Improving our health: Why is Canada lagging behing in establishing needle exchange programs in prisons?

Current Situation in Canadian Prisons. Rates of HIV and HCV in prison populations in Canada are much higher than those found in the general population. The high rates of HIV and HCV in Canadian prisons are closely related to two factors - the high proportion of prisoners who injected illegal drugs prior to their incarceration, and the high rates of HIV and HCV among injection drug users in the wider community. Despite their illegality, the penalties for their use, and the significant amounts of money and effort spent by correctional services to stop their entry, illegal drugs do get into prisons and prisoners do use them. Outbreaks of HIV and HCV in prison have been documented in other countries, and there is evidence that it is also occurring in Canadian prisons. All prison systems in Canada have implemented some harm reduction measures to varying degrees, including the provision of bleach for disinfecting needles, and methadone maintenance. While bleach and methadone programs are important components of a harm reduction approach in prisons, they are not an adequate substitute for the provision of needle exchange for injection drug users. International Experience. Over 50 NEPS have been established in prisons of varying sizes and security levels in six countries in Europe and Central Asia. Evaluations of these NEPs have shown that NEPs reduce risk behaviour and prevent disease transmission; that NEPs result in other positive outcomes for prison health; NEPs do not result in an increase in illegal drug consumption; NEPs facilitate referrals to drug treatment programs; there were no instances of syringes being used as weapons; and there was a high level of acceptance of NEPs among prison staff. (Extract of the publication)