Needle programs for prisoners increase safety

Drug use in jail is a reality and reducing harm is vital, say Richard Elliott and Rick Lines.

In December 2016, federal Health Minister Jane Philpott committed her government to a new national drug strategy that reinstates harm reduction as a non-negotiable pillar. It was a welcome announcement, signalling a modest shift away from the last decade’s emphasis on prohibition and punishment — policies that continue to kill people who use drugs in Canada.

This commitment to harm reduction and evidence-based responses to problematic drug use has come at a time of crisis, including a massive spike in opioid fatalities in Canada. To its credit, the federal government has taken a number of important steps, easing access to naloxone for reversing overdoses, and passing the “Good Samaritan” law removing the risk of prosecution for drug possession if someone calls for help in an emergency. The health minister has also approved several applications for safer injection sites, and she introduced Bill C-37, which would — if passed without some damaging amendments made by the Senate — make it much easier to open and operate these life-saving health services.

But as Canada hosts the 25th Harm Reduction International Conference May 14-17 in Montreal, the world is watching. Now is a good time to underscore that harm reduction must be reflected throughout Canadian policy, including in prisons.

Prisoners do not surrender their right to health services upon entering a corrections facility. Both federal and international human rights law mandate that such health services must be equivalent to those available outside prison. But Canada remains in ongoing breach of this obligation: if the government is serious about adopting an evidence-based response to

Almost one-third of federal prisoners reported using drugs during the past six months.

problematic drug use, and serious in its claim to respect Charter rights, then we must offer needle and syringe programs in prison.

Rates of HIV and hepatitis C (HCV) in prison are much higher than they are in the community at large.

Now consider the reality that drugs in prison, as in broader Canadian society, are a part of life. Almost one-third of federal prisoners reported using drugs during the past six months in prison, while 17 per cent of men and 14 per cent of women reported injecting drugs. Yet there is little or no access to sterile injection equipment in prisons; instead, makeshift “rigs” to inject are often shared among multiple people.

Just last month, Philpott again expressed her support for needle and syringe programs in prisons. When asked about such programs, the public safety minister has repeatedly stated he supports “evidence-based policies.”

Here’s the evidence: Since 1992, these programs have been introduced in 70 prisons in more than a dozen countries around the world. There has never been a single reported incident in which needles from such programs were used as weapons against staff or other prisoners, nor do studies of such programs indicate any increase in drug use.

Rather, these programs create a safer environment for both staff and prisoners by curbing the spread of HIV and HCV from non-sterile equipment, as well as reducing the current risk of accidental needle-stick injuries from concealed equipment.

Consider also the bigger picture: the majority of prisoners are later released, so prisoners’ health is a serious matter of public health. It is also important to note that First Nations, Inuit and Métis people are disproportionately incarcerated, and that unsafe drug injection plays a key role in fuelling the HIV and HCV epidemics affecting indigenous people.

Failing to provide prison-based needle and syringe programs does disproportionate harm to indigenous people.

Drug policy in Canada is at a critical juncture. As part of its stated commitment to harm reduction and evidence, the Canadian government must implement prison-based needle and syringe programs as soon as possible.