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Used needles are displayed at a needle exchange in Miami, May 6, 2019. Despite the pandemic’s slowdown, Correctional Service Canada still plans to expand needle exchange programs currently offered at nine federal prisons, government officials say. THE CANADIAN PRESS/AP/Lynn Sladky
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OTTAWA — Despite the slowdown in the pandemic, the Correctional Service of Canada still plans to expand needle exchange programs currently offered at nine federal prisons, government officials say.
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In a presentation given at the International AIDS Conference in Montreal on Friday, Henry de Souza, the agency’s director general of clinical services and public health, said “a number of institutions” have been identified for expansion and the program will continue to be implemented across the country. .
Inmates have been able to request sterile drug use equipment at two Canadian prisons since 2018, and seven more were added in 2019. Some advocates have raised concerns that the program, which aims to reduce needle sharing and the spread of infectious diseases, could be canceled after the numbers showed poor uptake.
Only 53 inmates were actively using the programs in mid-June, officials told an AIDS conference Friday night, out of 277 who have been approved to participate in the past four years.
These programs are in addition to the country’s only prison-based “overdose prevention service,” which began operating in 2019 at the medium-security Drumheller Institution for men in Alberta. It is essentially a controlled injection site offering sterile equipment and supervised consumption.
Since the site opened, there have been 55 participants, 1,591 visits and zero overdoses on the site, conference officials said. The correctional service says it also offers mental health counseling, access to naloxone to counteract the effects of opiate overdoses and preventative treatments such as pre-exposure prophylaxis — a medicine taken to prevent HIV infection.
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All these efforts have led to a reduction in infections, said Marie-Pierre Gendron, an epidemiologist with Correctional Service Canada. She said HIV infection among prisoners nationally has declined from 2.02 percent of the prison population in 2007 to 0.93 percent in 2020; and hepatitis C decreased from 21 percent in 2010 to 3.2 percent in 2021.
Lynn Leonard, an associate professor at the University of Ottawa who was hired by the agency to evaluate the programs, said during a panel Tuesday morning that both programs have had “significant beneficial outcomes” for inmates and she has seen “potentially successful institutional adoption.” despite initial pushback from staff.
Preliminary results of her study found that the program appears to have resulted in significant reductions in HIV infections in institutions that implemented it. Overdoses at Drumheller have decreased by more than 50 percent overall since the controlled consumption facility opened.
“I’m encouraged by the way they describe the program as something they’re proud of,” said Sandra Ka Hong Choo, 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. This is not the case in prison needle exchange programs in other countries, some of which are completely anonymous or even offer syringes in automatic dispensing machines.
“This is really a critical gap in the program,” she said.
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Asked about the low take-up, the correctional service said in a statement on Tuesday that it had reviewed evaluation reports that showed 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 warden approval before they can access the programs, officials described the process. Nearly a quarter of applications to participate in the program are rejected, according to statistics presented at the conference.
Shawn Huish, a warden at Mission Institution in British Columbia, said it’s a challenge to change the mindset of corrections workers who are used to looking for drugs, confiscating them and trying to stop inmates from taking them — while making sure inmates , that those participating in the program will not affect their release.
There was a lot of “fake news” about wrestling, Huish said, including a billboard erected outside the prison that painted the program in a negative light.
“Our biggest focus was to talk, to educate, to break down the fear. Admitting a needle in prison can be scary for people,” he said. “You’re afraid you’re going to stick yourself with a needle. So we looked at the records. In two-and-a-half years, we’ve had one member of the team get stabbed, and that was during a search, and it was a thumb stab.”
Leah Cook, regional public health manager for the Prairies, led the implementation of the supervised injection site at Drumheller and said it was “the only known service of its kind in a correctional setting on the world stage, which I am incredibly proud of. “
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Cook said a “safe zone” was set up so program participants could bring their own stash of drugs into the monitoring room without fear of being searched – and it was called the “yellow brick road” .
Leonard’s survey found that staff members at Drumheller preferred it to the needle exchange program and believed it was safer and more successful.
The corrections service’s statement said it was 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 to expand the needle exchange program, the statement said, while Collins Bay Institution and Springhill Institution are being considered for expanding the overdose prevention service.
This report by The Canadian Press was first published on August 2, 2022.
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