About Canada’s Current PNSP

Our court proceedings actually spurred the Correctional Service of Canada (CSC) to introduce a ‘Prison Needle Exchange Program’ (PNEP) in federal prisons. That program, which began in 2018, is currently rolling out to prisons, albeit much too slowly and with critical flaws; so most prisoners still don’t have access to sterile injection equipment.

The Correctional of Service of Canada’s (CSC) program has serious deficiencies that are not in keeping with public health principles or professionally accepted standards.

Most fundamentally, CSC’s PNEP violates prisoners’ confidentiality without reasonable justification. For example, prisoners who wish to participate must subject themselves to a “threat risk” assessment based on security rather than clinical need, requiring a warden to approve each prisoner’s participation. Those who are accepted must participate in twice daily “visual inspections” to verify accountability for the equipment distributed, which will be perceived by prisoners as a significant intrusion. The PNEP also involves the widespread sharing of information regarding prisoners’ participation.

There is no working program in the world that uses the approach adopted by CSC, which will inevitably operate as a very strong barrier to access. Nor is there justification for this approach.

In more than 25 years of functioning prison-based needle and syringe programs, there has not been a single reported incident of assault with needles from such programs anywhere in the world. Occupational safety is better — not worse — where these programs exist, because occupational staff are far less vulnerable to accidental needle-stick injuries and also less likely to experience such an injury with a needle/syringe that has been shared by many people.

These breaches of confidentiality run contrary to national and international standards of medical ethics and conduct, public health principles, and the international experience of effective prison-based needle and syringe programs.

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Prisons need a needle exchange. There are a lot of people who come in, and haven’t done drugs before, and become addicted inside… They come out with a HIV or hepatitis C infection…If they had needle exchanges in institutions a long time ago, it would have saved a lot of people’s lives.”