Pubdate: Sat, 30 Oct 2004
Source: Ottawa Citizen (CN ON)
Copyright: 2004 The Ottawa Citizen
Bookmark: (Harm Reduction)
Bookmark: (Hepatitis)
Bookmark: (Incarceration)


Canadian prisons might help reduce the spread of HIV and other
blood-borne diseases with a needle-exchange program for inmates, but
at too great a cost to the country's corrections policy.

On Wednesday, both the Ontario Medical Association and the Canadian
HIV-AIDS Legal Network called for Corrections Canada and other
authorities to start letting incarcerated drug users exchange dirty
needles for clean ones. While the OMA acknowledges that HIV is not
known to be an epidemic among prisoners, it cites correctional-service
figures that 1.8 per cent of 12,755 federal prisoners were known to
have the virus in 2001, more than double the rate among non-imprisoned
Canadians. Hepatitis C is vastly more common, with an estimated 23.5
per cent of prisoners having the liver disease, a rate that is 29
times that of the population at large. The doctors' association cites
several correctional-service studies that say injection-drug use is
on the rise in Canadian prisons. Its most recent figures are that 20
to 25 per cent of prisoners reported injecting drugs while doing time.

Sharing needles to inject drugs is a common enough practice on the
outside, and it's no leap to assume it's even more common in prisons
and jails. And, of course, the spread of disease from using dirty
needles can affect those who don't use illegal drugs -- including
inmates and guards.

The Citizen has argued both for the legalization of drugs (for people
who can use them without harming others) and for the distribution of
clean drug-use equipment to addicts as a public-health measure.
Prisons are different, however. Most inmates are there because they
have shown themselves incapable of behaving with due respect for the
safety or property of others, and in many cases drug use has
contributed to their problems.

What neither the OMA nor the legal-advocacy group presents is any
evidence about what impact a needle-exchange program might have on the
government's ability rehabilitate offenders. The law-advocacy group
belittles the idea that "providing bleach or sterile needles to
prisoners is seen to be condoning or promoting behaviour that the
prison should be seeking to eradicate as part of the individual's
'rehabilitation.' " But a prison that's supposed to rehabilitate
people who have problems with drugs simply cannot turn a blind eye if
those people continue to use them. If drug use is rampant in prisons,
this is an obvious failure of enforcement by Corrections Canada.

There is, however, valuable insight in the two groups' reports. They
point out, for example, that treatment for drug users is lacking in
many prisons. While methadone programs wouldn't help all drug addicts,
it's bizarre that they're available to very few prisoners, and often
limited to those on methadone before they were sent to prison.

Reducing the spread of HIV, hepatitis C and other diseases is a worthy
goal to which the federal and provincial governments should pay more
attention. They must not, however, abandon their responsibility to
help problem drug-users who are in prison. Supplying them with
needles, instead of doing more to stop their access to drugs, would be
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