EXPERT TELLS OF PRISON NEEDLE SWAP

Needle exchange programs had operated successfully in Swiss prisons
since 1992 and there had been no incidents of syringes being used as
weapons, a conference was told yesterday.

The health and safety of prison officers was more secure in jails that
operated syringe-exchange programs because of a reduced risk of
needle-stick injuries, said Dr Joachim Nelles, said the head physician
at University Psychiatric Services of Berne, Switzerland.

Dr Nelles was speaking at a Public Health Association conference in
Sydney yesterday.

In an interview with The Age, Dr Nelles said that Swiss authorities
had held information sessions for prison officers to counter fears
that syringes could be used as weapons.

"Since 1992, they haven't had any incidents where syringes were used
against staff or other inmates, and I believe that the situation for
the staff is more secure when you have an exchange program," he said.

"Where people are there are drugs, and where drugs are there are
syringes, and if the syringes are forbidden and confiscated then
(prisoners) hide the syringes, and they cut them down, and the risk of
getting an injury from hidden syringes is much higher than if you have
open rules."

Dr Nelles said that Switzerland's first jail-based needle exchange
program was implemented through the disobedience of the jail's doctor,
who was so concerned at the high number of prisoners who were sharing
syringes that he began issuing clean ones.

He was caught one year later, but, rather than sacking him, officials
decided to take the riskier course of trying out a sanctioned exchange
program at the low-security men's prison.

Needle exchanges had since been introduced into three other
low-security adult jails and there were plans to try them at
medium-security facilities. Close evaluations had been conducted on
the program's success at one women's and one men's jail.

Dr Nelles said the findings showed the introduction of syringe
exchanges was not followed by increases in drug intake or intravenous
use. Sharing of syringes dropped significantly, but it had been
impossible to tell whether this had an impact on the transmission of
infectious viruses such as hepatitis C as it could lie dormant for up
to 15 months.

The Swiss syringe exchanges involved the use of dispensers, located on
the back of toilet cubicle doors - so it was not possible to tell
which prisoners used them. Prisoners inserted used syringes into the
dispensers in exchange for clean ones.

But drugs remained illegal and were confiscated if
detected.

Australian health and drug rehabilitation experts have called for
trials of the exchanges to try to reduce the spread of blood-borne
viruses such as HIV and hepatitis C among prisoners sharing needles.