Prison Based Needle and Syringe Exchange Programs in Australia - Case Study Example

Prison Based Needle and Syringe Exchange Program Name Institution Date Executive Summary Prisoners in Australia are at a higher risk of contracting bloodborne virus diseases. AIDS and Hepatitis C are on the wide spread in the Australian Prisons as compared to the general population outside prisons. The problem has been worsened by the practice of sharing syringes and needles as the prisoners are not allowed access to needles and syringes. The program is aimed at preventing new infections among the prisoners which occurs due to the sharing of the needles and syringes. However, the program may face some internal and external challenges. The major challenges are with the laws as the possession of the needles and syringes has been outlawed in the prisons. Meeting with the government authorities as well as the prison officers may however be important in terms of reversing the ban and hence the implementation of the program. The suggested time frame for carrying out the program is six months. This is due to the number of prisons as the program is intended to benefit all the prisoners. Measuring the outcome of the program is an important process. This will be achieved in the program by reviewing the rate of the new infections after the provision of the syringes and needles. A budget and resource plan will also be developed for the program. However most of the amount will be channeled towards the purchase of the needles and the syringes. Other resources ah may also be required during the program is the training resources. Strategies on the risk management process for the program will also be focused on the prevention of misuse of the syringes as well as preventing injuries. The measures to sustain the program will also be put in place so as to ensure that the spread of AIDS and Hepatitis C is completely reduced in prisons. Prison Based Needle and Syringe Exchange Program Introduction In Australia, the duty to care is the responsibility of the government and it should be provided to all the people in Australia regardless s of their situation. This includes the people in prison who are serving their sentences. The heath care services being offered in prisons is of low quality as compared to the healthcare offered to the other people in the society. Discrimination in terms of healthcare provision is also unconstitutional in Australia. However, the prisoners are highly discriminated in terms of provision of healthcare services. The provision of needles and syringe is not done in the prisons while in the society it is provided. In prisons, just like in the wider society, syringes and needles are used although in some instances it is used for illegal activities (Australian National Council on Drugs, 2002). However, the duty to care focuses on preventive measures in terms of combating disease. The prisoners usually share needles and syringes and hence leading to the transmission of blood borne viruses which causes diseases. Most of the prisoners who have contracted blood borne viruses in prison attribute it to sharing of needles and syringes (Mital, et al, 2013). It is due to this duty of care that prisoners should be provided with syringes and needles for preventing diseases that are blood borne. The paper thus discusses the issues of provision of prison based syringe and needles exchange for the purposes of utilizing a funding program. Situation analysis Rationale The current situation in the prisons in relation to the use of syringes is alarming. This is because of the ban on the use of syringes and needles by the prisoners (Gospodarecskaya, 2003). The prisoners are thus desperate and use high risk methods to smuggle the syringes and needles in the prisons. The process of smuggling the needles to the prisons is a risky one due to the methods that are being used. Some of the prisoners go to the extent of swallowing the syringes that have been attached to the dental floss. This exposes them to serious risks that may result to death. On the other hand, the match boxes are used for the purposes of sharpening needles which are used more than once by a number of prisoners. This directly exposes them to the bloodborne diseases like hepatitis C and AIDS (Dolan, 2001). The syringes in prisoners are usually regarded among the most precious items and it is usually rented from one prisoner to the other. Although the prisoners are aware of the risks, they have no alternative and hence the continuity of the practice. Most of the prisoners also know the risk factors that are associated with the sharing of the syringes. The needles and syringes are rarely cleaned as one may be caught with them. Most of the prisoners who use the syringes and needles are willing to protect their health but the lack of the resources is the main hindrance. The prisoners who are found with the syringes and needles are usually punished severely for being in possession of contraband items and breaking the prison laws. Although other prisoners require needles and syringes for genuine use, it is not availed for the fear of the syringes ending up with those who need it for illegal drug usage. The distribution of needles and syringes has also led to the reduction of infections of bloodborne viruses in the general population and the same can also be applicable to the prisons (Australian Institute of Health and Welfare, 2008). The prison authorities support the ban due to previous events that was associated with its use. In the past there was an incident where a prison officer was stabbed with a syringe containing blood of a prisoner who was HIV positive and it led to the death of the officer after contracting the disease (Wodak, 2004). Currently being in illegal possession of syringes in prison attracts a jail term of up to two years. The measures were put in place so as to ensure that the syringes and needles are not used in the prisons. On the other hand, the prison is regarded as a correctional facility where the prisoners have to be rehabilitated and reformed. This has thus made the prison authorities deal firmly with those who are found in possession of the needles and syringes. This has worsened the situation and hence the continuous exchange of the available illegal syringes. In the Australian prisons, 24% of male prisoners and 43% of female prisoners use injecting drugs which forces them to share the needles and the syringes. It is also important to note that most of the offenders who were caught with drug related offenses are also in prison and they continue with the use of injecting drugs (Topp, 2005). Although the percentage of people with AIDS is low in Australia with 0.5% of the total population, Prisons have a higher percentage. This has also lead to the increase in the infections of HIV/AIDS among the prisoners in Australia. On the other hand, the prevalence of Hepatitis C is much higher as compared to the general population. According to statistics based on the last ten years, the prevelance of Hepatitis C in prisons stand at 30 to 40 percent. The situation is worse in female prisons as some of the prisons have reported 50 to 70 percent (Australian Bureau of Statistics, 2007). Most of the new infections in orisons are attributed to the practice of sharing needles and syringes. The number of people who have died to blood borne diseases in Australian prisons is high although the exact number is not available. Most of the deaths have been linked to the sharing of needles and syringes that resulted to the infections. The sharing of syringes in prisons is thus a risk factor that increases the rate of infections of the bloodborne diseases. The situation is even worse as most of the convicts continue to use injecting drugs while in prison (Butler, 2002). Feasibility Assessment Although the program is beneficial to the prisoners in terms of improving their health through preventive measures, it may be impacted negatively by the internal environment. The laws and regulations that govern the use of syringes in prison are quite hash as prisoners risk prosecution if they are found in possession of syringes. The organizational as well as the economic factors may also affect the program as it will be required from time to time. Most of the healthcare organizations are however advocating for the distribution of the syringes and needles in prisons. This includes the international organizations like the world health organization and the human rights organizations (World Health Organization, 2007). Protests have also been witnessed by the human rights groups for the support of distributing needles and syringes in the prisons. This indicates that the future of the program is bright. The government is also considering the issue and it may fully support the program in future. However, the future issue that also includes the increased risks of drug use in prisons due to the distribution of syringes and needles is of concern. Physical harm may also be caused by the syringes and needles among the prisoners in future and incase of prison fights and riots. The program will involve the consultations of various stakeholders for it to be successful. The prison authorities and the staff are the main stakeholders as they are in chare of the prisons. They should be educated on the importance of distributing the syringes and needles for the purposes of improving the heath of the prisoners. Their roles should also be supervision to avoid the misuse of the needles and syringes. The lawmakers should also be involved for the purposes of ensuring that the laws regarding the use of syringes and needles are amended. The healthcare workers in the prisons should also be involved in the program for the purposes of ensuring they educate the prisoners and also come up with the appropriate guidelines (Milloy, 2012). The human rights groups as well as the social worker who are involved with the welfare of the prisoners should also be involved in the program. Educating the prisoners should be done by the stakeholders. The program will be fully implemented in the prison facilities. Further statistics on the conduct of the prisoners should also be obtained so as to prevent physical harm that may be inflicted by the needles and syringe. On the other hand, the additional information regarding the measures put in place to combat the transmission of bloodborne diseases should also be availed. This is for the purposes of integrating the measures in the program to combat illegal drug use which also has harmful effects on the heath of the prisoners. Target group The program targets all the prisoners who are using the injecting drugs. The prisoners who also use syringes and needles for other purposes are also targeted in the program. This program targets both male and female prisoners in Australia who are above the age of eighteen years old and are using injecting drugs. On the other hand, the program will not discriminate on the basis of race or ethnic background but will focus on any prisoner facing the risk. Goals and objectives The main objective of the program is to ensure that the bloodborne diseases are prevented among the prisoners who use injecting drugs by distributing needles and syringes for each prisoner who needs it. To prevent the transmission of AIDS and Hepatitis C among prisoners by reducing the number of new infections transmitted by sharing of needles and syringes through availing ensuring ready access to the syringe and needles due to the high infection rates in order to combat the transmission within six months. To eliminate the discrimination in the healthcare provision among prisoners through equipping them with needles and syringes in order to discourage sharing that is responsible for transmission of blood borne viruses and hence enhancing the health of the prisoners within half a year. Program activities The program will involve distribution of syringes and needles to the prisons to ensure that it is readily available for prisoners who use injecting drugs. Educating the prison authorities on the importance of preventing the spread of bloodborne viruses through avoiding the sharing of syringes. Educating the prisoners on the importance of avoiding the practice of sharing needles and syringes in terms of combating the spread of AIDS and Hepatitis C. Timeline Month Activities 1 2 3 4 5 6 Planning of the program Meeting with stakeholders Education of the prisoners Procurement of the syringes and needles Supply of the needles to the prisons and distribution to prisoners. Monitoring the progress of the program. Evaluation The evaluation of program is for the purposes of determining the performance of the program in relation to its goals and objectives. The program with therefore be evaluated based on its goals and objectives with regards to the use of syringe and needles among the prisoners. The rate of infections will provide an important insight on the performance of the program. A decrease in new infections with regards to AIDS and Hepatitis C will be an indication that the program is performing well. However if there will be an increase, then it means that the program is not achieving the desired results. On the other hand, since the aim of the program is to eliminate the sharing of the needles and syringes, decrease in the sharing practice will be an indication of the success of the program. Reduction of harm among the prisoners in relation to the use of needles and syringes will also indicate that the program is successful. The percentage of deaths and new infections with regards to AIDS and Hepatitis C should be achieved as the practice of sharing g the syringes and needles has been one of the main contributing factors to the spread and new infection with regard to the bloodborne virus diseases in prisons. Budget and resources The success of the program will be dependant on the budgetary allocation and the resources. Some of the resources may be sourced outside the organization while other resources will be utilized from within the organization. The training of the stakeholders will be required and the facilitators within the organization will conduct the training. This is due to their expertise in the program concepts. On the other hand, the training materials will have to be purchased outside the organization. During the implementation of the program, experts as well as temporary employees will also be required for the purposes of implementing the program. The terms of the employees will be on a fixed contract. The main equipment that will be required during the implementation of the program will be the needles and the syringes. This will have to receive a high percentage of the total budgetary allocation for the program. This is also considering that the program cannot be successful if the syringes and needles are not available. It is also important to note that during the training and meeting with stakeholders a facility has to be hired (Nadler, 2012). However, when educating the prisoners, the training will be conducted in the prisons by the facilitators. Funds should also be allocated to carter for transport of the facilitators as they move from one prison to the other. This can however be done using the resources of the company. The technical resources will however be required during the monitoring and evaluation of the program and experts will also be involved. Risk analysis Risk Management strategies Policy issues. Legalizing the use of syringes may be seen as an act of condoning the use of injecting drugs in prisons (Iversen, 2013). To minimize risk of increased use, the program will work closely with social workers to assist the prisoners to quite the practice and only use the needles and syringe as the last option. Safety issues The needles and syringes may be used as weapons that may lead to physical injuries of the prison officers as well as other detainees (Fisher, 2012). To reduce this risk, proper counseling as well as education will be carried out among the prisoners and the officers. The syringe will also be used to identify the prisoners in possession of illegal drugs. Accidental needle and syringe injuries Due to the increased number in the needles and syringes, accidental injuries may occur (Sindicich, 2013). The program will ensure that the disposal bins are provided to prevent the accidental injuries. Economic issues The cost of the program may be high as it will require a continuous implementation and hence threatening the success of the program. This will be countered by involving other stakeholder to make their contributions. References Australian Institute of Health and Welfare (AIHW) (2008). 2007 National Drug Strategy Household Survey: first results, Australian Institute of Health and Welfare, Canberra. Australian National Council on Drugs. (2002). Needle and syringe programs: position paper, Australian National Council on Drugs, Canberra. Australian Bureau of Statistics, (2007). Prisoners in Australia 2007. Australian Bureau of Statistics. Butler, T. (2002). Inmate Health Survey 2000, Corrections Health Service NSW, Sydney. Dolan, K. (2001). ‘Can hepatitis C transmission be reduced in Australian prisons?’, Medical Journal Of Australia, vol. 174, no. 8, pp. 378-379. Wodak, A. (2004). Supply, demand and harm reduction strategies in Australian prisons implementation, cost and evaluation (Research Paper), Australian National Council on Drugs, Canberra. Topp, L. (2005). Needle and Syringe Programs: A review of the evidence, Australian Government Department of Health and Ageing, Canberra. Gospodarecskaya, E. ( 2003). ‘Introducing retractable needles into needle and syringe programmes: a review of the issue’, The International Journal of Drug Policy, vol. 14, issue 3, p.233-239. World Health Organization. (2007). Guide to Starting and Managing Needle and Syringe Programmes, World Health Organization, Geneva. Milloy, M. J. (2012). High-risk drug-use practices among a large sample of Australian prisoners. Drug and alcohol dependence, 126(1), 156-160. Mital, S. et al. (2013). Prevention of HIV and Other Blood-Borne and Sexually Transmitted Diseases in People Who Inject Drugs: Current Status and Future Prospects. In The New Public Health and STD/HIV Prevention (pp. 221-249). Springer New York. Nadler, L. (2012). Designing training programs. London: Routledge. Iversen, J. (2013). Reduction in HCV Incidence Among Injection Drug Users Attending Needle and Syringe Programs in Australia: A Linkage Study. American journal of public health, (0), e1-e9. Fisher, D. (2012). Assessment of risky injection practices associated with hepatitis B, hepatitis C, and human immunodeficiency virus and using the blood-borne virus transmission risk assessment questionnaire. Journal of addictive diseases, 31(1), 80-88. Sindicich, N. (2013). Rates of injection in prison in a sample of Australian-injecting drug users. Journal of Substance Use, 18(1), 65-73. Read More