Use of Bleach and Methadone Maintenance Treatment Program as Harm Reduction Measures in Canadian Penitentiaries
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Why we did this study
Correctional Service Canada (CSC) conducted the 2007 National Inmate Infectious Disease & Risk Behaviours Survey to obtain information about inmates’ health risk-behaviours, use of health programs, and knowledge of human immunodeficiency virus (HIV) and hepatitis C virus (HCV). This information will help CSC to better address the health needs of inmates.
What we did
In collaboration with inmates and the Public Health Agency of Canada, CSC developed a self-administered questionnaire. A random sample of men and all women were invited to complete the questionnaire. Inmate participation was voluntary. To ensure privacy and confidentiality, an external private company administered and retained the anonymous questionnaires, and provided CSC with an anonymous database for analysis. In total, 3,370 inmates across Canada completed the questionnaire in 2007.
What we found
A minority of inmates reported risk factors for blood-borne infections (BBIs): 17% reported injecting drugs, 38% reported tattooing, and 13% reported piercing while at CSC; these behaviours may lead to BBI exposure through the use of non-sterile equipment. Of inmates who used injection drugs, 68% reported using someone else’s used injecting equipment. Notably, fewer inmates used someone else’s equipment for tattooing and piercing on a CSC range (ranging from 15% to 40%).
Among all inmates, 87% were aware of CSC’s policy about bleach access and 57% had tried to get bleach. The majority of inmates who engaged in injecting, tattooing and/or piercing at CSC reported using bleach-cleaned equipment. More inmates who reported using someone else’s used injecting equipment reported accessing bleach than their counterparts.
Some inmates reported problems getting bleach (37%). Maintenance issues were the primary problem (men 69%, women 48%) and 48% of women also reported that they had to ask staff for bleach.
Generally, inmates who reported injecting opiates were more likely to use someone else’s used equipment than inmates who reported injecting non-opiates, which may increase the risk of exposure to BBIs. CSC offers Methadone Maintenance Treatment Program (MMTP) to reduce the frequency of opiate use and thus exposure to BBIs. At the time of the survey, 7% of inmates reported being on MMTP. Among those who reported being on MMTP, 60% did not report in-prison opiate use recently. For those not on the program but who had previously tried to join it, less than 1% had been taken off for diverting methadone, 17% had been taken off for other reasons, 29% had taken themselves off and 53% reported not meeting the program requirements.
What it means
Among high-risk groups, bleach is being used as intended despite some access issues.
The majority of MMTP participants did not report recent opiate use. Some inmates did report failing to meet program criteria. Future research of why inmates at higher risk of BBIs do not access available harm reduction items and more detailed examination of the reasons for failing to meet MMTP criteria would be useful to ensure full accessibility to harm reduction measures.
For more information
Thompson, J., Zakaria, D., Jarvis, A. (2010).Use of bleach and the methadone maintenance treatment program as harm reduction measures in Canadian Penitentiaries. R-210 Ottawa: Correctional Service Canada.
To obtain a PDF version of the full report, contact the following address: email@example.com.
Prepared by: Jennie Thompson
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