Radio Current Affairs Documentary: Needle exchange

Adrienne Francis reported this story on Tuesday, January 10, 2012 18:30:00

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ELIZABETH JACKSON: Out of sight and out of mind. The rights of convicted criminals are often glossed over. But in the nation’s capital, human rights legislation is designed to protect prisoners. The ACT Government is considering a plan to provide prisoners with clean drug injecting needles and syringes. If the pilot program goes ahead it would be a first in Australia. However, most prison officers are vehemently opposed and some are vowing to boycott any moves to trial prison needle and syringe programs.

Our reporter Adrienne Francis visited Canberra’s new prison to file this report.

PRISON GUARD: (To dog) Find it!…

ADRIENNE FRANCIS: For anyone attempting to smuggle narcotics, syringes, weapons, mobiles, alcohol or poisons into Canberra’s only prison, first you need to get past the sniffer dogs.

The two year old jail and remand centre can house up to 300 inmates.

CANINE UNIT CORRECTIONS OFFICER: Canine, about to conduct a passive alert search on intending visitors at the Alexander Maconochie Centre. The search entails a low and high search on a person using the canine’s olfactories.

(To dog) Hey mate, find it!

CANINE UNIT CORRECTIONS OFFICER 2: If the dog gives a positive response which is a sit response to the presence of a narcotic odour that person will then be taken to a room and we’ll have a conversation with that person and we’ll try and establish a) whether they are carrying some form of narcotic with an intent to try to introduce it into the centre, b) if it is residue odour if that person is under the influence of a drug and then we take the appropriate action.

(Sound of computerised voice on metal detector: “Access denied, please exit”)

ADRIENNE FRANCIS: Screening for contraband doesn’t end there. There are x-ray body scanners and ion scanners to detect drug and chemical residues and before entry all staff and visitors are weighed and identified through an eye scanner. All baggage passes through a metal detector and x-ray.

Bernadette Mitcherson is the executive director of ACT Corrective Services.

BERNADETTE MITCHERSON: We know that approximately 80 per cent of people coming into custody were under the influence of alcohol or a drug at the time they committed the offence.

ADRIENNE FRANCIS: For a few drug addicted inmates, custody can provide an opportunity to detox.

BERNADETTE MITCHERSON: There are another group who are not at a point where they want to stop using and have drug seeking behaviours which take a number of formats.

They might know they are coming into custody and try and bring something with them if they go to court and are expecting to have a sentence. They might put pressure on family and friends to bring things in and we know they do that because we can listen to telephone calls.

ADRIENNE FRANCIS: There were a lot of hopes in some sections of the community that the new jail you could potentially keep drugs out. Can you?

BERNADETTE MITCHERSON: Every jurisdiction internationally and nationally struggles with this issue. Anyone who says that they’re totally drug free is looking at life and their business through rose-coloured glasses so I think it’s probably a near impossible task.

ADRIENNE FRANCIS: Some health policy advocates warn it would require draconian measures to curb illicit prison activities which would undermine rehabilitation of inmates.

Michael Moore is the chief executive officer of the Public Health Association of Australia. He’s also an adjunct professor at the University of Canberra and a former ACT health and corrections minister.

MICHAEL MOORE: The sorts of things that would need to be done to stop drugs going into prison is body cavity searching everybody going in and out of the prison.

So this would not be a great work environment for prison officers, starting your day with a body cavity search. But probably just as important, you know somebody is imprisoned for six months and that’s the average time, doesn’t want their wife or their mother coming in and being body cavity searched before they can come in for a visit.

(Sound of voices over the two-wave radio)

FORMER INMATE AND ILLICIT DRUG USER: I have spent two separate like times in there, and they were both for assaults. There was a lot of drug use, (inaudible) wasn’t very clean.

ADRIENNE FRANCIS: This 26 year-old Canberra man has spent more than a year inside the Alexander Maconochie Centre. We can’t identify him for legal reasons. He’s also an illicit injecting drug user and has been unemployed for a long time.

FORMER INMATE AND ILLICIT DRUG USER: There’s like heroin, a lot of ice has been getting in, I know that, and bupe.

ADRIENNE FRANCIS: Bupe is short for buprenorphine. The prescription drug is similar to methadone and is administered to treat people addicted to heroin or other opioids such as morphine.

The former Canberra inmate says he’s seen other prisoners share needles. Among injecting drug users needles are sometimes referred to as weapons, equipment, works or fits, an abbreviation for outfit.

FORMER INMATE AND ILLICIT DRUG USER: From what I have seen from when I was in there, there was a fit that was used for about six months while I was there. It was just one needle and they’d just file it down. They’d use it through all the guys in the unit, very blunt. You could see it was blunt. Like, it kind of turned me off a little bit but I guess for somebody who has never done it before I can understand why they would want to go, like try it, and stuff and why they start in jail.

ADRIENNE FRANCIS: The shared needles or fits are often cut down to the twenty or thirty unit markings on the side of a 100 millilitre syringe. Called short 20s or short 30s, they’re easier to smuggle into jail and conceal from prison officers.

FORMER INMATE AND ILLICIT DRUG USER: Yeah, sometimes in the mouth, sometimes in the body. Different places.

ADRIENNE FRANCIS: He says he contracted hepatitis C before being convicted. And he’s not alone. The latest annual health survey of prisoners in Canberra found close to half of those voluntarily tested had been exposed to hepatitis C at some time during their life.

That’s more than 20 times the prevalence in the Canberra community. However, the survey did not screen for current infection. The virus is transmitted through blood and it affects the liver causing inflammation. If left untreated it can lead to cancer.

It’s not clear when or how these prisoners were exposed to the virus.

The Public Health Association of Australia’s chief executive officer Michael Moore.

MICHAEL MOORE: Certainly amongst the women it is very, very high. Different strains of hepatitis C are likely to be shared. And remember it’s not just one strain of hepatitis C, it is a series of strains. So even when somebody has hep C, if they are sharing needles the problem can be exacerbated by getting different strains.

ADRIENNE FRANCIS: And there is evidence that a minority of Canberra prisoners have contracted hepatitis C while in custody. Voluntary blood screening has revealed two cases of hepatitis C contraction within the Canberra prison over the last year. And while none of the Canberra prisoners who volunteered for screening tested positive to HIV, health advocates are concerned about the multiple sharing of worn injecting equipment.

NICOLE WIGGINS: So if HIV gets into the prison and amongst injecting drug users it will spread very quickly and it has been shown in internationally HIV can, a couple of prisoners can have HIV and within a few months like a third of the prison population will have HIV.

ADRIENNE FRANCIS: Nicole Wiggins is the manager of the Canberra Alliance for Harm Minimisation and Advocacy.

NICOLE WIGGINS: We haven’t had an HIV outbreak in our prisons yet but it is pure luck, not good management and it is only a matter of time until there’s a HIV outbreak in our prisons.

ADRIENNE FRANCIS: Nicole Wiggins says inmates are not alone in their vulnerability to blood borne disease infection.

NICOLE WIGGINS: At the moment guards are at risk of accidental needle stick injury because the syringes in there at the moment are hidden in all sorts of places around the prison and guards get needle stick injuries.

ADRIENNE FRANCIS: Switzerland became the first country to provide its prisoners with clean drug injecting equipment in 1992. Since then eleven other countries including Germany, Spain, Luxembourg, Belarus, Moldova, Kyrgyzstan and Iran have introduced prison needle and syringe programs.

Ralf Jurgens reviewed the performance of these prison programs for the World Health Organisation. He’s the co-founder of the Canadian HIV Aids Legal Network.

RALF JURGENS: Studies consistently show a marked reduction of sharing of injection equipment and in none of these systems that have introduced needle exchange programs in prisons there have been new cases of HIV infection.

ADRIENNE FRANCIS: The possibility of the first Australian prison needle and syringe program gained momentum in the ACT during the tenure of former chief minister Jon Stanhope. He oversaw construction of the Territory’s $130 million prison and remand complex, which opened in 2008.

For the 95 years prior to this all Canberra criminals were transported across the border to New South Wales jails. Unlike all other Australian jurisdictions the new Canberra prison operates under the ACT’s Human Rights Act.

JON STANHOPE: It recognises each of us have inalienable rights, such as the right to privacy and in the context of the operation of a prison, a right not to be subjected at a whim and without reasonable cause to a body search.

ADRIENNE FRANCIS: Jon Stanhope says the jail’s mandate is to rehabilitate and educate inmates rather than punish them.

JON STANHOPE: Prisoners are sent to prisons as punishment but the sending of them to the prison isn’t for punishment. It’s a very, very important distinction and the Human Rights Act essentially underscores that to ensure that in the regime that applies, the regime doesn’t impose this secondary punishment over and above the removal of their freedom.

ADRIENNE FRANCIS: Jon Stanhope drew his public policy inspiration from the philosophy first advocated by the centre’s controversial namesake Alexander Maconochie.

JON STANHOPE: Recognised universally as a great prison reformer and certainly the pre-eminent penal reformer in Australia’s history, a onetime commandant of Norfolk Island that turned traditional notions of corrections on their head.

Took the decision to treat prisoners as human beings, to have some regard for their rehabilitation, believed in their redemption or the possibility of redemption and transformed things such as recidivism rates, return to prison, was stunningly successful and then interestingly was recalled or sacked as a result of his progressive attitudes. That it was too progressive for the order of the day.

ADRIENNE FRANCIS: Jon Stanhope says he regrets not introducing a needle and syringe program from the start of the prison’s operations.

JON STANHOPE: Perhaps I was naive that we would establish a prison, that we would inculcate a human rights culture that the prison officers and all those that work within the prison would be with us, that they would willingly grasp the opportunity to work in a very different environment in a very different prison.

ADRIENNE FRANCIS: Instead he handed the baton to his successor, ACT Chief Minister Katy Gallagher. Prior to her elevation she commissioned the former ACT Health and Corrections Minister Michael Moore to investigate potential models for a needle and syringe program at the jail.

MICHAEL MOORE: People are entitled to the same level of health care and the same access to health within a prison as they are outside of the prison.

ADRIENNE FRANCIS: The Moore Report recommended changing the ACT Correction’s Management Act to require the establishment of a prison needle and syringe program. It also recommended the creation of a contained program within the jail’s health centre that could be run by a non-government organisation or ACT Health.

MICHAEL MOORE: So a prisoner would say I need to go to the health centre as they do at the moment. That prisoner would be escorted by a prison officer, as happens at the moment. Once they reach the health centre the prisoner then says to the triage nurse, separate from the prison officers, actually what I need to do is inject.

They are taken to a room and looked after by the non-government organisation where they’re allowed to inject and then the equipment is left in the health centre and never goes out into the prison.

ADRIENNE FRANCIS: Michael Moore estimates a prison program could cost less than $100,000 a year. But the saving to taxpayers from preventing disease transmission and the related health care costs hasn’t been modelled. He also suggested simpler alternatives including exchange of dirty needles for clean injecting equipment or prison needle vending machines.

MICHAEL MOORE: It will be used as a political football. We are already within an election year. The elections in the ACT is in October of 2012. It is an issue that will not only have to be judged in terms of the health consequences which are really clear, the human rights consequences which are really clear but in terms of the political consequences.

ADRIENNE FRANCIS: The ACT Chief Minister Katy Gallagher has repeatedly voiced her support for the proposed pilot but concedes she faces a battle with the union representing most of the prison officers.
KATY GALLAGHER: I could storm through and say here’s a needle and syringe program, it’s starting next year and then have a fair bit of unrest within that setting, within the workplace and not actually be able to deliver it anyway. But I haven’t given up hope that we’ll be able to come out with something innovative that actually deals with the blood borne virus issue.

ADRIENNE FRANCIS: But the majority of Canberra prison officers are not convinced.

The Community and Public Sector Union represents more than 10,000 public prison officers nationally. The CPSU has a total membership of 160,000 people.

Nadine Flood is national secretary.

NADINE FLOOD: We have had officers who have been subject to needle stick injuries and indeed we have had an officer who has died from such an injury.

ADRIENNE FRANCIS: Ms Flood says the union is strongly opposed to the pilot program.

NADINE FLOOD: Well custodial officers not only in the ACT but in fact around the country have three critical concerns about such programs. That is workplace health and safety, the prospects for prisoner rehabilitation and the legality of custodial officers’ actions and whether they would be put at risk by being complicit in illegal activity.

ADRIENNE FRANCIS: This Canberra prison officer won’t be named or allow his real voice to be heard. But he’s eager to share his concerns about complicity.

PRISON OFFICER: We have had 12 overdoses at the AMC since the AMC opened. It seems to me that we are introducing this as a harm reduction scheme but we are potentially creating more harm. I mean where does the department stand if somebody dies from an overdose in the injecting room with the needle that the department has provided?

ADRIENNE FRANCIS: The Canberra prison officer acknowledges no jail has been able to eliminate drugs but he says condoning drug use in custody threatens rehabilitation.

PRISON OFFICER: For them to get the drugs into prison is costing them 10 times the amount that it costs for the same drugs on the outside. The way they do that is they rack up huge debts with illegal gangs, then when they come out there is only one way they’re ever going to pay those debts back and that is going straight back to crime.

ADRIENNE FRANCIS: And he says providing prisoners with clean needles would effectively introduce weapons into the prison.

PRISON OFFICER: To introduce the potential of blood filled syringes means that the prisoner is armed and the prison guards are not. If we are faced with blood filled syringes then we are faced with lifelong change.

ADRIENNE FRANCIS: Another unnamed Canberra prison officer agrees.

PRISON OFFICER 2: What’s happening would be a decrease in my security. There’s almost 100 per cent against the needle exchange and for the prisoners that I interact with on a daily basis we have almost total opposition to the needle exchange program because in their case they are locked inside, they are being stood over and the syringes can be used as a weapon, whether they are used or not, but as a psychological weapon.

ADRIENNE FRANCIS: Some former prisoners like this 26 year-old Canberra man disagree.

FORMER INMATE AND ILLICIT DRUG USER: There would be a limit to how many that they’d get and I don’t think the guys would want to use it, like waste it on the guards. You know, I think they would want to use them for what they were intended for.

ADRIENNE FRANCIS: He says he’d support moves to provide clean injecting equipment to prisoners.

FORMER INMATE AND ILLICIT DRUG USER: I just think it would be a lot safer for the people in jail, even the guards, stop getting HIV and AIDS and hep C.

ADRIENNE FRANCIS: But the prison officer says it’s not only illicit drug injecting needles that risk spreading blood borne viruses. This Canberra prison officer says illicit tattoo needles are more prevalent than drug injecting needles.

PRISON OFFICER: We would find four tattoo guns to one syringe.

ADRIENNE FRANCIS: But isn’t the scarcity of the shared needles the concern? That because they are so scarce they are being shared with a bigger pool of people?

PRISON OFFICER: There is a scarcity of them there but like we have not been given the tools to stop the drugs getting in.

ADRIENNE FRANCIS: The ACT Chief Minister Katy Gallagher says illicit prison tattoo needles are also on her agenda and she’s considering a regulated prison tattoo service. Nonetheless, prison officers have warned they’ll embark on sustained industrial action if the Government proceeds with the needle and syringe program.

PRISON OFFICER: We would be quite prepared to go on strike. I for one would be going on strike as soon as it came in.

ADRIENNE FRANCIS: A threat which is being taken seriously by the ACT Chief Minister Katy Gallagher.

KATY GALLAGHER: Look I have no doubt that unless we work with them, introducing a program would be almost impossible.

ADRIENNE FRANCIS: Former ACT chief minister Jon Stanhope is also troubled by the strike ultimatum.

JON STANHOPE: I think the history here within in the ACT of the Alexander Maconochie has sent a very strong signal probably to the rest of Australia, don’t develop human rights, don’t respect the human rights of some of the most marginalised people within your society or your community, namely those of prisoners, because this is what you’ll cop.

I often dwell on this in darker moments in terms of progressive governments. There are not very many political leaders in Australia prepared to stand up and defend the rights of convicted criminals or prisoners. It just doesn’t happen.

So it will take, I think, a lot of courage. But I do believe the prison officers do have the capacity essentially to sabotage a good policy such as this and that would be a travesty.

ADRIENNE FRANCIS: And in some overseas prisons industrial action has sabotaged needle and syringe programs.

In Spain Xavier Majo Roca has been involved in the development and implementation of these programs in more than twenty Catalan prisons in the north-east of the country.

He says they began attempting to introduce prison pilots in 1997 but the programs couldn’t begin until 2003.

XAVIER MAJO ROCA: There was a strong opposition from prison officers, especially from the trade unions of prison officers.

ADRIENNE FRANCIS: Dr Majo oversees harm reduction policies at the Catalan Ministry of Health’s substance abuse program. He says the programs have not led to increased prisoner drug use, needle stick injuries or violence.

(To Dr Majo) Does this kind of issue then require a particular political courage?

XAVIER MAJO ROCA: Yes it needs some political courage because on the one hand you have trade unions which can be very strong against this program while in fact there is no real fact supporting their fears or their misconceptions.

ADRIENNE FRANCIS: Former ACT chief minister Jon Stanhope warns that political inaction could end up being more costly for governments. In the United Kingdom deaths in custody are investigated and governments can face charges of corporate manslaughter.

Jon Stanhope advocates all Australian jurisdictions should be held accountable for deaths in custody in a similar way. And that includes deaths in custody from infections transmitted due to the absence of clean injecting equipment.

Dr Xavier Majo Roca says a similar lawsuit prompted Spanish authorities to pilot prison needle and syringe programs.

XAVIER MAJO ROCA: One inmate got infected with HIV and they said that he got infected in our prison and he was not able to access clean needles. That went to the media, put pressure on our politicians to implement the needle and syringe exchange program in our prisons.

ADRIENNE FRANCIS: The ACT Chief Minister Katy Gallagher says she’s still considering her options.

KATY GALLAGHER: Look and I think if you go back in history you’ll see that prison officers weren’t that supportive about condoms in jail when the AIDS epidemic was upon us. You know they’ve resisted change in correctional settings sometimes for good reasons.

They are an artificial environment, they’re closed settings, they’re not the same as the community, so I think we have to also listen to that but, you know, I think also in dealing with modern views about how we minimise harm, sometimes it requires a rethink.

ADRIENNE FRANCIS: As politicians come and go Australian prisoner and health advocacy groups have vowed to continue pushing their case for policy change. In the meantime this 26 year old former inmate is worried about his family members, partner and friends who are still in custody at Canberra’s jail.

FORMER INMATE AND ILLICIT DRUG USER: I just don’t want to see them get like hep C and go through what I’ve gone through. It is not a very pretty lifestyle.

ELIZABETH JACKSON: That report by Adrienne Francis. And you’ve been listening to a radio current affairs documentary.