Initiative in Substance Matters (CRISM). (2024). Management of opioid use disorder: 2024 update to the national clinical practice guideline. CMAJ\u202f: Canadian Medical Association Journal, 196(38), E1280\u2013E1290.","journal-title":"CMAJ : Canadian Medical Association Journal"}],"container-title":["Canadian Journal of Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.17269\/s41997-026-01186-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.17269\/s41997-026-01186-x","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.17269\/s41997-026-01186-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T13:58:16Z","timestamp":1775743096000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.17269\/s41997-026-01186-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,9]]},"references-count":19,"alternative-id":["1186"],"URL":"https:\/\/doi.org\/10.17269\/s41997-026-01186-x","relation":{},"ISSN":["0008-4263","1920-7476"],"issn-type":[{"value":"0008-4263","type":"print"},{"value":"1920-7476","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,9]]},"assertion":[{"value":"14 January 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 March 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 April 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this paper. Le Foll has obtained funding from Indivior for a clinical trial sponsored by Indivior. He was part of the Steering Board for a clinical trial for Indivior. He will be receiving funding for a clinical trial sponsored by Lilly, and has received in-kind donations of placebo edibles from Indiva. He is a consultant for Shinogi, ThirdBridge, Guidepoint, and Changemark. He is part of a scientific advisory board for NFL Biosciences. Fischer has received various grant-\/contract-based research supports on topics of substance use epidemiology, interventions, and policy from public funding and government agencies (i.e., public-only sources)\u00a0in the past three years. He is the PI of a CSC-funded research MOU\/project on drug use\u2013related overdose in corrections (administered by the University of the Fraser Valley)\u00a0that is un-related to the present publication.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The views and perspectives presented in this Commentary are those of the authors only, and do not represent those of the organizations that employ or fund\/support them or their research.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclaimer"}}]}}