Injection Drug Use in Prisons A quick sketch of the global situation and a review of prison-based needle exchange. Matt Curtis International Harm Reduction Development Program Open Society Institute [email protected]
Drugs are available and injecting is preferred route, syringes are extremely scarce, and risk behavior is enforced by the environment while risk perception is often misguided.
“Drugs were around but you see a syringe is a forbidden thing. And so they didn’t really figure very much. With drugs it is possible to hide them somehow, somewhere, but well, how do you hide a syringe? So, if someone somehow got hold of a
syringe—maybe they brought it in or stole it from the medical centre—then it was just superachievement. Then that syringe would do the rounds and rounds and rounds of the whole camp. And then you get loads of syphilis, AIDS and . . . Someone would shoot up once and then in the course of the next 2 months about 20 people would be in the isolation ward with viral hepatitis.” (Barnaul, male, 18)
Sarang A., Rhodes T et. al. “Drug injecting and syringe use in the HIV risk environment of Russian penitentiary institutions: qualitative study.” Addiction 2006 forthcoming.
“Last time [I shared] … we shared one syringe between five. We took heroin. A person brought a gram of heroin, and we took it using one syringe. [And after, what did you do with the syringe?] We kept washing it out, and then hid it in order to use it the next time. Because in prison they are hard to get hold of.” (Volgograd, male, 27)
“We got a gram, shot up, five of us shot up. [ five. We took heroin. A person brought a gram of heroin, and we took it using one syringe. [With the same syringe?] Of course, of course, what else? Then, no-one . . . There’s the HIV
section, well a whole section of people who’re
infected with HIV, they live separately and that’s it.
There they don’t have anything in common . . . And they check you immediately for HIV in the camp, as soon as you arrive and they check immediately there.” (Barnaul, male, 56)
By the end of 2005, more than 50 PNEPs were operating in:
PNEPs utilize various methods for distributing syringes: five. We took heroin. A person brought a gram of heroin, and we took it using one syringe. [
No evidence that PNEPs have serious, unintended negative consequences
Determinants of success:
Any measure undertaken now to prevent the spread of HIV will benefit prisoners, staff, and the public.
Canadian HIV/AIDS Legal Network
International Harm Reduction Development
Open Society Institute
European Network on Drugs & Infections
Prevention in Prisons