In Australia, the prison system has introduced needle exchange schemes to eliminate, as far as possible, the hazards to health of needle sharing among the prison population.
Rates of Hepatitis B and C and HIV are high and with a high incidence of IV drug abuse needle sharing had become inevitable, with a corresponding decline in standards of prison health.
Questions in today’s BMJ refer to the “glacially slow worldwide movement of redressing health inequalities in prisoners”, and the lack of such needle exchange schemes in UK prisons is singled out for criticism.
“Why is it taking so long for this policy to be rolled out in the UK? Regardless of personal views on whether prison should be for punishment or rehabilitation, it should not be punitive to health.
“Despite the UK Department of Health’s intention back in 1999 to “identify health problems, deliver treatment and ensure seamless transition back into the community,” the government seems unable to turn this into policy. Community needle exchange programmes have a long history of reducing harms, particularly the transmission of blood borne viruses such as HIV and hepatitis C. They also encourage people to engage with drug health services, thereby enabling social and psychological problems to be tackled.
“The rationale for needle exchange programmes in prisons is also clear. According to the 2010 Patel report, around 69% of people entering prisons had taken drugs within the past 12 months—40% of them within the past 28 days. Another UK report found that 69-75% of prisoners who had injected drugs inside prisons shared needles. A review of prison needle exchange programmes published in 2003 showed that they are feasible, reduce risky behaviour and the transmission of blood borne infection, and have no unintended negative consequences. Fears that needles could be used as weapons in prisons seem to be unfounded. The benefits of prison needle exchange programmes were also documented in a best practice guide published by the National AIDS Trust in 2011.
Brett J. Why have prison needle exchange programmes not yet been rolled out in the UK? BMJ 2012;345:e6211
There are several issues of concern. Is the management of sharps waste in prisons adequate? What is, and can more be done to reduce, the risk of sharps injury among prison staff and others?
Greater control of drug abuse and the health risks associated by needle sharing in prisons may well be achieved by the introduction of needle exchange schemes. Alternatively, might there be a case for some reasonable security in prisons, to keep prisoners in and drugs and needles out? That too will have a significant positive impact on health, reducing the risks of needle sharing and sharps injury.
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A former federal inmate and four AIDS prevention organizations are suing the federal government for failing to provide needle and syringe exchange programs inside Canadian prisons.
The lawsuit, which is being filed today in Ontario’s Superior Court of Justice, claims the government is violating the rights of inmates under the Canadian Charter of Rights and Freedoms by failing to provide such programs inside prisons.
But instead of seeking a monetary settlement, the plaintiffs are asking for what’s called a supervisory or structural injunction, according to lawyer Douglas Elliott. He called it a rare ruling in which a judge could order the government to set up needle exchange programs in prisons across Canada
Read more: http://www.cbc.ca/news/canada/story/2012/09/25/aids-organizations-lawsuit-needle-exchange.html?goback=%2Egde_2865387_member_168527348
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Thanks Paul
Have you been in contact with the Home Office (pretty useless as they are unlikely to help) and the POA (much better if you can get through to the right person)?
I assume that you have tried the various bibliographic databases. The best for this is PubMed where searches from prision* and needle* will pick up a large number of papers that address this subject, mostly focussing on disease incidence for HIV, Hep C, Hep B, rather than studies of needle use in particular.
Rememeber the illicit use of syringes and needles sneaked into prisions, and the data on confiscations from visitors that will give you another angle for assessment. Sharps injury for POs are a huge problem and the use of sharps-PPE is widespread. But this is not only needles and the data for sharps injury may be badly skewed. And then there is the very popular DIY tattoo habit that is significant in sharing and disease transmission, mediated by shards of metal, plastic and glass, and a variety of home made pigments including soot and ink from felt pens etc!
You could also trawl the Environment Agency records (separately for England and Wales, and for Scotland) to quantify the sharps waste outputs from prisons. I would wager a lot of money on teh EA being blatantly unhelpful, probably citing commercial confidentiality which means that their records are in a poor state and the can’t or won’t make the effort! However, it’s worth a try, remembering also some legitimate output from prison health services.
Good luck
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Paul S – around 69% of people entering prisons had taken drugs within the past 12 months – please could you tell me which report this is form, I am currently writing my dissertation arguing for the introduction of prison needle exchange schemes in the UK and this point would prove very useful. Thanks