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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
dungfungus 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 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: :

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 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 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 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.

John Hargreaves 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 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 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 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 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.

wildturkeycanoe wildturkeycanoe 10:14 pm 09 Jan 17

Drugs and needles shouldn’t be in jails in the first place. Surely giving them the means with which to continue to use drugs is not helping them rehabilitate back into society. Drugs are illegal outside of prison so why is it tolerated, indeed accommodated, inside prison walls?
If we are going to just accept that there is nothing that can be done to stop drugs getting in and then pander to them by providing safe facilities in which to inject, why not just open a pub and let them drink alcohol too? Why not supply whatever they need to make their stay behind bars as comfortable and bearable as possible?
I wonder how many people who were clean while being responsible citizens, ended up getting hooked on drugs only after getting locked up for other crimes?

TL;DR – Jail is supposed to be a disincentive to do crime, not a holiday camp!

artuoui artuoui 9:24 pm 09 Jan 17

Like many ALP politicians, John has clearly forgotten why unions exist and who they are for. The CPSU is backing its members – the people paying their dues – and representing their clearly stated concerns. Unions exist to do this, not to put themselves above their membership and pursue their own political or ideological program. Obscenities like that whole Health Services Union fiasco become possible when a union forgets why they are there and who they are for.

A_Cog A_Cog 9:18 pm 09 Jan 17

John, I remain stunned you were ever elected to anything. Yes, on medical grounds, a needle exchange reduces rates of transmissible disease. But the inmates are in jail because of the crimes they committed, not the blood-borne diseases they had. The main reason they committed those crimes? DRUG ADDICTION.

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, where we are supposed to control every facet of their lives, so much so, that here in the ACT, this box is human rights compliant!” especially when they’re supposed to be getting rehabilitated? You’re advocating locking crims up to rehabilitate them, and also advocating not rehabilitating them. Nice.

And if you reckon the drugs are hard to stop, maybe not blow millions on the arboretum? Like I said in your last AMC post, this is the worst jail in Australia, and when the Libs run Xmas and Manus, we scream about the inhumanity, but with an ALP Govt and a Greens jail minister in charge of this debacle, the horrors are somehow invisible.

No_Nose No_Nose 7:36 pm 09 Jan 17

How about mandatory weekly drug testing for inmates.

– 1st positive – No visits permitted and full sentence invoked with parole forfeited.
– 2nd positive – All privileges revoked and additional 1 month added to sentence
– Subsequent positives – additional 6 months added to sentence.

Sure we would probably have to expand the prison…but I’m OK with that.

James_Ryan James_Ryan 6:12 pm 09 Jan 17

Bryan said :

I have always thought that if I were to be threatened by a needle I would prefer it to be one that is one user and, mabe, relatively clean. One of the major obstacles is that the only (or first ?) Prison Officer to die from an infected needle was at Long Bay in the 90s. Our Officers, rightly, are still concerned at losing a colleague.

You’re right Bryan.

Of course Prison Officers are right to be concerned about their wellbeing. And that is precisely why it is important to understand the evidence and the context, and to not simply spout rhetoric (not saying you did, but this debate has been dragged to that level consistently by people with no grasp of or respect for the evidence of how prison NSPs work in the real world).

Something posted to the other AMC thread addresses the issue of Officer Geoffrey Pearce, killed with an HIV infected needle:

There is nothing stopping a detainee hell bent on stabbing a prison officer with a fit from doing that now, or at any time since the AMC was commissioned. There’s plenty of needles in there already. Every single one of them is a risk, yet the only time any AMC prison officer has been exposed to this risk is through needlestick injury when searching for unsterile fits that have to be hidden away.

Of course, then there’s the dramatic differences between Graham Farlow (who stabbed Officer Pearce) and an HIV+ prisoners in 2017. Farlow was an end-stage AIDS patient with dementia and an astronomical viral load. The fictional prisoner however is HIV positive in a time when modern HIV drugs has his viral load so low it’s undetectable. The chances of transmitting HIV are very low.

However, let’s pretend for a minute that … all those advances in modern medicine have never happened, and that the fictional prisoner is as potentially infectious as Graham Farlow. Post-exposure prophylaxis for HIV is a course of medicine that is commenced within 72 hours of a potential HIV exposure, and it prevents sero-conversion. In other words, had PEP been available to Geoffrey Pearce, he’d still be alive today. Anyone stabbed by the prisoner would commence PEP to prevent HIV infection. “Yes, but what about hep C and hep B”? Anyone can get vaccinated against hep B, and all prison officers should be. Hep C is now quickly and easily cured.

James_Ryan James_Ryan 4:54 pm 09 Jan 17

The greatest risk posed to prison officers by needles is through accidental needlestick injury. Needlestick injuries to prison officers occur sometimes when searching detainees, cells and other areas for contraband.

Prison NSPs operate already in every jail in Australia. When prison unions obstruct the introduction of regulated programs, they’re voting for the status quo. There is nothing more harmful than the current NSP.

As Hargreaves noted, the opposition to health programs demonstrated over years to be safe and effective is madness. It does make one wonder why. But then again, they’d look silly (publicly) and weak (to their union mates in other states and NZ) if they changed their position one inch. That’s why it was important to the union that they rejected the preferred model proposed by the ACT NSP Working Group; not because it was inherently unsafe, and not because it wasn’t a vastly safer proposition than the current unregulated model.

When condoms were introduced in NSW prisons, the union fought it every inch of the way.

The evidence supporting prison NSP is overwhelming. Yet some here think you can’t have an opinion unless you’re a prison officer. We’ve all got a stake in this because we’ve all got a stake in the health and wellbeing of our community and we all (most of us) pay taxes. It costs taxpayers a bomb to treat every single case of HepC and, without regulated access to sterile injecting equipment, our prisons are generating an endless supply of patients.

Bryan Bryan 3:27 pm 09 Jan 17

I have always thought that if I were to be threatened by a needle I would prefer it to be one that is one user and, mabe, relatively clean. One of the major obstacles is that the only (or first ?) Prison Officer to die from an infected needle was at Long Bay in the 90s. Our Officers, rightly, are still concerned at losing a colleague.

HardBallGets HardBallGets 3:02 pm 09 Jan 17

I see today that the AMA has joined the extensive list of organisations calling for illegal jail NSPs to be replaced with regulated NSPs.

To-date the prison union now stands opposed to the UN, WHO, UNODC, UNAIDS, the World Hepatitis Alliance, the PHAA, AMA, RACP, the ACT Government, and many others on this issue, plus eminent Australians like Neal Blewett, Sir Gustav Nossal, David Penington and Alex Wodak.

Either everyone else is wrong … or it’s the CPSU.

bulldog600 bulldog600 1:16 pm 09 Jan 17

Typical, never been faced with day to day issues in a prison but talk nonsense like this.
If I apply your logic of ” 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” to society it would be a mess.
People still drink drive, oh well lets be realistic about the success of RBT’s and let people drink 1 beverage while driving.
Immigrants coming to Australia, lets be realistic about the success of screening immigrants and just admit we have terrorists in our midst but hey lets give them extremist material too.

Enough with this as all the people wanting the needle exchange program in jails aren’t the ones who will be faced with the consequences as they are sitting behind their desks.
Blood borne diseases are in the prison systems already from prisoners already infected before they arrive.

Maybe you should sign up and go work for ACT Corrections which are bullies so you with this article fit the bill to work there but I suggest you go work as a guard and then re evaluate your opinion.

Blen_Carmichael Blen_Carmichael 1:01 pm 09 Jan 17

I think John and I agree that this proposed program presents absolutely no risk to a politician’s physical safety, especially when he does his advocating well outside the prison’s environs.

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