A new study on intravenous drug use in Canadian prisons argues that needle and equipment sharing is rampant among prisoners. And with needle-sharing being a primary contributor to increased rates of HIV and hepatitis C infections, the study calls for renewed support for government-run in-prison needle and syringe programs as a harm reduction strategy.
Drugs, of course, are illegal and contraband in Canadian prisons, yet inmates gain access to them nonetheless. Correctional Service Canada has stated that drug and alcohol abuse is a “major concern” in federal corrections. Almost 70 per cent of prisoners admitted are assessed as having a substance abuse problem and a 2007 inmate survey found that 17 per cent of men and 14 per cent of women admitted to using intravenous drugs while in federal prisons. A further 25 per cent of inmates stated that they are under pressure to participate in smuggling drugs into prison.
And while federal institutions do provide drug treatment programs and some harm-reduction services (such as bleach distribution for disinfecting used syringes), a key element has yet to be put in place, one which has been in use worldwide for over two decades: prison-based needle and syringe programs (PNSPs).
Studies have already shown the benefits of PNSPs. Providing sterile injection equipment, along with other supports, for prisoners who inject drugs means that they do not have to steal or create homemade injection equipment, which translates into lower rates of needle sharing, of abscesses and overdoses and decreased rates of in-prison HIV and hepatitis C infections. Nor have PNSPs been found to increase rates of drug use in prisons — in fact, declines have been associated with PNSP implementation.
Conducted by Emily van der Meulen of the Department of Criminology at Ryerson University in Toronto, the new study recruited 30 former prisoners from Ontario institutions with the help of community prisoner support agencies. Study participants revealed that while accessing drugs from within prison was not difficult, obtaining sterile and safe injection equipment was “relatively unheard of.”
Instead, the ex-prisoners divulged a variety of strategies they had witnessed, such as paying a fellow diabetic prisoner to use their syringes, stealing from nurses and prison health care staff and creating homemade needles and syringes from materials such as pens and coat hangers.
Sharing equipment was a given, too. One study participant stated, “Ten guys use the same needle, pretty much. …you gotta basically share a needle with everybody.”
The health impacts of such practices are readily evident, says van der Meulen. “Given the availability of drugs, the frequency of injection drug use, and the customary sharing of injection supplies, the resulting high rates of HIV and HCV in Canadian federal prisons are not surprising,” she says. “What is surprising, however, is the general lack of support from the prison service for harm reduction programs.”
Van der Meulen says that it’s time for Canadian corrections to adopt PNSPs so as to protect the “legal, ethical and moral right” of prisoners to adequate health care and related supports.
Last year, nearly 250 Canadian organizations involved in social service, HIV/AIDS, human rights and prisoner advocacy work signed a statement in support of PNSPs in Canada.