Give Inmates Clean Needles

Constructive pragmatism will do much more for inmate health than knee jerk conservatism.

A recent report from the Canadian HIV/AIDS network has called for the implementation of needle exchange programs in Canadian prisons. The report notes that rates of HIV and Hepatitis C infection are about 20 times higher in our jails than in the general population. Further, jail appears to be a breeding ground for illegal drug use, especially for intravenous drugs.

This isn’t news – we’ve known this to be true of federal institutions in Canada for more than a generation. And this report provides ample testimony from former inmates regarding the drug use that they and other prisoners engaged in. With a sporadic supply of needles, sharing equipment becomes commonplace.

How to respond to this problem? We could say that more effective law enforcement is the answer, but the drugs appear to be provided by a wide mix of individuals – visitors, guards, volunteers, and staff. How do we police this when so many different enforcement tactics have been tried already and haven’t worked?

For 30 years, knee jerk responses to this problem have been trotted out, along with somewhat boring if predictable howls of outrage. You know the routine – how stupid could a government be to actually encourage drug use by giving inmates syringes? Why shouldn’t every inmate with a history of drug use be strip-searched on a regular basis? You need to make these criminals understand that there are consequences for using drugs in jail, such as longer prison terms. And so on.

Sorry, folks, but these are people who are risking their health and their lives to use these drugs. And let’s not forget that this is fundamentally a problem of public health.

The line we draw between legal and illegal drugs has nothing to do with public health and everything to do with our political, social, and economic history. Those of you in the community smoking your pack of cigarettes and drinking your flask of whisky every day, don’t pretend that you are different, at least aside from the reality that your drugs of choice – alcohol and tobacco – are probably the most lethal on the planet.

It’s time to bring pragmatism and the protection of public health (along with tax savings) to the fore. Implement and evaluate a program that provides clean syringes to intravenous drug users in Canada’s prisons. And don’t worry – there won’t be a horde of folks breaking down the doors to get in.