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Needle exchanges in federal prisons can save money and lives

When Ottawa recently announced a multipronged strategy to fight the deadly fentanyl crisis – a strategy that includes supervised drug consumption sites – Health Minister Jane Philpott boasted of "our renewed, evidence-based approach to Canada's drug strategy."

If Ottawa is so keen on an evidence-based approach to drugs, why did it walk away from mediation aimed at settling a lawsuit calling on the government to provide needle exchanges in prisons? Mediation sessions were scheduled this week but Ottawa's lawyers backed out at the last minute. The lawsuit, brought in part by a former inmate who acquired hepatitis C behind bars, is going forward.

For readers who are muttering, Needle exchanges in prison?! You've got to be kidding, please bear with us.

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Drugs in federal prisons are a real problem, in spite of Correctional Service Canada's zero-tolerance policy. A 2012 study by Parliament's Standing Committee on Public Safety noted that illegal narcotics find their way over the wall in all sorts of way, including in the handbags of mothers who can't say no to their addicted child's pleadings. It is simply unfeasible for CSC to lock down a prison to such a degree that no drugs will ever get inside.

The problem is that inmates using injectable drugs share the limited number of contraband needles and syringes available to them. People in federal prisons are consequently far more likely to acquire AIDS/HIV or hepatitis C than the general population. They arrive in prison healthy and leave with chronic diseases that cost society millions of dollars to treat. Sometimes, they die.

The best approach, then, is to implement harm-reduction measures. Needle exchanges, which are common in Canadian cities and not particularly controversial, help limit the spread of infectious diseases, and save lives and money.

But prisons are not miniature versions of society. People can't just come and go, no questions asked. In effect, the advocates of prison needle exchanges are asking for something more controversial – safe injection sites, where addicts take illicit drugs in a monitored environment that is exempt from Canada's Controlled Drugs and Substances Act. That's a big ask for a prison system, and it probably explains why Ottawa is wrestling with this issue.

The government must acknowledge, though, that harm-reduction programs are cost-effective, according to numerous studies. They can also be safely operated in prisons, according to the real-life experiences of other jurisdictions around the world.

And they are just. Incarcerated addicts shouldn't be denied the health protections that are available to everyone else. The government should have faith in its evidence-based approach, and bring harm reduction inside prison walls.

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