Calls for needle exchange programs in jail

THE spread of blood-borne diseases such as hepatitis B and C among Australia's prison population has prompted a call for jails to establish needle exchange programs.

There are currently no syringe programs active in any Australian prison despite infections becoming more frequent.

Up to two-thirds of female inmates and one-third of males in prison are infected with hepatitis C, according to the Department of Health's Fourth National Hepatitis C Strategy 2014-2017.

Meanwhile 43% of Aboriginal and Torres Strait Islander people in Australian jails have contracted the potentially fatal virus.

A 2013 Corrective Services NSW study found 37% of the state's prison population said they had used drugs while behind bars.

And despite calls from the World Health Organization and the United Nations Office on Drugs and Crime, Australia still does not have any needle exchange programs operating in prisons.
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UNSW National Drug and Alcohol Research Centre Professor Kate Dolan wrote an online opinion piece calling for the state governments to revisit the issue.

"In the West, more than one third of inmates have a history of drug injection. In NSW, it's about half of inmates," she said.

"This is in stark contrast with levels of drug injecting in the general population, which are less than 0.5% in Europe and Australia.

"While those in the community may not feel at risk, most inmates are released back to their communities.

"Many prisoners serve short sentences of about six months or less. And sentences served by women tend to be shorter, three months or so."

Professor Dolan said the NDARC reviewed prevention programs for prisoners including education, voluntary testing and counselling, needle and syringe programs, methadone, condom provision and antiretroviral therapy for HIV.

"Only seven countries - Moldova, Kyrgyzstan, Germany, Luxembourg, Portugal, Spain and Switzerland - provide all six interventions in their prisons," she said.

"However, the actual level of coverage in these countries remains unknown."

She said ice had overtaken heroin as the main drug injected in Australian jails, and years of research had proven syringe programs to be safe and effective at reducing infection.

"While we are still grappling with how we can best treat these people, users should be provided with cognitive behavioural therapy to manage their addiction and the underlying problems that led them to use," Professor Dolan said.

"While Australia has led the way in the control of HIV in prison, it still has to control hepatitis B and hepatitis C.

"For every 100 people in prison who has ever injected drugs, 14 will become infected with hepatitis C each year.

"Treatment is available and has been provided in NSW for several years now, but most other states have not yet introduced this costly but effective treatment.

"If other states follow suit, we could virtually eliminate hepatitis C infection from the prison population."