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Get with the program, CPSU

John Hargreaves 6 January 2017 30

Safe injecting facility - syringe

I just can’t figure why the CPSU is against the safe injecting facility at the AMC. They have way too much say in whether the occupants of the AMC can have the same harm minimisation opportunities as the rest of us.

They have no say in whether the safe injecting facility in the City operates or not, so why should they have any say in its operation in our prison?

They say that they are worried that the custodial officers are at risk from being stabbed. I reckon they are more at risk now than if there is a safe injecting facility available to the residents of the AMC.

Let us remember that the community facility is not run by the police, or corrections officers. It is run by Directions ACT in partnership with ACT Health. The availability of clean syringes is regarded as a health issue not anything else. It is part of a regime to get people off drugs.

How’s this for an idea? When people share needles, Hep C is spread, HIV is spread, all manner of blood borne diseases are spread. If clean needles are used that the risk of that spread is removed. Hep C is rampant is all prisons because the corrections officers just can’t stop the needles getting into the prison. I reckon that the corrections officers are a greater risk now than if they had a clean needle program happening in there.

This is how it works.

Firstly, an understanding of the health facilities in the AMC is required. The medical centre is a “Health Centre” just like the ones on the outside. It is not part of the Corrections system. It is staffed by health professionals and the prisoners are delivered there and once inside, they are clients of the health system not of the corrections system.

So, let’s see how Prisoner 248 copes. Presently, he is addicted to heroin and gets his stuff smuggled in (and there is no stopping the smugglers completely), he also gets his needles smuggled in or makes them himself. He shares the needle around in exchange for drugs when he runs out.

He contracts Hep C and gives it to everyone he shares a needle with. If he gets hassled by the officers, he can always threaten them with an unclean needle.

If he overdoses or has a reaction. Tough luck. He can just hope someone finds him and helps him.

But, if he can get a needle from the health centre under control conditions, the transmission of Hep C is thwarted, there is no need to smuggle needles into the prison nor any need to make them onsite.

If he has a reaction, there is a nurse nearby to administer a health regime to save his life. If he has an overdose, a nurse is there to administer naltrexone to counter the effect of the drug.

While he is in the facility he is exposed to a regime of education designed to help him off the drugs as part of a whole-of-patient regime. He is also subjected to voluntary health assessments relative to his drug dependence and the correlation of drug use and general poor quality health is explained to him.

The officers are not at risk because the whole episode is supervised by the health staff who are trained in this type of work.

When Prisoner 248 is finished in the health centre, he is escorted back to the cells or the yards. He is not under the influence of the drugs to the same extent as would be case if he was not supervised.

Before anyone accuses me of avoiding the issue of drugs being in the prison at all, my view is that the officers still should be trying to stop the drugs getting in but need to be realistic about the success of their endeavours. I see no conflict at all in having two separate systems to achieve the safety of both officers and inmates.

The CPSU needs to understand that drug dependence is a health issue and the health professionals are best place d to deal with it. Corrections officers are not experts in this field and the attitude of the union continues to put officers at risk by opposing a system which prevents the spread of blood borne disease and which controls the effects of drugs ingested by prisoners. A person high on drugs is best handled by a health professional.

The community at large needs to know that the objections of the CPSU do not acknowledge that there is a facility in the AMC which is not within their authority and which is well able to handle this issue. Further, Directions ACT can administer a safe injecting place just as they do in Civic.

Also, the terminology is misleading. Sure, dirty needles are exchanged for clean ones, but clean ones are available even if there are none to be swapped. The clinical oversight of people is more important than the needle swap. Having the opportunity of talking people around is missed in the AMC and I put this at the feet of the CPSU.

Right now, due to some dogmatic attitude opposing a safe injecting place in the AMC, prisoners’ lives are at risk and so too are the lives of the officers. This opposition is madness and the CPSU needs to be called on it.

They should get with the program and support it.


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30 Responses to Get with the program, CPSU
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Chris Mordd Richards 1:00 am 17 Jan 17

Grrr, gotta re-read before submitting better, did it again sorry – We might not have *SOLUTIONS* (not problems) for every problem in a jail yet – should have read, my bad.

Chris Mordd Richards 12:58 am 17 Jan 17

I sometimes vehemently disagree with John H on here, sometimes I vehemently agree.

In this case it is the latter, and the hypocrisy on show in these comments is revealing in and of itself.

Sorry – that comment applies the same to this piece as John’s other AMC piece.

The NSP is a no brainer, it’s time we stopped arguing about it and just followed common sense. We might not have problems for every problem in a jail yet, but as NSP does solve one major one, arguing that we haven’t solved all the other problems yet is no reason to hold back introducing an NSP into the AMC when it does solve one important problem right now. The evidence for this is overwhelming, it is appalling this is still being argued over and not implemented already.

James_Ryan 10:01 am 15 Jan 17

You’re grasping at straws.

Just because some serious traffic accidents are caused by factors other than alcohol, doesn’t stop the police from conducting RBT operations.

Just because BBVs can be transmitted by other means, doesn’t stop governments from providing NSP services.

90% of hep C infections are transmitted through unsterile injecting.

BBVs can be transmitted by toothbrushes, razors, fighting, but the likelihood is pretty low when you compare it with injecting. Tattooing is a transmission risk, but much lower than injecting.

The CPSU have got this one wrong.

Blen_Carmichael 2:29 pm 14 Jan 17

John Hargreaves said :

As you have admitted, it is a facility within the health area of the prison and not the general concourse and thus within the responsibility of medical staff and not corrections officers. I see no reason for them to be involved…

I see. What about the prison cafeteria, which is full of metal instruments such as knives and forks and other lethal weapons? Presumably this is the responsibility of the catering staff and not corrections officers. Likewise, the prison gymnasium, with all its heavy weights, would be the responsibility of licensed gym instructors, and not corrections officers. In fact corrections officers should not attempt to influence policy in these areas presumably because it’s not in their bailiwick, I take it, John?

John Hargreaves 10:40 am 14 Jan 17

Calet… I refer you to James Ryan’s references re safeguards. In all my discussions with prison authorities and officers over my years as minister, I received the same story.

on the other issues you raise, I agree that they are issues confronting all elements of society and not just prisons but where a solution has been suggested and proved to be efficacious, we should go with it. I won’t, however, lump them all together and miss an opportunity just because I can’t solve the lot.

This solution saves lives. Period. It removes an element of tension between inmates and officers, a good thing. As you have admitted, it is a facility within the health area of the prison and not the general concourse and thus within the responsibility of medical staff and not corrections officers. I see no reason for them to be involved let alone stop the program from starting just because they are misinformed.

Calet 10:24 am 13 Jan 17

John, you do very well ignoring much of what I wrote. This issue goes beyond whatever issues you have with the CPSU. I completely understand the nature of the NSP proposal. The NSP working group proposal was a safe injecting room located in the health centre. It provided equipment to inject drugs and the opportunity for intervention by medical professionals and referrals to programs. No injecting equipment was to leave the health centre. I agree that a properly designed and resourced injecting room is the safest way to provide clean injecting equipment. It is a very suitable solution if injecting was the only vector of BBV transmission but unfortunately it is not.

I am interested in your answers to some questions I raised though:

• What is your solution to the problem of infection due to tattooing in the prison?
• What is your solution to the problem of infection due to blood transmission due to fighting or violence?
• What is your solution to the problem of transmission due to someone accidentally picking up his cellmate’s razor or toothbrush?
• What is your solution to sexual transmission?
• What degree of success do you think it would have without the support of officers?

Also John, where has an NSP been proved to safeguard officers interstate? A reference to the data to back up that statement would be useful.

James_Ryan 7:45 pm 12 Jan 17

chewy14 said :

The problem with this is that whilst drugs are illegal, we shouldn’t be facilitating their use within the prison system.

Prisoners are already facilitating drug use within the prison system. The reality is access to drugs and access to needles.

With respect, it’s not like a regulated NSP will provide anything in terms of “facilitating drug use” that they don’t already have … except sterility, safer injecting, access to medical professionals, & referral to drug and alcohol programs.

It pays to remember that evaluations of current regulated NSPs around the world shows no increase in drug use, no increase in injecting, no safety incidents for staff, just reductions in health problems, better relationships with prison staff, increased referral to drug and alcohol programs.

chewy14 11:45 am 12 Jan 17

The problem with this is that whilst drugs are illegal, we shouldn’t be facilitating their use within the prison system.

The solution isn’t a room for illegal drug injection inside prison, it’s the legalisation of drug use and then its management as a health issue both within and without prison.

James_Ryan 11:22 am 12 Jan 17

Calet, as you know enough to put together that considered response you are probably well aware that important elements of your argument are not correct. Providing specifics here will identify their source, but you and I both know that you’ve said things that are aspirational or policy commitments but are not matched by reality.

The AMC is a hot mess in lots of ways, so there’s little to be gained by assuming that current policy settings will somehow come good and correct the harms and risks. As previously acknowledged, if prison staff can’t get their internal relationships right then what chance is there that detainees will flourish and heal?

This from Winnunga Nimmityjah, by way of just one example, goes to the “real concern for the welfare of prisoners” aspiration that you have cited.

For those who thought following the damning indictment of ACT Corrective Services in the Moss Report into the care (in reality the lack of care) of Steven Freeman in the AMC that things couldn’t get worse, then the recent revelations of widespread and systemic bullying in ACT Corrective Services will come as a shock.

The Canberra Times reported on 23 December that at a meeting of management and staff of ACT Corrections in late November 2016 that allegations were made by staff of ‘a toxic workplace run by fear and high levels of absenteeism, workers compensation claims, staff turnover and unbearable workloads’.

The Canberra Times reported that staff of ACT Corrective Services ‘have told of the risk of suicide and self- harm’ as a result of ‘systemic and widespread workplace bullying’. The allegations are being investigated (internally) by the Professional Standards Unit in the Chief Ministers Directorate.

If, heaven forbid, the allegations are in fact correct and this is how staff in ACT Corrective Services do treat each other, then one’s heart not only goes out to the staff being bullied in this way but also to detainees and people subject to corrections orders and how they may also have been treated.

These allegations coming as they do on top of the damning Moss Report, the recent very critical reports of the Auditor-General and the Standing Committee on Justice and Community Safety suggest that it is past time for action…

… Winnunga AHS believes that the Government should implement as a matter of urgency all the recommendations of the Moss review and consider the need for further and broader reform.

John Hargreaves 11:16 am 12 Jan 17

Sorry Calet, but you either misrepresent the facts or misunderstand the nature of the NSP proposal. Have another look at James Ryan’s posts. the NSP does not “hand out needles”, it is a safe injecting facility where old needles are received and disposed of and clean needles used and returned to the nurse for destruction. Net result, one less dirty needle.

Further, I just can’t belie4ve that the officers would reject a proposal which has been proved to safeguard their fellow officers interstate and overseas. This is madness.

And as for the CPSU being a slave to its members, really? Since when has that been the case. I was a member for nearly 30 years and know that campaigns and leadership comes from the union hierarchy. As for unions dabbling into political and policy areas, were you at the ALP annual conference in the last couple of years? From your stance I doubt it. Well, I was and I saw the tussle.

dungfungus 10:46 am 11 Jan 17

rommeldog56 said :

So, how many times have people been caught smuggling drugs into the AMC ???

To reduce the flow of drugs into our Human Rights Compliant prison, , do they open incoming mail/parcels and deliveries to check for drugs and other contraband, do they use drug sniffer dogs in cell/inmate searches and on inmate visitors, contractors, jail employees, etc ? Or have they given up on that too ?

The drugs must be getting in somehow.

I think most of us know how drugs get in there and most every other prison in the world.

A cashless financial system will solve that problem in time.

SunRider 12:07 am 11 Jan 17

As eminently sensible as an NSP sounds, there is one fatal flaw in the idea. According to recent news reports, ACT Corrective Services appear to be struggling to to manage themselves at the moment, let alone introducing additional and controversial issues into the equation. For example: :http://www.canberratimes.com.au/national/public-service/corrections-staff-at-suicide-risk-from-bullying-20161214-gtbgsh.html

Maybe they could focus on getting staff relations into a better space, and who knows? They may yet garner support for such schemes

Perhaps they should focus

Calet 6:40 pm 10 Jan 17

John, the CPSU is representing the custodial staff at the Alexander Maconochie Centre. The union’s role is to work on behalf of the staff employed in this role as legislation prevents staff publicly voicing their own opinions about this and other issues. The CPSU has no say, it will reflect and act on the directions of its members and nothing more.

The support of staff for any prison based NSP is imperative for any successful NSP program to work. The members did not agree with the first model provided by the NSP working group and voted against it. Obviously, the working group didn’t get it right the first time. There was nothing in it to address tattooing, you may want to do some research on injuries to officers from tattooing equipment in the AMC.

The operation of a safe injecting facility in the community is irrelevant to this discussion as it operates under a completely different set of circumstances and security issues to a prison based program. I am supportive of the needle exchange programs in place in the community. The safe injecting room which has been running at Kings Cross provides some life saving intervention and is a valuable public health resource.

A prison changes the dynamic as it is filled with people who the courts feel are not safe to leave in the general community. There are a high percentage of mentally ill prisoners, violent prisoners, non-compliant prisoners and many of these prisoners are infected with blood borne viruses.

Prison NSP programs are running in other countries. Some have been tried and shut down. The currently operating programs in Switzerland, Germany, Luxembourg and even Iran are all based around heroin use. Heroin is a sedative, people inject it and kick back and relax. Most injecting drug users in the AMC are methamphetamine users. This alone brings a completely different set of problems due to the often violent and aggressive behaviours and psychosis this drug can cause.

Blood borne viruses can be transmitted by sharing injecting equipment. They can also be transmitted by tattooing. Blood borne viruses are transmitted during violent incidents, this is an unfortunate but undeniable part of prison life. Blood borne viruses are transmitted by unsafe sex between prisoners, this still happens despite the ready availability of condoms and dental dams. Hep C can even be transmitted by sharing razors or toothbrushes. An NSP only addresses one of these vectors of transmission.

There is a cure for Hep C. The new generation Hep C treatments are 100% effective. They’re even on the PBS. As for HIV, bleach is effective in cleaning needles and is already readily available to all prisoners in the AMC. A properly cleaned needle will not pass on HIV. Of course, this would require a prisoner to take a little responsibility for their own health which seems to be a null point to some overly enthusiastic advocates of an NSP in the AMC. HIV treatments are also effective, people live long and healthy lives with HIV. HIV post-exposure prophylaxis treatments are effective in preventing infection as well if administered in a timely manner.

The “saving people from an overdose” argument doesn’t appear to correlate with the facts here. How many prisoners have died from an overdose when injecting drugs in the AMC? None is the likely answer. Prisoners have a much greater chance of surviving an overdose in prison that outside. A check of readily available stats will show you that he has at least a 400% higher risk of dying from an overdose in the community than while in prison. Check some custodial vs community corrections statistics worldwide, it’s the truth. The same person in prison has a much smaller risk of dying from an overdose because there are officers and health staff able to immediately respond to a medical incident.

This issue doesn’t require a knee jerk solution forced into place, it required a much better thought out holistic system. Handing out needles doesn’t fix the whole problem. It doesn’t fix the large percentage of infections from tattooing, from fighting, from unprotected sex. It doesn’t fix the addiction problem. It only reduces some of the risk to some of the people that refuse to address those risks themselves.

What the “NSP at any cost” advocates fail to acknowledge is that custodial officers are more than just the ignorant “guards” they are regularly labelled as. They have a real concern for the welfare of the prisoners under their care. They are the first point of call for most prisoners with family issues, issues with other prisoners, case management issues and yes, even health issues. The days of standing on a catwalk and pulling a handle to herd prisoners into a yard until lock-in have been gone for a long time and the officers at the AMC work very closely and intensively with the prisoners on a whole range of issues and they do it well.

What the government needs to do is to take small steps here. It might not make for a keynote speech for a doctor or politician feeling heroic for their personal contribution to prisoner health but that shouldn’t be what this is about. Start with some real peer education towards some effective long term rehabilitation. Teach prisoners to teach other prisoners. Make efforts to address the ongoing issues faced by these prisoners when they return to the community after their normally short custodial sentences. This is usually when prisoners relapse into heavy drug use.

Word has it that there may be a NSP trial running in another state in Australia with a much larger correctional system than the ACT. There will be lessons to be learnt and relevant evidence to be had in the future. There will most likely be a holistic and effective blood borne virus reduction program at some point in the future but it needs to be done properly and address treatment as well as all vectors of blood borne virus transmission, not just injecting equipment.

Why not make a concerted effort to treat the Hep C problem in the AMC and the wider community through medical treatment and a invest in a well-resourced peer education system in the meantime?

rommeldog56 12:19 pm 10 Jan 17

As a Tax Payer / Ratepayer and law abiding citizen, I figure that I have rights too ??

So, if we dont have a needle exchange at AMC, diseases like Hep and Aids will spread within the jail and then be “released” into the community when the prisoner is released. Also, the drug dependency, which is often why they are jailed in the 1st place, will also “released” back into the community.

If there is a needle exchange at AMC, prisoners logic says that there may be reduced health problems associated with using dirty needles. But, will not the prisoners with drug habits maintained in the AMC, also be released back into the community and need to feed that habit by conducting more crimes ?? Also, while its still illegal to use drugs in the AMC “here – have a fresh needle to shoot up with the illegal drugs u shouldn’t have anyway” !! That just doesn’t make sense.

So either way, as I see it, the community gets it in the neck.

But, to just give up is also, to me, totally unacceptable.

James_Ryan 11:01 am 10 Jan 17

John Hargreaves said :

I urge readers to re-read James_Ryan’s thread on this. Spot on.

Aw, shucks. But why take my word for it when readers could instead consider what the United Nations says. You know, the U.N.

According to the United Nations Office on Drugs and Crime (UNODC, 2014), prison NSPs have been successfully implemented in prisons of all types in a range of countries from Kyrgyzstan to Switzerland. A meta-analysis (which is a statistical technique for combining the findings from independent studies and is commonly used to assess the clinical effectiveness of healthcare interventions) of scientific evaluations of prison NSPs (St?ver & Nelles, 2003) specifically addressed the two most often cited concerns of NSP opponents:
1. Prison NSPs will increase injecting drug use.
2. Prison NSPs create a more dangerous environment for staff and prisoners.

The meta-analysis found:
– Prison NSPs increased safety for staff and prisoners. There is no evidence of regulated access to injecting equipment leading to misuse and no recorded safety problems with needle disposal. Further, the study found NSPs contribute to workplace safety, can co-exist with and facilitate referral to other drug interventions, and are effective in a wide range of models and prisons.
– No increase in the number of people who inject.
– No increase in drug consumption or injecting.
– No increase in the amount of drugs in institutions.
– Prison NSPs have not resulted in Officers condoning drug use and drugs remain illegal in every prison where NSPs operate.

https://www.unodc.org/documents/hiv-aids/publications/Prisons_and_other_closed_settings/ADV_COPY_NSP_PRISON_AUG_2014.pdf

John Hargreaves 8:56 am 10 Jan 17

I urge readers to re-read James_Ryan’s thread on this. Spot on.

And… Rommeldog,56 yes all that IS done.

And for the record, I was Minister for Corrections and have been in the AMC many times and when the Opposition Spokesperson for Corrections I visited jails in every state and Territory, except Tasmania, 12 in all to inform myself on corrections issues.

James_Ryan 8:10 am 10 Jan 17

rommeldog56 said :

The drugs must be getting in somehow.

Indeed, and needles too.

When the prison was first conceived, the idea of an NSP was raised considered. However with the advice of Corrective Services it was decided by Jon Stanhope’s government that instead of an NSP we would operate a drug free prison. It was then agreed that policy position would be revisited with a review of the success or otherwise of the drug free prison.

Corrective Services failed to deliver a drug free prison. It was a bit of a set up when you think about it, because they were being expected to deliver something that no one else has managed to achieve. There’s no shame in a prison with contraband circulating, it happens everywhere.

We have a prison where drugs and needles are available now, regardless of the policy position on NSP or anything else. And that’s the problem with arguments above that we shouldn’t have an NSP because prisoners shouldn’t be using drugs or needles. Everyone agrees that prisoners shouldn’t have drugs and needles, but they do. So faced with that reality and the significant harms that come from the current policy settings, do we continue to pretend that a drug free prison is possible or do we align policy with reality and endeavor to minimize the harm to detainees and the risk to officers?

Another problem with arguments above is the idea that if you introduce an NSP you have to accept and condone drug use. In every prison globally where regulated NSPs operate, drugs remain illegal and Prison Officers do not condone drug use. Their job remains the same, including interdiction of contraband.

It is an interesting discussion to have, and one that could be more enlightening if people of all opinions stuck to the facts.

rommeldog56 7:19 am 10 Jan 17

So, how many times have people been caught smuggling drugs into the AMC ???

To reduce the flow of drugs into our Human Rights Compliant prison, , do they open incoming mail/parcels and deliveries to check for drugs and other contraband, do they use drug sniffer dogs in cell/inmate searches and on inmate visitors, contractors, jail employees, etc ? Or have they given up on that too ?

The drugs must be getting in somehow.

rommeldog56 7:11 am 10 Jan 17

A_Cog said :

How the hell is it good policy to toss your hands in the air and plead “we cannot stop drugs flowing into a secure steel box we made…..

They can not stop speeding , illegal parking, etc either. So, I trust that those offenders will not be pursued either.

buzz819 7:02 am 10 Jan 17

I don’t know why the CPSU is not using it as a bargaining tool.

The needle exchange will be accepted if; more strict searches of visitors are in place, harsher penalties for people found to be in the possession of drugs in the AMC, mandatory drug rehabilitation for all detainees who use the needle exchange.

And finally, the way it should work is that the needles are only available for use in the clinic; so inmate 248 has a dirty needle in the yard, he comes in, swaps it for a clean needle, BUT has to surrender that needle after using it at the clinic. Therefore, lessens the dirty needles in the yards, and stops the introduction of new needles.

On top of that, the officers can use it as intel gathering of who is using the exchange to target the people who have the drugs in the prison.

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