Despite pandemic delays, Correctional Service Canada still plans to expand needle exchange programs currently offered in nine federal prisons, government officials say.
Henry de Souza, the agency’s director general of clinical services and public health, said during a presentation at the International AIDS Conference in Montreal on Friday that “a number of institutions” have been identified for expansion and the program will continue. carried out across the country.
Inmates have been able to request sterile drug use equipment at two Canadian prisons since 2018, with a further seven added in 2019. Some proponents have expressed fears that the program, designed to reduce needle sharing and the spread of infectious diseases, was canceled after numbers showed low uptake.
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In mid-June, only 53 inmates were actively taking advantage of the programs, officials told the AIDS conference Friday night, of the 277 approved to participate in the past four years.
These programs complement the country’s only prison-based “overdose prevention service,” which started operations in 2019 at the Drumheller Institute for medium-security men in Alberta. It is essentially a controlled injection site, with sterile equipment and consumption under observation.
Since the site opened, there have been 55 participants, 1,591 visits and zero overdoses at the site, officials told the conference. The correctional service says it also offers mental health services, access to naloxone to counteract the effects of opioid overdose, and preventative treatments, such as pre-exposure prophylaxis — drugs used to prevent them from contracting HIV.
All of these efforts have led to a decrease in infections, said Marie-Pierre Gendron, an epidemiologist with Correctional Service Canada. She said HIV infection rates among inmates fell nationally from 2.02 percent of the prison population in 2007 to 0.93 percent in 2020; and hepatitis C has fallen from 21 percent in 2010 to 3.2 percent in 2021.
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Lynne Leonard, an associate professor at the University of Ottawa who was contracted by the agency to evaluate the programs, said during a panel Tuesday morning that both programs have had “significant beneficial results” for inmates, and she saw “successful institutional adoption in the end.” despite initial staff reductions.
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Preliminary results of her research showed that the program appeared to lead to a significant reduction in HIV infections in the institutions that set it up. Overdoses at Drumheller have fallen by more than 50 percent in total since the controlled consumption site opened.
“I am encouraged by the way they describe the program as something they are proud of,” said Sandra Ka Hon Chu, co-executive director of the HIV Legal Network.
But a major “red flag” that could lead to lower participation is the fact that security personnel are involved in the process, she said. That’s not the case with the needle exchange programs in other countries, some of which are completely anonymous or even offer syringes in automated dispensing machines.
“It’s really a critical flaw in the program,” she said.
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Asked about the low adoption rate, the correctional service said in a statement Tuesday that it reviewed evaluation reports indicating that participation rates “may be the result of considerations such as stigma, fear, lack of understanding of harm reduction initiatives and the nature of addiction.”
Inmates are subject to a security threat assessment and security guard approval before accessing programs, as officials described the process. Nearly a quarter of requests to join the program have been turned down, according to statistics presented at the conference.
Shawn Huish, the director of Mission Institution in British Columbia, said it has been challenging to change the mindset of correctional workers who are used to searching for drugs, confiscating them and trying to prevent inmates from using them _ while they at the same time reassuring the inmates that participation in the program would not affect their release.
There was a lot of “fake news” to combat, Huish said, including a billboard erected outside the prison portraying the program in a negative light.
“Our main focus was talking, educating, breaking through the fear. If a needle is recognized in prison, it can be scary for people,” he said. ‘You’re afraid you’ll get needle pricks. So we looked at the files. In two and a half years, a staff member was poked, and that was during the search, and it was a thumbtack.”
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Leah Cook, the regional manager of public health for the Prairies, oversaw the implementation of the supervised injection site in Drumheller and said it is “the only known service of its kind in a correctional setting on the world stage, of which I am incredibly proud.” on am. ”
Cook said a “safe zone” was created so program participants could carry their own drug stash to the observation room without fear of being searched — and it has been nicknamed the “yellow brick road.”
Leonard’s research found that Drumheller employees preferred it to the needle exchange program and thought it was safer and more successful.
The correctional service statement says it is committed to “further implementation” of both types of programs as part of its mission to “better support patients with problematic substance use needs.”
Warkworth Institution and Bowden Institution have been identified for an expansion of its needle exchange program, the statement says, while Collins Bay Institution and Springhill Institution are under consideration for an expansion of its overdose prevention service.
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