Public Safety Committee on April 1st, 2010

[Brent Rathgeber, Conservative, Edmonton—St. Albert, AB]

Under this model you're advocating for, would other CSC officials be required, specifically a nurse, or would the inmates be allowed the needles and just inject on their own timetable?

[Sandra Ka Hon Chu]

Again, it depends on the model that should be adopted in the different prison systems. We've never actually had a pilot, as you know. So I think we would have to test which model would work the best in our system. But there are many models we can learn from, based on the number of prisons where they've existed now for some years.

[Brent Rathgeber, Conservative, Edmonton—St. Albert, AB]

What about methadone and this other substance, suboxone? Are those not a more effective and better way of dealing with inmates who have addiction problems than handing out needles?

[Sandra Ka Hon Chu]

Methadone is an effective method of dealing with addiction for people with opiate addictions, but I think we've heard from other witnesses that methadone treatment is not always available and not everyone wants to use it.

Not everyone has an opiate addiction. Some people might be using other drugs. Cocaine injection drug use is something that we've seen is prevalent within the prison system, within federal prisons as well.

So it's not effective for all people. It's a very effective treatment, but prison needle and syringe programs are another component of a more comprehensive harm reduction and public health program.

[Brent Rathgeber, Conservative, Edmonton—St. Albert, AB]

It takes two substances to accommodate an addiction: one is the drug; and one is the instrument. You will agree with that.

[Sandra Ka Hon Chu]

I'm sorry, I don't think of the needle as a substance.

[Brent Rathgeber, Conservative, Edmonton—St. Albert, AB]

The needle is of no value without the drug.

[Sandra Ka Hon Chu]

Right.

[Brent Rathgeber, Conservative, Edmonton—St. Albert, AB]

So does the duty to accommodate then not also extend to the drug?

[Sandra Ka Hon Chu]

Drugs have been illegal in all the systems where the needle and syringe programs have existed. So they would remain illegal.

[Brent Rathgeber, Conservative, Edmonton—St. Albert, AB]

I understand that. But I read your brief and you talked about section 15 of the charter and dealing with prisoners equally to people of society. So if there is a duty to accommodate, the logic would be that the state should also provide the prisoner with the drug.

[Sandra Ka Hon Chu]

That's not what we're advocating for at this time, and that's not what I'm speaking about.

[Brent Rathgeber, Conservative, Edmonton—St. Albert, AB]

Thank you.

[The Chair, Conservative, Garry Breitkreuz]

Okay. Mr. Holland, please.

[Mark Holland, Liberal, Ajax—Pickering, ON]

Thank you, Mr. Chair.

Thank you to the witness for appearing today.

You might be aware--the minister recently announced a deal with ballooning prison populations--that Canada will violate an international agreement of which it is a signatory, a UN agreement, against double bunking.

I wonder what your feelings are around the implications for infectious disease with a ballooning prison population and double bunking. I think it's also important in terms of what that means to communities, given that 91% of inmates get back into the general population.

[Sandra Ka Hon Chu]

I read the transcript of Craig Jones, who was here before. I agree with him 100% that double bunking and the increasing prison population will only contribute to the worsening of the environment within the prison system.

We've spoken to many prisoners who did not previously use drugs, but who use drugs once they enter prison because they're coping with a really harsh prison environment. Double bunking will only escalate that. It can't make it better. It's only going to make the infectious diseases rate go up. That's what we speculate will happen, and when I've talked to community groups who work with people in prison, that's what they feel as well.

I think it's important that you mentioned the 91%, the number of people who are being released into the community. There were 2,000 people infected with hepatitis C in 2006, and 200 people infected with HIV. That's unacceptable.

[Mark Holland, Liberal, Ajax—Pickering, ON]

That figure was 2,000 people being released with hepatitis C, and 2,000 with HIV?

[Sandra Ka Hon Chu]

It's 200.

[Mark Holland, Liberal, Ajax—Pickering, ON]

That's 200 people into the general community.

[Sandra Ka Hon Chu]

In 2006.

[Mark Holland, Liberal, Ajax—Pickering, ON]

I think this is important. We talk about the risk associated with a needle exchange program. You mentioned European jurisdictions that initially had these same concerns and they never materialized.

Perhaps you could weigh the risk, on the one hand, of the needle exchange program to inmates with the risk to public safety and public health, on the other side, of not having programs that curb this rapid rise in infectious disease within our prisons.

[Sandra Ka Hon Chu]

That's precisely what the systemic evaluations have told us. The risks with the concerns about these needle and syringe programs have simply not materialized. There have been no increases to institutional violence. Needles have not been used against staff or other prisoners.

If we don't implement this, every passing day there are more people becoming infected with HIV and hepatitis C. I've spoken to people, as part of a report that we released earlier this year, who believed confidently that they were infected while they were inside.

[Mark Holland, Liberal, Ajax—Pickering, ON]

One of the arguments is that all we have to do is clamp down on drugs: stop the drugs from going in and we've got an answer. We've had many years of that policy being implemented and tens of millions of dollars spent. The result in random drug testing is that drug use has actually gone up during that period of time.

How do you assess the argument that the only answer is to shut the doors on drugs coming into the prisons and then we eliminate the problem?

[Sandra Ka Hon Chu]

I think it's one component of an approach; it's one component to stop the drugs from coming in. But the last CSC deputy commissioner mentioned that it simply does not stop drugs. There's no prison in the world where drugs do not enter.

Given the significant amount of resources that have been spent in the last ten years, and the correctional investigator's finding that drug use has not gone down, you can't focus exclusively on drug interdiction. There needs to be a comprehensive approach.

[Mark Holland, Liberal, Ajax—Pickering, ON]

On the question of cost, can you compare the cost of some of the actions you're suggesting--needle exchange programs--with the cost of treating somebody with HIV/AIDS, hepatitis C? Comparing the costs of a preventative-type program versus a do-nothing approach, what would the cost differential be?