Drug problem in Canadian prisons is mounting. As drug addicts pass across syringes, hepatitis C is on the rise, a House of Commons Committee heard last week.
Hepatitis C is an infection caused by a virus that attacks the liver and leads to inflammation. It is passed through contact with contaminated blood most commonly through needles shared during illegal drug use.
Making a presentation before the committee Thursday, Peter M Ford with the Department of Medicine, Queen's University, Ontario, warned, .
"We haven't seen the full impact of this yet. When it happens, we're going to have people in prison with liver failure. We're going to require hospitalization, expensive medication. The transplant system is simply not going to be able to cope with the volume."
Referring to studies that suggest at least 30 per cent of Canada's prisoners have hepatitis C, Dr. Ford told the MPs that several countries, including Russia and Iran, already have needle-exchange programs in prison that are preventing disease. Canada should set up similar programs, he stressed.
Dr. Ford, who is involved in providing care to federal prisoners with HIV/AIDS for a long time, has been stressing the need for a better health deal to prisoners.
Injection drug users are especially
unlikely to access health care outside prison, and incarceration
may be the only opportunity to address their addiction and their
other health problems, he wrote along with his colleague Wendy L. Wobeser, back in 2000 in the Canadian Medical Association's Journal.
There is little evidence that Correctional Service Canada is
making any serious effort to provide treatment to any drug users,
whether they take drugs by injection or other means. Drug rehabilitation
programs are inadequate or nonexistent, and, on the whole, methadone
is available only for heroin addicts who were enrolled in methadone
programs before imprisonment. The physician who attempts to
provide appropriate treatment often meets with resistance from
prison authorities. Failure to address the addiction makes treatment
of HIV or hepatitis C difficult, given that compliance with
therapy is linked to treatment of the addiction. Inadequate
treatment of HIV may lead to resistant forms of the virus in
an environment where sharing of injection equipment facilitates
the spread of infection.
Failure to provide adequate screening and failure to provide
timely treatment may increase the burden of ill health later
on and may also increase the costs to the health care system, they had said then.
The federal correctional system is made up of 52 prisons across Canada with each institution housing men and women who are serving sentences of two years or more. There are five regions mandated to operate these federal correctional facilities: the Atlantic, Quebec, Ontario, the Prairies and the Pacific. Each region is accountable to Correctional Services Canada's (CSC) National Headquarters in Ottawa.
Although there are many ways to reduce the transmission of HIV and HCV, there are only a few measures that can be implemented inside federal prisons to bring about those changes, argues Anne Marie DiCenso, Executive Director of PASAN (Prisoners with HIV/AIDS Support Action Network).
Since 1992, PASAN activists have been fighting for federal prisons in Canada to implement four main harm reduction measures. These include: bleach distribution, safer tattooing, syringe exchange and methadone maintenance. All were supported by The Expert Committee on AIDS and Prison, a Correctional Services Canada funded study on prisons and HIV/AIDS, published in 1994. But not much progress has been made on any of those fronts.
Correctional staff who oppose the distribution of needles in prison say it condones drug use. In reality, it is not an endorsement of drug use, but a concern for the health and safety of prisoners - and the broader health of the community given that most prisoners will eventually be released. Not providing clean needles to prisoners when it is known that injecting drugs is occurring, is tantamount to condoning the spread of HIV and HCV, says DiCenso.