HEP C IN PRISON 'AWESOME' PROBLEM

Local News - A Kingston physician who conducted two landmark health studies
of intravenous drug users in two area prisons is calling for a national
public debate on the epidemic of hepatitis C among federal inmates.

Dr. Peter Ford, director of the HIV clinic at Kingston General Hospital,
said the high rate of hepatitis C infections among prisoners is a serious
public health problem that will place enormous stress on the health-care
system in the next decade.

"Unlike SARS, which kills you in a couple of weeks, this takes 20 years to
do it," he said. "The burden of cost to the health-care system from all
these folks is going to be awesome."

Ford said a public debate is needed on how to manage the epidemic and how
to find more appropriate methods of punishing drug-addicted offenders. The
potential for savings in law enforcement, prison costs and personal
property is phenomenal, he said.

"They're sending a lot of people to prison for drug offences who should go
into rehab and shouldn't go to prison at all," Ford said in an interview
yesterday. "Drug use is an illness. These people are addicted. They're just
as sick as if they were alcoholics but we don't provide them with adequate
treatment or the wherewithal to behave safely."

Ford said many inmates start using drugs for the first time after they're
behind bars. They do so, he said, to cope with the "mind-numbingly boring"
and often dangerous environment inside prisons.

"It's boring, it's dirty, it's smelly and, on occasion, it's really scary,"
Ford said. "If you're in there for five or six years, what are you doing to
do? You'll do anything to alter your state of consciousness."

Ford told The Whig-Standard there's nothing new in a recent report by the
Correctional Service of Canada that found almost one in four inmates are
infected with hepatitis. The high rate of infection among intravenous drug
users has been known for years, he said.

In 1994, Ford led a Queen's University study that examined the prevalence
of hepatitis C and HIV in two Kingston prisons, Joyceville and the Prison
for Women. HIV or human immunodeficiency virus is the organism that causes
AIDS.

The study found that 27 per cent of Joyceville inmates were infected with
hepatitis C and one per cent had HIV. The incidence was higher in the
Prison for Women, where 40 per cent of inmates had hepatitis C and one per
cent had HIV.

Prison for Women is now closed.

The findings were "a real jolt" and were shared with the Correctional
Service, solicitor general and the public, Ford said.

Four years later, the researchers retested the Joyceville inmates and found
that 33 per cent of the prison population was infected with hepatitis C and
two per cent with HIV. The Prison for Women had closed by that time.

The Correctional Service abruptly shut down a third study planned in 2002
without providing any reason, Ford said.

"This [CSC report] is not news to anybody who's in the business," he said.

Ford, who is also a consultant for the Correctional Service, and his
colleague, infectious disease specialist Dr. Wendy Wobeser, hold regular
monthly HIV clinics at every prison in the Kingston area.

Ford said that inmates talk to him during his visits and express concern
about the widespread use of intravenous drugs.

It's common knowledge, for example, that syringes are shared by as many as
20 to 30 inmates, he said.

"That's really scary," Ford said. "That means the chances of that syringe
having hep C in it is 100 per cent."

Injection drug use is the common means of transmitting the hepatitis C
virus, which causes an inflammation of the liver that can lead to cirrhosis
or liver cancer.

The virus is also spread by direct contact with the blood of an infected
person and other bodily fluids.

Ford criticized the Correctional Service for its refusal to introduce a
needle exchange program in federal penitentiaries.

The fact that HIV infections are dropping among drug users outside prison
is proof that needle exchanges work, he said.

"HIV rates are going down in the drug-using community because of needle
exchange schemes but almost certainly going up in the prisons because there
is no needle exchange," Ford said.

"These folks are going to get out and when they get out they're going to go
on doing what they were doing when they were in - and do it with different
people.

"They're going to spread disease. And we need a public debate on how to
handle this."

Ford said he agrees with the refusal by federal prison officials to
introduce mandatory infectious disease testing in prisons.

"Mandatory testing would be against the whole human concept of human rights
and a complete bloody disaster," he said. "There would be riots."

Statistics compiled earlier this year by the area health unit indicate the
infection rate of hepatitis C in the Kingston region is nearly double the
provincial rate. An estimated 97 people of every 100,000 have the disease.
Health Canada estimates that 57 of every 100,000 Ontario residents have the
virus.

When the infection rate of inmates is included in the Kingston figures, the
rate of infection is roughly quadruple the provincial average.

Tina Knorr, hepatitis C strategy co-ordinator at the Street Health Centre
on Montreal Street, said yesterday that she occasionally receives calls
from inmates who have contracted hepatitis C and want more information
about the disease.

The centre hands out about 1,000 needles a day to drug users from all over
southeastern Ontario. Needle exchanges have proven to reduce the risk of
HIV and hepatitis infections, Knorr said.

She noted that young people who are intravenous drug users have lower rates
of HIV and hepatitis C than older users because they are more aware of
"harm-reduction" techniques.

Knorr added that the Street Health Centre is often accused of "enabling or
increasing" drug use by handing out free needles but "it's obvious people
are getting infected if they are not using" [clean needles]."