Public Safety Committee on April 1st, 2010

[Sandra Ka Hon Chu]

No, prison-based needle and syringe programs in other countries.

[Maria Mourani, Bloc, Ahuntsic, QC]

Oh, the programs are in other countries!

[Sandra Ka Hon Chu]

Yes.

[Maria Mourani, Bloc, Ahuntsic, QC]

I have not seen needle dispensing machines at the Correctional Service.

You do realize that correctional officers have to deal with violence inside the walls on a daily basis? This violence is a result of drugs being injected, but it is also a result of the offenders' ability and ingenuity to use any object to assault fellow inmates or guards.

[The Chair, Conservative, Garry Breitkreuz]

This is your final question. Please wrap it up.

[Maria Mourani, Bloc, Ahuntsic, QC]

An unaccounted-for needle can become very dangerous, just like a pencil.

[Sandra Ka Hon Chu]

We did an access to information request with CSC some years ago, and they showed I think it was over 100 accidental needle stick injuries in that period of about five years, and not a single case where a needle was used as a weapon.

I can speculate about the reason why. It's because these are very valuable. They're so scarce. People don't want to use them as weapons and give them up because you have to pay to use them. In the jurisdictions and other countries where these needle syringe programs exist, they have not been used as weapons.

[The Chair, Conservative, Garry Breitkreuz]

Thank you.

Mr. Davies.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you.

First of all, I just want to thank you for the incredibly well-researched document you provided us. I don't think I've seen more footnotes in a presentation in any other thing we've had.

My colleague on the other side asked who would pay for the needles if they were provided. Who pays the $22,000 a year to treat someone with hepatitis C, and $29,000 a year to pay for an inmate with HIV?

[Sandra Ka Hon Chu]

CSC.

[Don Davies, NDP, Vancouver Kingsway, BC]

CSC pays for that. Do you know what the annual cost of a needle supply would be?

[Sandra Ka Hon Chu]

I'm not sure. When I speak to the people at the Ontario harm reduction distribution program, they tell me an actual needle costs between five cents and ten cents, each needle.

[Don Davies, NDP, Vancouver Kingsway, BC]

Okay, five cents and ten cents.

[Sandra Ka Hon Chu]

And that's based on their distribution network.

[Don Davies, NDP, Vancouver Kingsway, BC]

Okay.

[Sandra Ka Hon Chu]

They're pennies.

[Don Davies, NDP, Vancouver Kingsway, BC]

I think the conclusion on which is more cost-effective is pretty apparent.

In terms of accidental sticking in cells, I've talked to prison guards who have told me that a common workplace fear of theirs is when they're doing cell searches and there's the risk of being accidentally stuck by surreptitious needles, which are hidden in all manner of places.

Have you ever heard that concern expressed by prison guards?

[Sandra Ka Hon Chu]

Yes, we have. The previous colleague, who has spoken to them before, did. When we did the access to information request, we found that this in fact happened quite a few times in the course of a five-year period, over 100 times.

[Don Davies, NDP, Vancouver Kingsway, BC]

Where I come from in Vancouver, in British Columbia, in Vancouver today—and it's gone on for years—we have had a safe needle exchange program on the streets, as well as a safe injection site. But just in terms of the safe needle exchange, where addicts can go and get a clean needle and they turn in their old one and get a clean one, successive governments of every stripe have continued to support that program. It strikes me that a drug addict on the street has access to better health care outcomes than someone who is under federal care when they come into the corrections system. Would that be an accurate statement?

[Sandra Ka Hon Chu]

I believe so, yes. I think it makes absolutely no sense to deny someone who would, on the street, have access to the needle and syringe program. In fact, many of the people we have spoken to said they took advantage of those needle and syringe programs in the community, but when they were in prison there was no availability.

[Don Davies, NDP, Vancouver Kingsway, BC]

My last question is on a statement you make on page 19 of your report that PNSPs “facilitate referrals of users to drug addiction treatment programs”. You made the point that it actually doesn't lead to increased drug use, but it actually may lead to accessing drug treatment. Can you maybe elaborate on that for us?

[Sandra Ka Hon Chu]

Yes. In evaluations where these programs exist, the frank conversations that prisoners have with health care staff and with peer health workers who have been trained on harm reduction and drug addiction and treatment have led to referrals of people to drug treatment programs. So that was what the evidence has demonstrated. It creates an opportunity for a conversation with health care staff, peer health workers, or external NGOs.

[Don Davies, NDP, Vancouver Kingsway, BC]

I think everybody agrees that drugs in prison are undesirable, that they are dangerous, and it leads to a problem that we all agree is something to be dealt with. But I think we're talking about harm reduction here.

What I was going to ask you in my last question is that sex among inmates in prison is prohibited, yet we provide condoms and dental dams. Drugs in prison are prohibited, yet we just heard that we have methadone dispensed to people in prison. Does it not seem inconsistent to you that we would not go the final step and provide paraphernalia that we all agree, and all experts agree, including the United Nations, would reduce the spread of infectious blood-borne diseases?

[Sandra Ka Hon Chu]

Yes. When we know that CSC provides bleach, and the singular reason for that bleach provision is to clean needles for HIV, and it's not effective at all for hepatitis C cleansing, then it's inconsistent, absolutely. Bleach is provided with instructions on how to clean syringes and needles for injection drug use.

[Don Davies, NDP, Vancouver Kingsway, BC]

So even if we don't approach this from a rights-based position, from a public health point of view—