Expansion of prison needle exchange programs going ahead despite pandemic delays

Despite pandemic slowdowns, Correctional Service Canada is still planning to expand the needle exchange programs currently offered at nine federal prisons, government officials say.

At a presentation given to the International AIDS Conference in Montreal on Friday, Henry de Souza, the agency’s director general of clinical services and public health, said “a number of institutions” have been identified for an expansion, and the program will continue to be implemented across the country.

Inmates have been able to request sterile equipment for drug use at two Canadian prisons since 2018, and another seven were added in 2019. Some advocates have expressed fears the program, which is designed to reduce needle sharing and the spread of infectious disease, could be cancelled after numbers showed a low uptake.

Only 53 inmates were actively using the programs in mid-June, officials told the AIDS conference Friday night, out of 277 who had been approved to participate over the last four years.

These programs are in addition to the country’s only prison-based “overdose prevention service,” which began operating in 2019 at the men’s mediumsecurity Drumheller Institution in Alberta. It is essentially a supervised injection site, offering sterile equipment and consumption under observation.

Since the site opened, there have been 55 participants, 1,591 visits and zero overdoses at the site, officials told the conference. The correctional service says it also offers mental health counselling, access to naloxone to counter opioid overdose effects and preventive treatments, such as pre-exposure prophylaxis — medicine taken to prevent getting HIV.

All of these efforts have led to a decrease in infections, said Marie-Pierre Gendron, an epidemiologist at Correctional Service Canada. She said HIV infection among inmates nationally is down from 2.02 per cent of the prison population in 2007 to 0.93 per cent in 2020; and hepatitis C is down from 21 per cent in 2010 to 3.2 per cent in 2021.

Lynne Leonard, a University of Ottawa associate professor who was contracted by the agency to evaluate the programs, said during a Tuesday morning panel that both programs have had “significant beneficial outcomes” for inmates, and she saw “eventual successful institutional adoption” despite initial pushback from staff.

Preliminary results from her study found that the program seemed to lead to a significant decrease in HIV infections at the institutions that put it into place. Overdoses at Drumheller were down more than 50 per cent overall since its supervised consumption site opened.

“I’m encouraged by the way they’re describing the program as something they’re proud of,” said Sandra Ka Hon Chu, co-executive director of the HIV Legal Network.