A former federal inmate told a Toronto audience Friday that despite the threat of infection, many prisoners put their health, and later the health of the public at risk as they inject intravenous drugs using recycled needles.
It's accounts like Darren McInenly's that are fuelling a renewed call from a consortium of AIDS prevention and harm reduction groups for needle and syringe programs in Canadian prisons.
They argue such programs — which give inmates access to clean needles — would not only protect prisoners from infection but would also safeguard against the spread of diseases once inmates are released.
"People get drugs, they're going to use them regardless," McInenly said in a video chat, stressing that he didn't use intravenous drugs behind bars himself but saw many who did.
"Even though we're as careful as we can be, guys still share needles. Diseases spread...Enough people do get out and spread those diseases in the streets."
Canadian prisons do not currently permit the distribution of sterile injection equipment and the federal government has repeatedly said it has no plans to implement such programs, despite their success in some countries.
"Our government has a zero tolerance policy for drugs in our institutions," said a spokesman for Public Safety Minister Steven Blaney. "Our government will never consider putting weapons, such as needles, in the hands of potentially violent offenders."
But experts say HIV and Hepatitis C rates in the prison system are "astronomically higher" than they are in the public community, with injection drug use appearing to be a driving factor.
"Closing our eyes to the problem isn't going to help. People are going to continue to get infected and these are fatal illnesses," said Sandra Ka Hon Chu, a policy analyst with the Canadian HIV/AIDS Legal Network.
"We think it's really pressing to discuss it and share with the public a lot of the evidence to support these programs".
Chu's group, along with three other AIDS prevention organizations and a former federal inmate launched a lawsuit against the federal government last year over the lack of needle and syringe exchange programs in Canadian prisons, saying that was a failure to protect prisoners' right to health.
"I think this is a really hard sell for the public because they think people stay in prison forever. But over 95 per cent of people in prison are eventually released," said Chu.
"So they're part of our community and we should care about their health and well-being."
Federal prisons provide inmates with bleach that can be used to clean shared syringes, something AIDS prevention groups say is an acknowledgment of the drug use that takes place in prison.
At least one expert, who has studied prison needle and syringe programs around the world, said intravenous drug users are rarely able to curb their addictions behind bars.
"Nobody wants to have drug use in prison, the question is whether the existence of clean syringes and needles is tempting people to use drugs at all, or to use more drugs. This is not the case," said Heino Stover, a professor at the University of Applied Sciences in Frankfurt who is in Toronto to speak about the issue.
"They just do what is being done already, they are drug users, they all experience relapses while in prison and then while they relapse, they should use clean materials."
A lack of access to clean syringes means tens of prisoners share the same, blunt and sometimes make-shift needle over and over again, driving up the risk of infection, said Stover.
Compounding the matter is the risk infected inmates pose when they return to their public lives.
"They are endangering others without knowing they are infected or without knowing they might harm others, so it's a matter then of public health," he said.
"(Prisoners) have to have the same means of protection that they would use outside. It's generally a question of equivalence."
In countries like Switzerland and Germany where prison needle programs exist, Stover said inmates can access clean syringes from dispensers or from medical staff, who hand them out without questions.
Some studies have found such programs can help combat addictions as they can provide inmates with a point of contact that acts as a "bridge function" into support services or detox programs outside prison, said Stover.
While the programs remain controversial, Stover encouraged officials to look at their implementation in countries that have allowed them.
"Once introduced it runs completely smoothly and undramatically. People get used to it in a very short period of time,' he said. "This would be an additional service which would fit into the ambitious health-care service of Canada."