CONSERVATIVE GOVERNMENT SCUTTLES NEEDLE EXCHANGE

Rejecting the findings of a Public Health Agency of Canada (PHAC)
review that indicated needle-exchange programs for injection drug
users in prisons reduce the need for health care interventions, the
Conservative government says sterile syringes aren't needed to
control the spread of AIDS and hepatitis C in cellblocks.

Although a Prison Needle Exchange Program (PNEP) has long been
advocated as a means of reducing the spiraling incidence and cost of
treating infectious diseases within the prison population, Public
Safety Minister Stockwell Day has decided a needle-exchange program
is fiscally unjustified.

"We prefer to educate inmates about the dangers of using drugs in
prison. Tolerance zero," says Day spokesperson Melissa Leclerc. "We
will move ahead with some concrete [educational] initiatives when we
review the corrections system."

But a recently-released risk--benefit review of PNEPs, conducted by
PHAC for Corrections Canada, found that PNEPs reduce the sharing of
dirty syringes. The report, Prison Needle Exchange: Review of the
Evidence, crafted by a 9-member panel also indicated that PNEP's
yield higher participation in drug treatment programs, a decrease in
health care interventions related to injection-site abscesses, and a
decrease in the number of overdose-related deaths.

PNEPs have no effect on the extent of injection-drug use or on the
incidence of needle-stick injuries as there's no evidence syringes
are more widely used as weapons against staff or inmates, the report
adds. As well, "prison staff attitudes and readiness to accept PNEPs
shifted from fear and resentment to acknowledgement that PNEPs
represent an important and necessary addition to a range of harm
reduction services and health and safety interventions -- many staff
advocate strongly to safeguard the ongoing support and delivery of
the programs."

The report also indicates that infectious diseases have become an
enormous public health problem within Canada's prisons. In 2004, some
25.2% of 13 107 federal inmates were infected with hepatitis C and
1.4% with HIV, compared with 0.8% and 0.2%, respectively, within the
general population. Those stats become even more alarming for inmates
with a history of injection drug use. For those, the hepatitis C
prevalence rate is 73% and the HIV rate is 3.8% (men) and 12.9% (women).

Studies cited in the report show that roughly 11% of inmates inject
drugs while incarcerated and roughly 30% of those share dirty needles.

Information about post-PNEP bloodborne virus rates internationally
was generally unavailable, except for Spain, where evidence indicates
there's been significant decreases in hepatitis C (from 5.1% to 2.0%)
and HIV (from 0.6% to 0.2%) seroconversion rates.

Among those who have urged the adoption of PNEPs are the Ontario
Medical Association, the 1994 Expert Committee on AIDS in Prison, the
Standing Senate Committee on Social Affairs, Science and Technology,
and the Canadian HIV/AIDS Legal Network.