Harm reduction is a critically important part of the approach to drug use and misuse in society and in prisons. The law requires that the Correctional Service of Canada provide health care to professional standards to reflect what is available in the community. A variety of harm reduction measures are available outside prison walls, and some of them are already available inside penitentiaries.
In the 1990s—I think it was 1999—the health advisory committee for the Correctional Service of Canada looked at the issue of prison-based needle exchange and reflected that this would be something worth pursuing in the Canadian context. My office issued a recommendation to support exploration of prison-based needle exchange back in 2003-04, in our annual report that year. The Public Health Agency of Canada was engaged by a study in 2005 or 2006 to look at prison-based needle exchange around the world and looked at some that were in operation.
The biggest concerns voiced have been around staff safety—that if syringes were more available inside an institution, perhaps they could be used as weapons, or staff might be subject to more needle-stick injuries. The worldwide experience is the opposite. Well-managed prison-based needle exchanges tend to reduce the chances of being accidentally injured by a needle during a cell search, etc. There has been a lot of exploration around prison-based needle exchange, and certainly it has been demonstrated to be an effective harm reduction measure.