Pubdate: Mon, 15 May 2017
Source: Montreal Gazette (CN QU)
Copyright: 2017 Postmedia Network Inc.
Authors: Richard Elliott and Rick Lines
Page: A8


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

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

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 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 Metis
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

(Richard Elliott is executive director of the Toronto-based Canadian 
HIV/AIDS Legal Network. Rick Lines is executive director of Harm 
Reduction International, based in London, U.K.)
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