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Conviction politics: needle exchange established in ACT prison

The announcement yesterday by Chief Minister Katy Gallagher to establish a needle exchange in the ACT’s Alexander Maconochie Prison is historic. Politicians need votes like the rest of us need oxygen…

Katy Gallagher and the ACT government have acted in the best interests of the community. AAP/Alan Porritt

The announcement yesterday by Chief Minister Katy Gallagher to establish a needle exchange in the ACT’s Alexander Maconochie Prison is historic. Politicians need votes like the rest of us need oxygen. And they know that there are no votes in prisons. But prisoners are a major concern for public health and human rights.

Despite prison authorities all over the world doing everything in their power to stop drugs entering prisons, they still get in. And they always will. Charles Manson, the most closely-guarded prisoner in the Western world, was still able to obtain illicit drugs behind bars.

But why do prison inmates take drugs despite the huge risks they run? A prisoner once explained to me that “a day off your face is a day off your sentence”. Last year, an inmate in a Jakarta jail told me that drugs were sometimes cheaper in his prison than in the community.

Less than 1% of the community injects drugs. But those who do inject about two to three times a day (or about 60 to 100 times a month). These days people injecting in the community are likely to share needles and syringes with about half a dozen close friends each year. Most of the time, they inject using brand new sterile needles and syringes. Other harm reduction measures are generally readily available. In the community HIV infections, but not hepatitis C infections, are rare.

A prisoner once said to the author that – a day off your face is a day off your sentence. Todd Huffman

That’s quite a contrast with the situation in prisons. Up to 25% of prisoners will inject drugs while they are behind bars. Prisoners who inject drugs do so much less frequently than their counterparts in the community – perhaps only half a dozen times a month. But they will often share each needle and syringe with between six and ten other inmates. The needles and syringes used in prison are cut down and will have been used previously, perhaps hundreds of times. They are perfect and efficient vehicles for transmitting viral infections.

Most HIV and hepatitis C infections that occur in prisons are only detected when the former inmate is back in the community. By then it’s almost impossible to prove where the infection was contracted. People who use drugs often serve frequent but short prison sentences and so often move between the community and prison.

It’s difficult explaining this situation to the community. More draconian approaches to prison are always expensive, rarely effective and often have severe unintended negative consequences. But draconian approaches are political viagra while pragmatic and effective approaches are often considered politically suicidal.

That’s why it’s taken more than 20 years before any politician in the English-speaking world has done what Katy Gallagher has had the courage to do. Politicians who stand up for important principles deserve to be strongly supported. Katy Gallagher will be greatly admired for the rest of her life by people who understand that protecting public health and human rights is critical.

A needle exchange kit. Todd Huffman

Sooner or later, a prisoner or former prisoner who can prove that they acquired HIV or hepatitis C in a correctional system elsewhere in Australia will sue the prison authority for failure to provide duty of care to the level provided in the community for the last quarter century.

A court will then award them a large sum of money. One by one, correctional authorities in other jurisdictions will act either before or after such a court case. But the experience with the introduction of community needle syringe programs in Australia in the late 1980s suggests that it will still be a difficult and protracted battle extending this decision to the rest of the country.

This is a great moment for public health and human rights. The ACT government’s decision reminds us that offenders get sent to prison as punishment, not for punishment. They’re certainly not sent to prison to acquire dangerous infections and then spread them to their loved ones and friends in the community.

Those who like to demonise all politicians should think about Katy Gallagher and the ACT government courageously acting in the best interests of the community. We should remember with gratitude how politicians from all parties in the early years of HIV excelled themselves by ranking the national interest above their short-term political interests. Katy Gallagher is following in this great tradition.

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16 Comments sorted by

  1. Tom Hennessy

    Retired

    "a prisoner or former prisoner who can prove that they acquired HIV or hepatitis C in a correctional system elsewhere in Australia will sue the prison authority for failure to provide duty of care to the level provided in the community for the last quarter century"

    I was reading an article about this where the car thief got raped four times in prison and caught hepatitis by these encounters. Is he too able now to "sue the prison authority for failure to provide duty of care" ? Or is he just sol ?
    They should just throw drugs in all their food which keeps them docile. Would cut down on alot of trouble. Just like mental hospitals and old folks homes. No rapes , no fights.

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  2. Jonathon Field

    PHD candidate

    Thanks for this article.

    I fully support needle exchange programs in prison. I believe this is an excellent harm minimisation strategy. I accept the dangers but believe there is ample evidence from European countries that this can be managed safely.
    Perhaps needle exchange in prison and in the community is an opportunity to critically reflect on our attitude towards our use of recreational drugs, legal and illegal and on the failure of the war on drugs. Remember the vast majority of offenders are returning to our communities.
    To what extent do our policies and laws on drugs make criminals and make our society less safe, both from crime and preventable disease?

    A mature debate on this issue is long overdue

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    1. Lynne Newington
      Lynne Newington is a Friend of The Conversation.

      Researcher

      In reply to Jonathon Field

      I recall when Sisters of Charity wanted to inroduce a needle exchange programme in NSW in 1999, and the Vatican refused. With their years of prison ministry, prisoners would have had one years ago.

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  3. Jon Hunt

    Medical Practitioner

    I agree this is a brave thing and compassionate thing to do, so atypical of politicians!

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  4. Lisa Waller

    Senior Lecturer in Journalism at Deakin University

    Thanks to Alex Wodak, not only for this really important and heart-warming news but for the great contributions he has made over the years to improving the lives of people at risk of, or living with blood-borne viruses through his work and advocacy.
    The ACT Government and its leader Katy Gallagher deserve praise and support for taking this brave and positive step, as do all the many people who have worked with such dedication and passion in Hepatitis C and HIV prevention and support to get needle exchange programs into Australian jails.
    This is a really big step and I'm very optimistic that the outcomes of the needle exchange program will prove it is really good public policy.

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  5. Dianna Arthur
    Dianna Arthur is a Friend of The Conversation.

    Environmentalist

    I agree a needle exchange program is needed in jails, even if like Tom Hennessy we don't see prisoners as worthy of humane treatment. Tom and others should note that most prisoners return to civilian life - we need healthy and sane people released from prison.

    Where I question the author is in this comment:

    "Politicians need votes like the rest of us need oxygen. And they know that there are no votes in prisons."

    First part of comment I agree with, but the second part?

    Apparently not…

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    1. Dennis Alexander

      logged in via LinkedIn

      In reply to Dianna Arthur

      I think Alex was saying that there are no votes in being compassionate to prisoners. The ACT Liberals have already come out in opposition to the policy with rather punitive minded rhetoric.

      In some, perhaps many, people's minds, prison is a place where people pay for their crimes by foregoing many of their rights and privileges as citizens. A public health argument just doesn't make sense to them, or if it does, does not outweigh the retributive and restitutive arguments.

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    2. Dianna Arthur
      Dianna Arthur is a Friend of The Conversation.

      Environmentalist

      In reply to Dennis Alexander

      I take your point.

      Many people are not aware that by treating prisoners harshly they are exacerbating criminal behaviour. Why anyone would expect a person to behave well and responsibly within the accepted societal realm when released after being treated as a thug?

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  6. Rajan Venkataraman

    Citizen

    Thanks Alex. It is good to see credit being given where it is due. I understand that the former Chief Minister Jon Stanhope was also an advocate for prison reform and the rights of prisoners.

    The only thing from your article I can't understand is why prison authorities have not already been sued for failure to discharge a duty of care. Is it only the difficulty of proving that the disease was contracted in prison that is holding back such cases? Surely epidemiology is up to the challenge?

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    1. Margo Saunders

      Public Health Policy Researcher

      In reply to Rajan Venkataraman

      I'd be interested in knowing more about the 'duty of care' thing in circumstances such as this. The idea reminds me of the prediction made some years ago by leading Australian anti-smoking campaigner Stephen Woodward that smokers would one day sue their employers for allowing them to smoke at work. I don't believe that's happened yet.

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  7. Dee Allwood-Soden

    logged in via Facebook

    How can use of an illegal substance be encouraged in Australian gaols.
    Correctional Officers are at risk of needle stick injuries every day as it is. They don't get any special compensation for being injured in this manner. And the ramifications on their personal lives while they are waiting for the medical results to come back is devastation and embarrassing to say the least. If I was still in the job I would fight this, like I always have. Anyone NOT working in a gaol just does not understand.

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    1. Dennis Alexander

      logged in via LinkedIn

      In reply to Dee Allwood-Soden

      Thanks Dee, the situation of correctional officers is an issue. As you say, there is a daily risk now, likely with very contaminated needles. A more health oriented approach might reduce the risk a little, but there still needs to be a lot of work done on the safety aspects - just as there needs to be a lot more work done on how illicit drugs & needles get into prisons now - as you will no doubt be aware, correctional officers are one possible avenue.

      However, I don't think needle exchange programs encourage drug use, they simply recognise the reality and attempt to reduce the potential for harm from widely shared needles.

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    2. Dee Allwood-Soden

      logged in via Facebook

      In reply to Dennis Alexander

      While ever they have contact visits there will be drugs in gaols.
      Do not forget to include ALL support staff including lawyers in your list of possible smugglers of drugs into prisons. The incidence of these people smuggling drugs and other contraband, such as mobile phones, is far higher than that of officers.

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  8. Wayne Cole

    Public Servant

    While you are all sitting here slapping yourselves on your backs about how good you feel about this subject, and how you are fixing the community, PLEASE! You make me sick! Two words for you all on both sides of the argument.... Geoffrey Pearce... Look that name up!

    Clean syringes won't fix your world in gaols. But forgive for my "knuckle scrapping" views but isn't drug use illegal but what we will do is say to these people, who by the way don't want to follow rules and laws of this society…

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  9. Melanie Raymond

    Chair, Youth Projects, independent NFP

    Yes there needs to be work done around safety of employees, however NSPs have a long record of success in stemming blood borne virus and saving our health system billions of dollars in the process.The reality is that drugs are in prisons, being used, and we can let that place be a source of HIV and Hep C infection, or deal with the issue as a public health measure that will affect the whole community if transmission rates are allowed to increase.
    NSP programs throughout Australia have been operating for a many years with a record of safety and effectiveness, despite public distaste for the problem and the clients they support.

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