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Ebulletin #28

30th November 2005

VOICES RISING - Volume 3, Number 11

McDowell's Prison Drug Plan "puts political posturing before public health", says IPRT

The Irish Penal Reform Trust (IPRT) has criticised Justice Minister Michael McDowell's recipe for so-called "drug free prisons", noting that his plans to introduce mandatory drug testing while denying HIV prevention programmes such as syringe exchange will only make current prison health problems worse.

Speaking earlier today to a group of Prison Governors on the Government's proposed new Prison Drug Strategy, the Minister confirmed his intention to introduce mandatory drug testing (MDT) in prisons in spite of the evidence that the scheme does not achieve the results Mr. McDowell claims.  The Minister also reiterated his opposition to the introduction of prison syringe exchange programmes as a means to prevent the transmission of HIV and Hepatitis C in prisons via syringe sharing, despite the international success of such programmes and their support by the World Health Organization.

"The Minister's speech is a vivid illustration of his ignorance of evidence-based prison drugs policy," said IPRT Executive Director Rick Lines.  "The failure of mandatory drug testing and the success of prison syringe exchange is well documented internationally and easily accessible for anyone interested in examining it.  That the Minister's comments are so at odds with international best practice suggests the Government's new policy is based upon a desire to appear 'tough on drugs', rather than on evidence of effectiveness. In his comments today, the Minister is clearly putting political posturing over public health." 

Earlier this year the prison service in Scotland announced plans to scrap mandatory drug testing after admitting the policy has failed to tackle rising heroin use. According to a senior Scottish prison official quoted in The Scotsman newspaper,  "The existing approach to tackling drugs in prison MDT simply isn't working. People are continuing to use drugs...Mandatory testing only really works if people are willing to be treated, but if they aren't then it isn't much use."   Scottish Prison Officers also voiced their opposition to MDT, saying it has encouraged heroin use among prisoners and has created a confrontational relationship between staff and prisoners that has discouraged uptake of drug treatment programmes.

Said Mr. Lines, "The Scottish experience reflects the existing international evidence that rather than combating drug use in prison, MDT actually increases heroin use and heroin injecting and leads many to begin injecting heroin because it is more difficult to detect by urine screening. This has also been documented by prison officials I have met from Britain, Canada, Switzerland and Germany.  By encouraging increased injecting, MDT increases the risk of HIV and Hepatitis C transmission in prisons via syringe sharing."  

"It is indeed ironic that on the same day UNAIDS announced that the number of HIV infections worldwide has topped 40 million persons, our Justice Minister has announced that he has no intention of introducing life-saving HIV prevention programmes into Irish prisons."

"Drug use in Irish prisons is a serious problem requiring a serious solution.  Failed gimmicks such as MDT are an unwelcome distraction to those of us working to promote comprehensive and effective responses to drug use and HIV/Hepatitis C in prisons based upon solid international evidence.  The Government must abandon its plans to impose this failed scheme and instead implement comprehensive drug treatment and HIV/Hepatitis C prevention measures such as syringe exchange that reflect international best practice," said Mr. Lines.

IPRT works with prison officials in Eastern Africa

In mid-November, IPRT Executive Director Rick Lines travelled to Nairobi, Kenya at the invitation of the United Nations Office on Drugs and Crime (UNODC).

Mr. Lines worked for 3 days with prison officials from Kenya, Mauritus, Tanzania and Uganda to assist them in developing HIV prevention programmes for prisoners who use drugs. 

While in Nairobi, Mr. Lines also visited Kamiti Prison and met with prison officials and prisoners.

Photos of the project are available on the IPRT website. 

IPRT speaks in Australia

In late November, IPRT Executive Director Rick Lines travelled to Sydney, Australia where he was keynote speaker at the conference "Prisons and Blood-borne Viruses: Old Challenges, New Solutions",  organised bythe Consortium for Social and Policy Research on HIV, Hepatitis C and Related Diseases.

Mr Lines's presentation, entitled "Things that Matter: 10 reasons why harm reduction measures must be provided in prisons", advocated for the implementation of evidence-based approaches including syringe exchange in prisons while dismissing programmes such as mandatory drug testing as ineffective and dangerous.

While in Sydney, the IPRT was also invited to address the Annual General Meeting of Community Restorative Centre, a community-based organisation in New South Wales dedicated to supporting prisoners, ex-prisoners and their families.

See media coverage of Mr Lines' presentation below. 

IPRT addresses College Historical Society at Trinity College

On November 16th, IPRT Chairperson Claire Hamilton participated in a debate at the College Historical Society at Trinity College Dublin, the oldest college debating society in the world. The debate addressed the motion "That ASBOs represent another attack of the State on civil liberties."

We are pleased to say that our team won the debate! 

IPRT holds mid-year briefing meeting for members

On November 17th, the IPRT organised a mid-term meeting for its members to discuss organisational progress since the Annual General Meeting in April. 

IPRT Chairperson Claire Hamilton and Executive Director Rick Lines addressed the meeting, and there was discussion on work to date and ideas for priorities and opportunities in the coming months.

"Expert calls for prisoner needle exchange program to curb Hep C" by Amy Fallon, Australian Associated Press

SYDNEY - A prisoner needle-exchange program for Australian jails must be put in place immediately to curb the alarming rate of Hepatitis C among inmates, an international expert says.

Statistics from the recent National Prison Entrants' Blood-Borne Virus Survey show 34 per cent of prisoners have Hep C compared with 1 per cent of the general population.

Hep C is a blood-borne virus primarily transmitted by unsafe injecting practices.

It is largely symptomless but can cause scarring of the liver cells (cirrhosis), liver failure and liver cancer over a number of years.

The report found 56 per cent of injecting drug users in Australian prisons have the virus.

Executive director of the Irish Penal Reform Trust, Rick Lines, is in Australia to attend a workshop on blood-borne viruses in jails at the University of NSW tomorrow.

The workshop will examine methods for protecting the health of prisoners, prison staff and the general community from Hep C infections in Australian jails.

Mr Lines, the keynote speaker, said governments had both a moral and legal responsibility to put a prisoner needle-exchange program in place to stop Hep C spread.

"I really think it is time for Australia and other countries that have a serious Hepatitis C problem relating to injecting drug use to take action to implement these programs," Mr Lines said.

"Failing to put a needle-exchange process in place is simply failing to actually recognise and implement what's evaluated as best practice internationally."

He said the world's first prison needle exchange, established in Switzerland in the early 1990s, had led to a decrease in Hep C as well as HIV/AIDS in jails.

Other nations that have taken up the exchange include Spain and Germany.

Mr Lines said introducing a prisoner needle-exchange program should not be seen as condoning drug use.

"Unfortunately, syringe exchange programs in prisons are very controversial," he said.

"But the fact of the matter is in the countries that have implemented them, they have been proved to be very safe and effective programs."

He said the high rates of Hep C in Australian prisoners was a result of the "criminalisation of drug use".

"In my experience a great many drug users don't stop being drug users just because they go to prison," Mr Lines said.

(c)  AAP

First for Australia - needle exchange program for ACT prison: Press release from the Australian Hepatitis C Council

Simon Corbell, Health Minister for the ACT, has confirmed that a needle exchange trial is to be considered for the new ACT prison. This would be the first in Australia.

Helen Tyrrell, the Executive Officer of the Australian Hepatitis Council said, "The Australian Hepatitis Council, supported by all State and Territory Hepatitis Councils, congratulates the Health Minister and the Stanhope Government for their leadership and vision on this issue.

"The realities of the prison experience are that drugs exist in all prisons and blood-borne viruses like hepatitis C are transmitted through the extremely dangerous unofficial practice of sharing drug injecting equipment. It is therefore the responsibility of authorities to look at all possible ways to minimise the risks to both inmates and staff."

With up to one in every two inmates in some States having hepatitis C, transmission of the virus between prisoners is a major prison and public health concern. As the average prison sentence is well short of 12 months this becomes a public health issue for all Australians, as people move out of prison into the community.

Needle and syringe programs have operated in the community for many years and have been highly effective in preventing the spread of hepatitis C and HIV. Many health experts say that further gains won't be made until we address transmission within prisons. It is therefore imperative that needle exchanges are introduced into prisons across Australia as soon as possible. 

There is clear evidence from Europe, where prison needle exchanges have been operating for over 10 years, to show that the safety of staff in prisons is substantially enhanced by the introduction of a carefully planned and controlled needle exchange. Staff needle stick injuries which previously occurred during cell searches are virtually eliminated and not one incident of a needle being used as a weapon against a prison officer has occurred. In addition overall drug use has not increased.

Ms Tyrrell says that the benefits of introducing such a program will be obvious to anyone who reviews the evidence. She hopes all members of the ACT Legislative Assembly will support the Minister on this important health matter.

"Don't jail under-23s, say researchers", The Guardian

Jailing offenders under the age of 23 is counterproductive as it increases the likelihood that they will commit more serious crimes, researchers said today.  

Most young offenders "grow out" of crime after the age of 18 with the majority no longer offending after 23, according to the charitable trust Barrow Cadbury.  

It said magistrates should treat young offenders on the basis of their maturity rather than their age, providing more support services to ensure they stay out of trouble as they reach adulthood.

An inquiry set up by the trust said specialist services were needed for offenders aged 18-24 because placing them in the prison system made them more likely to commit more crimes.

The Independent Commission on Young Adults and the Criminal Justice System noted that nearly 75% of offenders in this age range reoffend after being released from prison.  

The study also recommended that young offenders under 23 should not be required to disclose their criminal convictions to potential employers.  

It also called for the Independent Police Complaints Commission and the Home Office to set up a young adult advisory group to discuss how young people are policed.  

(c) The Guardian 

Lost in Transition: A Report of the Barrow Cadbury Commission on Young Adults and the Criminal Justice System

The independent Commission on Young Adults and the Criminal Justice System was established by the Barrow Cadbury Trust. The role of the Commission was to develop a way in which the criminal justice system can recognise the importance of the transition between adolescence and adulthood, to develop ideas about how the system can promote natural desistance from offending in young adults in transition, and to find a way in which the criminal justice system could better promote the life chances of young adults.The Commission began its work in summer 2004. A wide range of stakeholders were invited to submit written evidence or were consulted through one-to-one or roundtable discussions about the issues facing young adults in transition and what the solutions could be. A list of organisations consulted is appended to the report. Commissioners also made a number of study visits to projects aimed at helping young adults in transition, in the UK, in Europe and in North America. The recommendations contained in the report have been informed by the consultations and the visits.
A number of partner organisations undertook a range of projects for the Commission to help develop the recommendations and the report:
The Prison Reform Trust and Jane Gordon
MEL Regeneration
The Social Market Foundation
Crime Concern
Dr Colin Webster , Dr Rob MacDonald, Tracey Shildrick and Mark Simpson of Teesside University
The Office for Public Management (OPM)
Professor Roger Bowles and Rimawan Pradiptyo of the Centre for Criminal Justice, Economics and Psychology, University of York

Why a Commission?

Young adults aged 18-21 are at the peak age for offending yet, with Government strategy primarily focusing on those young people aged under 18, there are few programmes and services aimed specifically at those over 18.

This despite the fact that:

  • the peak age of offending for males is 18
  • 18-20 year olds constitute 42% of all first time offenders
  • 74% of male offenders between 18-21 reoffend within two years
  • black and minority ethnic young adults are over-represented at all stages of the criminal justice system
  • young adult crime costs up to £20 billion a year

Whilst success has been claimed for the Government's youth justice reforms, the prevention agenda around young people and offending has clearly neglected those aged 18-21 because they are classified as adults. Furthermore, following changes in the law, young adults are increasingly being held in adult prisons, rather than Young Offender Institutions, and their needs are not being met. Overall there would appear to be a significant gap in mainstream provision for this age group.

The Commission looked at what could be achieved by way of different approaches to this age group in the future, with regard to prevention of crime, support to individuals and developing greater community trust in the justice system. This meant going beyond current policy, looking for innovation and good practice and making some analytical judgements on the current practices and policy in relation to this issue.

The work of the Commission

The Commission has been Chaired by Greg Parston, co-founder and Executive Chairman of the Office for Public Management, who a long history of working to address issues of social inequality and has a particular interest in the issue of young adults at risk.

The Chairman has been supported by twelve Commissioners representing a broad mix of interest and perspectives.

"Home Office inquiry team barred from privately run child prisons" by Alan Travis, The Guardian

A former Labour minister called for the contracts of two privately run child jails to be terminated yesterday after they refused access to a Home Office team investigating their use of physical restraint techniques on teenage inmates.  

"I understand that these two secure training centres did not provide admission to the consultants employed by the Home Office to carry out the review of physical control in care," said Ms Keeble. "In these circumstances, the contract with the private company responsible should be terminated because they have not demonstrated that they are able to provide a regime that is either appropriate for the staff, or safe for the young people."

Sally Keeble, Labour MP for Northampton North, told the Commons that the unpublished report from the inquiry team, which included medical experts, recommended that more than 20 restraint techniques currently in use be scrapped. She said physical control was routinely used in Britain's four secure training centres, designed to hold the most troublesome 10- to 17-year-olds.

The highest use of restraint was at two centres run by Rebound, a subsidiary of GSL Limited, one at Rainsbrook, near Daventry, Northamptonshire, and the other at Medway in Kent. The official review of physical control techniques was triggered by the death of Gareth Myatt, 15, in Rainsbrook in April last year.

Ministers have modified some of the restraint techniques but decided to ban the use of only one of them - the "seated double embrace" which was involved in Gareth Myatt's death.

Contrary to the unpublished recommendations of the review team, ministers have allowed the continued use of a painful "karate chop to the nose" technique and a "thumb distraction" method.

Ms Keeble told a Westminster Hall debate yesterday that the "nose distraction" put staff at the risk of being bitten, and "thumb distraction" involved an adult hand restraining a child's thumb and had the potential to cause more injury than other techniques.

"How on earth do we, in the 21st century, manage to run a regime for young people that includes an equivalent of thumb screws?" she asked MPs.

"In at least one of the institutions, in place of the seated embrace a standing hold is used. But children are still being bent over - and it is bending that is so dangerous because this is what prevents breathing. During the course of my investigations I actually have had some of these holds demonstrated on me, and once shown, the risks are evident."

Official figures showed that restraint was used 3,289 times in 2003 and 1,228 in the first few months of 2004 in the four secure training centres.

There are 274 places in all the centres, and 322 "trainees" went through Medway in 2003 and 289 through Rainsbrook. The average age of those sentenced to detention and training orders is 14, and half of them are unconvicted teenagers on remand awaiting trial.

Fiona Mactaggart, the Home Office minister, denied there was a routine use of physical restraint in the centres and said that only a "tiny minority" of such incidents involved inflicting pain.

"We need to protect other trainees and the staff themselves in potentially violent incidents. We need to have ways that we can distract children who are behaving dangerously," she told Ms Keeble.

But she admitted that staff were increasingly using handcuffs as an alternative to the physical control techniques. Ms Mactaggart also confirmed that restraint was being used to ensure the compliance of the trainees and not just to defuse potentially violent situations.

© The Guardian

"Call for free condoms to combat spread of HIV in prisons" by Eric Allison and Paul Lewis, The Guardian

Prisoners should be supplied with free condoms and given access to a needle-exchange system in an effort to combat soaring rates of hepatitis C and HIV among inmates, a report says today.  

The study, published by the Prison Reform Trust and the National Aids Trust, reveals that rates of hepatitis C and HIV in prisons are 20 times and 15 times higher respectively than in the public.  

The survey of prison healthcare managers across the UK found a third of prisons had no HIV policy, one in five had no hepatitis C policy and more than half had no sexual health policy.

Prison healthcare, the report authors say, is "substandard" and many prisoners have no access to condoms, disinfecting tablets, clean needles or healthcare information.

The director of the Prison Reform Trust, Juliet Lyons, said: "Courts sentence people to custody not to inadequate healthcare, but the prison population is marked by poor health.   "It is time the NHS developed good, well-resourced policy and practice to tackle blood-borne disease in prison."  

She called upon the NHS to develop a programme aimed at reducing the spread of blood-borne disease in prisons.   "Anything else would amount to double punishment and lead to public health risk," she said. 

A recent Home Office study found that about 2% of prisoners inject drugs, although it conceded there may be significant under-reporting of drug addiction due to stigma and illegality. Today's report recommends that prisons carry out regular anonymous blood tests to establish more accurate levels of HIV and hepatitis C infection.  

In order to avoid the spread of sexually transmitted infections, male and female contraceptives - which are already distributed in Scottish prisons - should be made accessible free of charge to all prisoners so they do not have to request them, the authors say.  

They also argue that the promotion of a "lower-risk" drug campaign among prisoners, methadone programmes and a system of needle exchange would help to improve the quality of healthcare in prisons and reduce infections.  

Last April John Shelley, a long-term prisoner in Long Lartin jail, began legal proceedings against the home secretary claiming the refusal of the Prison Service to introduce a needle-exchange policy represents a real and immediate risk to his life. The Department of Health, doctors and drug-user support groups, say the current policy of distributing disinfectant tablets gives addicts inadequate protection from blood-borne infections such as HIV and hepatitis.  

April 2006 is the completion date for the transfer of prisoners' healthcare to the NHS, which has pledged to provide an equivalent standard of service in prisons as in the wider community.  

© The Guardian

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