Prison needle programs touted to reduce HIV and Hep C

“There’s lots of research to demonstrate how effective they are, and this (new report) is meant to show that they can be effective in Canada as well,” said Sandra Ka Hon Chu, director of research and advocacy for the Canadian HIV/AIDS Legal Network, who contributed to the report.

“We involved a broad range of stakeholders, including former prisoners and people who work in prison health care, to demonstrate how it might actually work.”

Researchers held a conference with experts, interviewed health workers, inmates and prison workers, and pored over existing studies to draft a series of recommendations for a future safe injection regime in Canadian jails. These include ensuring prisoners can easily access sterile needles and syringes in a way that’s confidential and devoid of disciplinary consequences.

It also argues prisoners should have access to drug education and addiction support from trained personnel, and that the justice system should generally move away from treating drug use as a crime and look at it as a health and social issue.

Critics of the programs have argued they could lead to increased drug use, or that prisoners could use syringes as weapons. The report counters that several studies — including reports from federal government agencies — found no evidence that prison needle programs lead to more drug use, and that there are no reported cases of needles being used as weapons from 60 existing clean-needles programs in prisons in other countries.

Seth Clarke, one of the report authors from the Prisoners with HIV/AIDS Support Action Network (PASAN), said that, assuming efforts to rid jails of drugs will never be entirely successful, safe-injection programs could mitigate the spread of HIV and hepatitis C by removing incentives to share and reuse needles, while also reducing prison health care costs.

“No drugs in prison is an aspirational goal that isn’t really achievable,” said Clarke, pointing out that the federal government also concluded this in a 2012 report on the “alarming” drug use in its jails.

The prevalence of HIV in prisons is roughly 10 times higher than in the general population, and it costs about $30,000 per year to treat an infected prisoner, the report says. According to a 2010 study cited in the report, 14 per cent of women and 17 per cent of men admitted to injecting drugs while in prison. A 2014 report estimated that 80 per cent of men entering federal prisons were identified as having substance abuse problems.

There’s also a human rights element to the report’s argument — the authors contend prisoners are entitled to receive comparable levels of health care as people living outside jails.

PASAN researcher Annika Ollner said there’s optimism that the previous government’s tough-minded approach to drugs in prison — which included $120 million for Corrections Canada’s anti-drug strategy in 2008 — will now give way to more support for harm-reduction strategies and the Liberals’ repeated promise to make “evidence-based” decisions.

The research, Ollner said, is already there. Their report points out that a 1999 study by Corrections Canada that reviewed international experiences with safe-injection programs in jails found they are “effective and well-proven,” and a 2006 study from the Public Health Agency of Canada found that they decrease needle sharing, lead to more drug treatment referrals and reduce the number of prison overdoses and deaths.

“We’re hopeful that this will move forward,” Ollner said.

A spokesperson for federal Health Minister Jane Philpott directed questions about safe injection programs in prisons to the public safety ministry, where spokesperson Scott Bardsley said the department couldn’t comment because of an ongoing legal challenge for prisoner access to clean needles that was launched in 2012.

Bardsley added, however, that “it is important to note that the government is committed to implementing evidence-based policy,” and that the department is mandated to address gaps in service for indigenous people and those with mental illnesses in the criminal justice system.

Lauren Callighen, press secretary to Ontario’s corrections minister, Yasir Naqvi, said the province already offers methodone and other treatments to inmates with drug dependency issues, and works to ensure those in prison have access to the same health care as everyone else. “We look forward to reviewing this report and specific recommendations,” she said.