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Matters of Substance

Should needle exchange programmes be introduced into prisons?

Wednesday, March 21, 2012

Australia’s ACT government caused a stir recently when it announced plans to introduce prison needle exchange programmes (NSPs) giving prisoners clean needles for personal drug use. It’s already being done in Spain, Germany and some other European countries.

Those on the har-reduction front ar vocal in their support for the idea, but prison guards and their unions are not. They've threatened to boycott prison NSPs and strike or resign if they go ahead.

In this edition of Viewpoints we provide the arguments for and against Needle exchange programmes in prisons.  Mäori wardens’ ability to intervene in specifically Mäori cases of drunk and disorderliness. What do you think, vote here.


The case against
Prison NSPs don’t minimise harm; they only create greater potential for it.

How can making it easier for prisoners to take drugs do anything other than increase drug use? Surely the best way to overcome dependence is stop using, and incarceration should be a time when prisoners are forced to face their addictions and seek help. Making drug use a more comfortable prison pastime does nothing to encourage that.

Similarly, these programmes are great for introducing inmates to drugs. If the tools for getting high are readily available, the likelihood of first-time use behind bars is only increased.

And then there’s the question of moral responsibility. Injecting drug use is illegal. Does that mean a prison guard who lets an inmate use the NSP becomes complicit to illegal activity? The point may be up for discussion, but prison guards should not have to face such a moral quandary as part of their everyday work.

Prison NSPs also send out conflicting messages to inmates. When they are brought to prison, they are extensively searched for drug paraphernalia. Family and friends who visit are also subjected to searches. Once inside, however, prisoners are freely given the very items they were searched for. This makes little sense and is exactly what it appears to be – authorities condoning illegal drug use.

But one of the biggest concerns is the threat to safety. Introducing NSPs to prison puts a powerful weapon into the wrong hands. Serious damage can be done with a sharp syringe, and many inmates and guards fear they will be used as weapons. Prison guards say there are plenty of instances where they have been pricked, and in 1997, one Australian officer died after being deliberately stabbed with a needle full of HIV-positive blood.

Finally, there are better ways to minimise harm from blood-borne diseases in prison than by introducing NSPs. For example, for every syringe found in Canberra’s Alexander Maconochie Centre, four illicit tattoo guns, which are also capable of transmitting infections, are discovered. Tackling that issue would reduce infections a whole lot quicker and be much more effective than giving inmates needles and telling them their drug use is perfectly acceptable.

The case for
NSPs in prisons are all about protecting drug-using prisoners who have the same basic human right to harm minimisation as anyone else. It eliminates needle sharing, which is one of the most efficient ways of transferring
blood-borne diseases. One Australian ex-prisoner reported seeing the same needle shared throughout an entire unit for six months, amounting to an incredible risk. But internationally, no prison running an NSP has reported a new contraction of HIV, which makes it pretty clear it works.

Secondly, NSPs in prisons around the world have been shown to reduce drug use and increase referrals to substance abuse treatment. Regular contact with health professionals who administer the needles gives inmates more opportunities to seek help and find a way past their addiction – and it seems they are taking them.

Thirdly, NSPs create a safer prison environment. Syringes are hard to come by, so inmates tend to hide them well. Any guard searching a cell is very much at risk of accidentally pricking themselves with a potentially infected needle. And World Health Organization evidence reveals there have been exactly zero incidents of prisoners using syringes as weapons in prisons with NSPs, so fears that more syringes in prisoner hands will put
guards at risk are groundless.

NSPs also contribute to a safer environment outside prison. The average sentence is just six months – plenty of time to get inside, get infected and get back out again to share your new disease with your family, friends and community. NSPs in prisons would markedly reduce this risk to us all.

Lastly, prison NSPs are extremely cost-effective. Royal Australasian College of Physicians estimates are that the $150 million or so invested in NSPs worldwide has saved between $2.4 and $7.7 billion based on the reduced rates of contracted infections. There’s no reason to think that a savings ratio of around 20 to one wouldn’t also apply to prisons.

It’s time to stop being squeamish, which puts us all in danger. No one likes the thought of prisoners shooting up, but the fact is, they are going to, and they will cause a lot less harm to all concerned if we can help them do it cleanly.