Despite the slowing of the pandemic, Correctional Service Canada still plans to expand the needle exchange program currently offered in nine penitentiaries, according to government officials.
In a presentation at the International AIDS Conference in Montreal this weekend, Henry de Souza, the agency’s director general of clinical services and public health, said that “a number of institutions” had been identified for expansion, and that the program will continue to be implemented across the country.
Inmates have been able to request sterile drug use equipment at two Canadian penitentiaries since 2018, and seven more were added in 2019. Some activists have expressed concern that the program, which is designed to reduce needle sharing and the spread infectious diseases, could be canceled after data showed low attendance.
Officials told the AIDS conference Friday night that only 53 inmates were actively using the program as of mid-June, out of the 277 inmates who had been cleared to participate over the past four years.
The program complements the country’s only prison-based “overdose prevention service,” which was launched in 2019 at the medium-security men’s facility in Drumheller, Alberta. It is essentially a supervised injection site, offering sterile equipment and consumption under observation.
Since the supervised site opened, there have been 55 attendees, 1,591 visits and no overdoses at the facility, officials said at the Montreal conference. The correctional service points out that it also offers mental health counselling, access to naloxone to counter the effects of an opioid overdose and preventive treatments, such as pre-exposure prophylaxis — a drug to prevent HIV.
All of these efforts have resulted in fewer infections, said Marie-Pierre Gendron, epidemiologist at Correctional Service Canada. She said HIV infection among inmates nationwide fell from 2.02% of the prison population in 2007 to 0.93% in 2020, while hepatitis C dropped 21% in 2010 to 3.2% in 2021.
Beneficial results
Lynne Leonard, an associate professor at the University of Ottawa, who was hired by the agency to evaluate the programs, told the Montreal conference on Tuesday morning that the two programs had had “significant beneficial results” for inmates. , and she saw “successful eventual institutional adoption,” despite initial reluctance from staff.
Preliminary results of his study revealed that the program appeared to result in a significant decrease in HIV infections in the facilities that had implemented it. In addition, overdoses at Drumheller Institution have decreased by more than 50% since the opening of its supervised injection site.
“I am encouraged that they describe the program as something they are proud of,” said Sandra Ka Hon Chu, co-executive director of the HIV Legal Network.
But a major “red flag” that could lead to lower turnout is that security personnel are involved in the process, she said. This is not the case in prison needle exchange programs in other countries, some of which are completely anonymous or even offer needles in vending machines.
“It’s really a critical flaw in the program,” she said.
Inmates are subject to a threat assessment by the facility’s security and approval by management before they can access programs, according to a description of the process by officials. Statistics presented at the conference indicate that almost a quarter of applications to participate in the program have been rejected.
Staff reluctance
Shawn Huish, warden of Mission Institution in British Columbia, said it was difficult to change the mindset of correctional officers who are used to searching for drugs, confiscating them and trying to prevent inmates to take them—while promising inmates that their participation in the program would not affect their eventual release.
There was a lot of “fake news” to combat, Mr Huish said, including a sign posted outside the prison that portrayed the program in a negative light.
“Our biggest goal was to talk, to educate, to allay fears. Accepting the presence of a syringe in prison can be frightening for people, he pointed out. You are afraid that people will be pricked by a syringe. So we looked at the records. In two and a half years, we had a staff member who got bitten, and it was during a search — and it was a bulletin board bug. »
Leah Cook, regional director of public health for the Prairies, oversaw the establishment of the supervised injection site in Drumheller. She said it was “the only known correctional service of its kind on the world stage — and I’m incredibly proud of it!” “.
Ms Cook said a “safe zone” had been created so program participants could carry their own supply of medication to the observation room without fear of being searched.
While it’s unclear whether the agency plans to expand the overdose prevention service to other facilities, Professor Leonard’s research found Drumheller staff members preferred it to the exchange program syringes — they found it safer and more effective.
Correctional Service Canada did not immediately respond to questions sent over the weekend.