Prison Needle Exchange Program

Since June 2018, the Correctional Service of Canada (CSC) has been rolling out a Prison Needle Exchange Program (PNEP) at federal institutions across the country to help prevent the sharing of needles among inmates and prevent the spread of infectious diseases, such as HIV/AIDS and HCV.

Consistent with the Canadian Drug and Substances Strategy, the PNEP complements other CSC harm reduction measures and health care services already in place to limit the spread of infectious diseases in federal institutions and ensures that offenders reintegrating into the community are doing so in a healthy and safe manner.

1. What are the objectives of the Prison Needle Exchange Program (PNEP)?
   
   The objectives of the PNEP are to:
   
   • reduce the sharing of needles and the number of contraband needles in circulation in institutions
   • facilitate referral to available drug-dependence treatment programs, including mental health services and opioid agonist treatment (OAT)
   • reduce the transmission of blood-borne viral infections, including HIV/AIDS and HCV
   • reduce the occurrence of skin infections related to injection drug use and decrease the need for health care interventions related to injection-site abscesses
2. What sites will implement the PNEP next?
   
   

   Prior to the implementation of the PNEP at any site, there are extensive consultations with institutional management and operations, the institutional occupational health and safety committee, the inmate committee, and the community advisory committee. CSC will continue to work with individual sites, taking into account operational considerations, before determining next steps in the rollout of the PNEP.

3. How do inmates participate in the PNEP?
   
   

   Prior to participation in the PNEP, inmates are required to meet with CSC Health Services, where a nurse will provide health teachings related to substance use, safe consumption practices, education on the harms of drug use, counselling on the risk of infectious diseases, and referral to other health care services. Inmates must then be approved by the Institutional Head or Deputy Warden, who confirms if there are any security concerns related to an inmate’s participation in the PNEP. This is determined through a threat risk assessment, similar to the ones completed for Epipens and needles used for insulin use. Inmates who participate in the PNEP must also sign a contract ‎acknowledging that they understand the rules of the PNEP and any breach may lead to their termination from the program.

4. How will CSC ensure that needles are not used as weapons against staff and other inmates?
   
   

   The safety and security of staff, the public, and inmates is a priority for CSC. Appropriate safeguards have been established in every institution to ensure that PNEP kits are safely stored and accounted for at all times. The need for inmates to produce a PNEP kit to correctional officers falls under the same principles as any other authorized sharp objects (hobby craft tools, insulin needles, Epipen). According to information provided by the United Nations Office on Drugs and Crime, prison needle exchange programs:

   • are not associated with increased assaults on prison staff or inmates
   • contribute to workplace safety
   • facilitate referral to available drug-dependence treatment programs
   • can coexist with drug prevention and drug dependence treatment programs


5. Are correctional officers expected to overlook inmates injecting drugs?
   
   

   Illicit drugs in federal institutions are contraband. Equally, any items used for injecting drugs that are not part of the approved PNEP kit are also considered contraband. The PNEP is a harm reduction measure available to inmates to manage their health needs. The program will help limit the sharing of needles and the spread of blood-borne diseases in federal penitentiaries, which contributes to safer communities.

6. What other harm reduction measures does CSC offer to inmates?
   
   

   CSC has an integrated approach to the prevention and control of blood-borne and sexually transmitted infections. With the introduction of the PNEP, CSC offers all interventions recommended by the United Nations Office on Drugs and Crime. These measures include:

   • screening and testing at reception and ongoing throughout incarceration
   • education on admission and throughout incarceration regarding infectious diseases and how to prevent their acquisition and/or transmission
   • access to trained peer support workers for advice, information and support
   • access to harm reduction material and information (e.g. condoms)
   • access to substance abuse programs in CSC and community-based Narcotics Anonymous
   • opioid agonist treatment (methadone/suboxone)
   • health promotion/prevention initiatives on risks of tattooing
   • mental health referral/counselling
   • post-exposure prophylaxis
   • pre-exposure prophylaxis
   • HIV and HCV treatment
   • prevention, diagnosis & treatment of TB (parallel screening for HIV & TB)
   • access to bleach
   • Overdose Prevention Service