(OTTAWA) The needle exchange program in federal penitentiaries is failing due to very low deployment by the Correctional Service and a lack of improvement since its introduction four years ago, according to activists from the fight against HIV-AIDS.
Since the most recent expansion of the program, in 2019, inmates at nine of the 43 federal penitentiaries have had access to sterile injection drug equipment. Last summer, the authorities announced that this program would be implemented throughout the country.
The HIV Legal Network released a report this week which concluded that most inmates still do not have access to the program, which has not extended beyond the original nine penitentiaries. Last June, only 53 inmates were participating in this program — out of nearly 13,000 federal inmates.
The co-director of the HIV Legal Network, Sandra Ka Hon Chu, believes that the low participation rates are mainly due to multiple levels of institutional approval and stigma.
“Many people who want to access the program — because there are, injection drug use in penitentiaries — cannot access it because of multiple barriers,” she explained.
The federal government said it was committed to expanding the program, but COVID-19 had delayed its plans.
A June 15 briefing note, prepared for Public Safety Minister Marco Mendicino, said consultations were held in early 2020 to expand the program to two more facilities, but “following delays due to the COVID-19 pandemic, re-engagement with these sites is necessary.”
The memo, obtained through an access to information request, also said the Correctional Service of Canada would be preparing plans for additional sites to be confirmed this fall.
Correctional Service spokeswoman Esme Bailey said in an email that the department is still committed to offering the program at other institutions and that consultations are continuing.
laborious process
For inmates, participation in this program requires approval which includes a nurse assessment and a threat assessment approved by penitentiary management. No reason is provided as to why an application is green-lighted or not.
Mme Ka Hon Chu argues that this mechanism creates an “extremely high barrier” that deters people from applying.
The HIV Legal Network study, conducted with the help of Metropolitan University of Toronto, concludes that the assessment process is based “on safety rather than clinical need”.
We also deplore that the program requires daily inspections to verify that the equipment is used correctly, “contrary to program models and recognized practices elsewhere in the world”.
Not very confidential
Participants receive a kit that contains a syringe, a heater, three bottles of water, a sachet of vitamin C and filters. Inmates should always keep the kit visible in their cell and consult a nurse when spares are needed.
Gold, M.me Ka Hon Chu points out that participants “uncover” themselves as drug users and that they risk being stigmatized by other inmates, staff and the parole board.
She notes that one of the most common concerns heard from researchers is that participants may be denied access to other programs.
The report recommends strengthening confidentiality by ceasing daily visual inspections of kits and providing more discreet distribution points. The report also indicated that a lack of knowledge about the program was affecting participant adherence.
Proponents argue that without adequate programs, the risk of HIV infection will continue to increase because inmates will turn to unsanctioned and dangerous ways to use drugs.
“The reality is that there is already a lot of injection equipment in prisons which (is) simply not regulated and which is not sterile”, recalled Mr.me Ka Hon Chu.
“Prohibitive and repressive”
The Correctional Investigator stated in his latest annual report, released last summer, that the needle exchange program “remains a program in name only” due to low inmate participation.
Ivan Zinger, who had raised the same concern in previous reports, also said that corrections’ drug strategy needed substantial reform.
He concluded that the Correctional Service’s culture of possession and use of simple drugs “remains mired in a prohibitive and repressive mindset”.
“Maintaining a zero-tolerance approach to drugs, based on ever more intrusive drug detection, discipline and enforcement — strip searches, body cavity searches, cell searches, charges, urinalysis — is an expensive game with diminishing returns,” the Correctional Investigator wrote in his most recent report.