With conviction: the case for controlled needle and syringe programs in Australian prisons

With the incidence of blood borne viruses being far higher in Australian prisons than in the community, this report calls for a trial of a controlled needle and syringe exchange program for inmates. The steady use of illicit drugs in Australia combined with a heavy focus on law enforcement, has contributed to a rapidly growing prison population.  It is currently estimated that 70 to 80 per cent of our prisoner population are incarcerated for drug-related problems.  Consequently many inmates have a history of injecting drug use. Despite a focus on supply and demand reduction, drug use, including injecting drug use, continues to occur in Australian prisons. And many inmates have their first experience of injecting drug use whilst incarcerated, taking this newfound practice back into the community on their release. The prison setting has been proven to be a high-risk environment for the transmission of blood borne viruses such as hepatitis C and HIV. Nearly 20 years ago the World Health Organization recommended the provision of sterile injecting equipment in prisons to further enhance HIV prevention. Over 50 prisons throughout Europe and Asia have since introduced Needle and Syringe Programs (NSPs). The health and cost benefits of Australian NSPs are well recognised. Yet in our prisons, where the incidence of blood borne viruses is far higher than in the community, we are yet to have a trial of controlled needle and syringe exchange. Recent Australian Government guidelines on HIV and hepatitis C have called for each State and Territory to identify prisons where a controlled NSP may be trialled. This report argues in favour of introducing of NSP services in prisons for inmates that inject, stating that NSPs in prison have the following benefits for staff and prisoners: No observable increase in injecting or other forms of drug use; Reduced blood borne virus transmission; Reduced needle-sharing and re-use; Reduced injecting-related health concerns such as abscesses; Reduction in needle-stick injuries for prisoners and staff; No instances recorded of needles being used as weapons