Pubdate: Wed, 03 Feb 2016
Source: Toronto Star (CN ON)
Copyright: 2016 The Toronto Star
Author: Alex Ballingall
Page: GT1


Researchers hope Liberals' 'evidence-based' approach will endorse
safe-injection programs

After years of pushing for safe drug-injection programs in Canadian
jails, health advocates say mounting evidence and a new government in
Ottawa present a chance to finally make it happen.

In a report published Wednesday, researchers in Toronto provide a
framework for the introduction of what they call "prison-based needle
and syringe programs" in Canada - programs that the authors argue are
sorely needed in provincial and federal jails to address levels of HIV
and Hepatitis C infections that are "astronomically" high compared
with those in the general population.

"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," she added.

The researchers hosted a conference with experts, conducted interviews
with health workers, inmates and prison workers, and pored over
existing studies before drafting 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

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
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-needle programs in prisons in other

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

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 80 per cent
of men entering federal prisons had 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 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

"We're hopeful that this will move forward," Ollner

A spokesperson for federal Health Minister Jane Philpott directed
questions about safe-injection programs in prisons to the public
safety ministry, where spokesman 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 for Ontario's corrections minister,
Yasir Naqvi, said the province already offers methadone 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.
- ---
MAP posted-by: Matt