Denial of needle and syringe programs to prisoners is cruel

What do you if you require a needle and don’t have access to one? You make your own. And if you’re in prison, you may have to get inventive.

“The first time I injected [drugs], I used my friend’s 3cc barrel from a real syringe, to which we attached a ‘needle’ made out of a Q-tip,” says Lenny Stevenson. “We sliced the shaft of the Q-tip on an angle to make a point. At the time, Q-tips were made out of plastic and had a hollow core,” he clarifies.

If that sounds painful to you, you’d be right. “The Q-tip ‘needle’ would […] puncture the vein and inject the drug, but would also cause a wound and produce a fair bit of bleeding. Many guys would regularly re-use the hole created to inject.”

This can be very dangerous. Especially because in jail, needles — unlike drugs themselves — are in very short supply, so sharing is inevitable. Says Stevenson, “The first time I injected, the makeshift rig I used was being used by at least seven other guys, and I know some of them were also sharing it with other guys.”

Often, prisoners end up sharing HIV and hepatitis C (HCV) as well. Stevenson is one of 50 prisoners or former prisoners who spoke with the Canadian HIV/AIDS Legal Network about the dangers they face because of lack of access to clean needles.

In Under the Skin, a report recently released by the Canadian HIV/AIDS Legal Network, authors Sandra Ka Hon Chu and Katrina Peddle provide a moving and enlightening exposé of the disturbing discrimination faced by drug users in jail.

If you think injection drug use is something that only affects a tiny minority, you’re wrong. According to a 2005 survey by the Canadian Centre on Substance Abuse, 4.1 million Canadians have injected drugs at some point in their lives.

Across the country, health advocates have responded to this reality by providing needle and syringe programs (NSPs), giving users clean needles as a cost-effective way to reduce the risk of HIV and HCV and facilitate access to care, treatment and support services. But those behind bars have not been so lucky. As the Legal Network report points out, “at this time no Canadian prison permits the distribution of clean needles.”

The government seems to be ignoring its own expert advice: an exhaustive international report by the Public Health Agency of Canada (PHAC) from 2006, which showed that prison needle and syringe programs (PNSPs) decreased needle sharing, injuries and overdoses, and increased the uptake of addiction treatment programs. It found that PNSPs did not lead to increases in drug use or prisoner violence. The report also noted the support of prison staff for PNSPs in institutions that have them.

The need for clean needles in Canadian prisons is actually greater than it is in the population at large. Rates of drug use are higher in prison than outside. And rates of HIV and HCV are also higher in prison — 10 to 20 times higher.

There are a lot of reasons for this. Because most drugs are criminalized, their use can result in jail time. Because our government focuses on punishing users instead of treating addiction, the cycle of problematic drug use is harder to break.

Because drugs are illegal, their trade is controlled by gangs and prohibitively expensive, leading people to theft and fraud to support habits. And of course, people use drugs to try to cope with the fact that prison is a horrible place to live. If you become addicted to a drug, you will be compelled to use it even in unsafe ways, like sharing homemade needles.

“Things I witnessed people using to make rigs for injecting included eye-droppers, pieces of glass from light bulbs and plastic pens that had been melted and stretched,” Ronald Sallenbach told the Legal Network, discussing his time in a BC prison. “You try not to think about the risks of sharing equipment… but when you need to get a hit, and don’t have a rig, you end up sharing.”

Sometimes a single syringe has to withstand many individual injections: “At least 50 people would share one needle,” says Christopher McPartlan, who did time at men’s facilities in Saskatchewan and BC.

In the past decade, the federal prison system has stepped up its efforts to curtail drug use in jail — with virtually no impact. There are many ways drugs get into prisons — from prisoners and their families to prison guards themselves. That is not going to change any time soon. What needs to change is the direct threat to prisoners’ health because they’re denied clean needles.

Most people in jail eventually return to the general public — and they deserve the same standard of health care and human rights whether behind bars or walking the streets as free men and women. The ongoing denial of needle and syringe programs to prisoners is truly a form of cruel and unusual punishment — one with potentially deadly repercussions.