The prison economy of needles and syringes: What opportunities exist for BBV risk reduction when prices are so high?

Stream: Advances in Harm Reduction
Date: Friday, 1 April 2016
Time: 2.00 pm – 3.45 pm

Abstract

Aim: A formal Needle and Syringe Program (NSP) is not provided in Australian correctional centres. Injecting equipment circulates in prisons as part of an informal and illegal economy. This paper examined how this economy generates blood-borne virus (BBV) risk and the risk mitigation opportunities for inmates.

Method: The HITS-p cohort recruited NSW inmates who had reported ever injecting drugs and who had a negative HCV serological test within 12 months prior to enrolment. For this study, qualitative interviews were conducted with 30 participants enrolled in HITS-p.

Results: A needle/syringe was nominated as being typically priced in the ‘inside’ prison economy at $100-$150 (range $50-$350). Purchase or hire of equipment was paid for in cash (including transactions that occurred outside prison) and in exchange for drugs and other commodities. A range of other resources was required to enable successful needle/syringe economies, especially relationships with visitors and other prisoners, and violence to ensure payment of debts. Strategies to mitigate BBV risk included retaining one needle/syringe for personal use while hiring out others, keeping drug use (and ownership of equipment) “quiet”, stealing used equipment from the prison health clinic, and manufacture of syringes from other items available in the prison.

Conclusions: The provision of prison NSP would disrupt the inside economies built around contraband needles/syringes, as well as minimise BBV risk. However, any model of prison NSP should be interrogated for any unanticipated markets that could be generated as a result of its regulatory practices.

Authors

Carla Treloar (Presenter), Centre for Social Research in Health
Professor Carla Treloar is Deputy Director and Head of the Hepatitis Research group at the Centre for Social Research in Health. Carla has been a member of the NSW and Australian Ministerial Advisory Committees and numerous advisory committees for government, health agencies and non-government organisations.

Luke McCredie, UNSW
Luke was the research nurse employed in the HITSp project.

Andrew Lloyd, UNSW
Professor Andrew Lloyd, School of Medical Sciences, UNSW, HITSp chief investigator.