The federal government is moving forward with plans to expand its current prison needle exchange program (PNEP) with several more institutions across the country this winter, despite calls for a substantial overhaul of the program before it scales up any further.
Six more institutions have been chosen as potential locations for the expansion, according to a list obtained by CBC News:
- Dorchester Minimum, N.B.
- Bowden Medium and Minimum, Alta.
- Mountain Medium, B.C.
- Collins Bay Institution, Ont.
- Beaver Creek, Ont.
- Federal Training Centre, Que.
Correctional Services Canada said several of the institutions are in their plans, but declined repeated requests to specify which ones.
“Although a few of the locations listed above are in the proposed plans for implementation of PNEP, further consultation will be undertaken prior to the determination of an implementation date,” the department said in an email.
The program has been available at nine other institutions for years, but criticized for low participation rates. Correctional officers and health-care advocates said flaws from the program’s initial launch need to be fixed if it’s going to help keep inmates and staff safe.
“We’re extremely concerned [at the rollout as-is],” said John Randle, Pacific regional president of the Union of Canadian Correctional Officers. “It’s just an expansion of the status quo.”
Program participation low for years, study found
The program launched in 2018 to prevent the spread of infectious diseases through shared needles, including HIV/AIDS and HCV, the virus that causes hepatitis C.
Participants receive a kit with one syringe, one cooker — a container used for mixing and heating a drug — three water bottles, filters and one vitamin C pill. Inmates need to keep the kits in a visible place inside their cells and visit a nurse when they need parts of the kit replaced.
They also need approval to participate, including an evaluation by a nurse and a threat assessment approved by a warden.
The program has been available at nine of the 43 federal prisons since it last expanded in 2019, but uptake has been slow.
In 2021, Canada’s correctional investigator said the program existed “more in name than in practice” because of low participation rates and needed “substantial reform” before scaling up.
The HIV Legal Network also published a study last year that found only 53 people were participating as of June 2022 — of nearly 13,000 offenders in federal custody. Some institutions didn’t have any inmates sign up.
The study, published by the network and Toronto Metropolitan University last November, said multiple layers of institutional approval and stigma are key reasons inmates weren’t signing up, along with confidentiality issues.
“You have to out yourself with security staff and tell other people in the institution that you’re part of the program and therefore a person who uses drugs,” said Sandra Ka Hon Chu, co-executive director with the HIV Legal Network.
“If all those confidentiality barriers were done away with, I think the program would be far more accessible.”
The HIV Legal Network said the program is necessary to prevent the spread of illnesses inside prisons, but needs substantial change if inmates are going to participate.
“[The expansion] is long overdue, but I’m also concerned that they’re suggesting or indicating that they’re not going to change the program model,” said Chu.
In a statement, CSC did not say whether the program had been substantially updated but said it is expanding “in comprehensive consultation with patients, employees and labour partners.”
“By implementing multiple targeted initiatives to our incarcerated population to prevent and manage drug use, including opioid use, we have shown that we are committed to the individuals under our care,” the email read.
Union wants supervised sites over exchange program
The Union of Canadian Correctional Officers does not support the PNEP because staff take a zero-tolerance approach to drugs in prisons. The union said it wants Ottawa to prioritize overdose prevention services (OPS) instead, so inmates aren’t keeping needles inside their cells or using them on their own.
The OPS sites in prisons include rooms for drug use where health-care staff are available to respond in the event of drug poisoning and provide counselling. Inmates stay at the site for half an hour at minimum so staff can monitor for signs of an overdose.
“We are deeply concerned about giving them even more tools to be alone in their cells when the majority of people dying from drug poisonings are already alone,” Randle said.
“The changes and advancements are missing [from the expanded program] and we’re not fixing the problem.”
CSC has implemented two Overdose Prevention Services (OPS), namely in June 2019 at Drumheller Institution in Alberta, and in July 2023 at Springhill Institution in Nova Scotia.
There have been no fatal overdoses at these sites since then. These OPS are the only existing prison-based supervised consumption sites known worldwide, according to CSC.
Planning and consultations are underway to implement an Overdose Prevention Service (OPS) at Collins Bay Institution in Ontario. Renovations are underway to offer the site as quickly as possible, a statement said.
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