Prison Based Syringe Exchange Programs

This paper analyses current trends in prison drug use, the prevalence of HIV/AIDS and HCV in prisoner populations and other information relevant to assessing the need for prison-based needle exchange programs in Canada. The first part presents background information on (1) the role of injection drug use (IDU) in the HIV and HCV epidemics, (2) prevalence of substance users and levels of substance use in Canadian prisons, (3) levels and patterns of injection drug use and needle sharing in Canadian prisons, (4) the prevalence of HIV and hepatitis C infections among Canadian prisoners, (5) evidence of cases of disease transfer from sharing needles in prisons, and (6) existing harm reduction policies and programs in provincial and federal correctional systems in Canada. The next section reviews international experience with prison-based needle exchange programs, emphasizing evaluations of their effects on behaviour and their effectiveness in reducing harms among prisoners who use drugs by injection. The third part provides a review of the legal/constitutional and moral/ethical rationales for providing sterile needles to prisoners and a brief summary of the previous calls for piloting prison-based needle exchange programs in Canada. The last part discusses several possible courses of action available to the Canadian government as it considers its options on prison-based needle exchange programs.

The key aim of this research was to provide an overview of the legislation, policy and practice concerning harm reduction services provided for problematic drug users (PDUs) in 9 European Union (EU) countries. To achieve this, the main objectives were to analyse international, national policies on harm reduction; to explore how harm reduction in conceptualised in different cultural contexts; to identify existing harm reduction initiatives in prisons; to identify the obstacles and barriers that need to be to overcome in order to implement harm reduction measures in prisons; to examine in detail the policies and harm reduction services in place in two sample institutions; to identify models of best practice and promote awareness of the harm reduction initiatives operating in the area of problematic drug users in custody, and finally to present examples of harm reduction measures in prisons from each of the sample countries. Key requirements needed in order to successfully implement sustainable harm reduction services in prisons are identified. These requirements can be formulated on all relevant levels: attitude towards and knowledge about harm reduction, drug addiction and health risks for all key actors, necessary changes both on the policy and practice level. Guidelines are formulated from evidence-based practice, as opposed to moral and value judgements. engl.

Syringe exchange programs and safe injection services are outside-the-box interventions increasingly being used by governments, nonprofits and citizens to address dire issues percolating in tandem with America's burgeoning opioid epidemic. People who inject drugs (PWID)--almost a million Americans annually--commonly use painkillers such as heroin and fentanyl, as well as methamphetamine, benzodiazepines, barbiturates and cocaine. Yet the users themselves are often obscured or marginalized by the bigger picture. This collection of essays covers policies and practices aimed at preventing both opioid-related deaths and related infections of hepatitis and HIV.

This volume addresses the interface of two major national problems: the epidemic of HIV-AIDS and the widespread use of illegal injection drugs. Should communities have the option of giving drug users sterile needles or bleach for cleaning needs in order to reduce the spread of HIV? Does needle distribution worsen the drug problem, as opponents of such programs argue? Do they reduce the spread of other serious diseases, such as hepatitis? Do they result in more used needles being carelessly discarded in the community? The panel takes a critical look at the available data on needle exchange and bleach distribution programs, reaches conclusions about their efficacy, and offers concrete recommendations for public policy to reduce the spread of HIV/AIDS. The book includes current knowledge about the epidemiologies of HIV/AIDS and injection drug use; characteristics of needle exchange and bleach distribution programs and views on those programs from diverse community groups; and a discussion of laws designed to control possession of needles, their impact on needle sharing among injection drug users, and their implications for needle exchange programs.