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Expansion of prison needle exchange programs going ahead despite pandemic delays

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By Marie-Danielle Smith in Ottawa

Despite pandemic slowdowns, Correctional Service Canada is still planning to expand the needle exchange programs currently offered at nine federal prisons, government officials say.

At a presentation given to the International AIDS Conference in Montreal on Friday, Henry de Souza, the agency’s director general of clinical services and public health, said “a number of institutions” have been identified for an expansion, and the program will continue to be implemented across the country.

Inmates have been able to request sterile equipment for drug use at two Canadian prisons since 2018, and another seven were added in 2019. Some advocates have expressed fears the program, which is designed to reduce needle sharing and the spread of infectious disease, could be cancelled after numbers showed a low uptake.

Only 53 inmates were actively using the programs in mid-June, officials told the AIDS conference Friday night, out of 277 who had been approved to participate over the last four years.

These programs are in addition to the country’s only prison-based “overdose prevention service,” which began operating in 2019 at the men’s medium-security Drumheller Institution in Alberta. It is essentially a supervised injection site, offering sterile equipment and consumption under observation.

Since the site opened, there have been 55 participants, 1,591 visits and zero overdoses at the site, officials told the conference.The correctional service says it also offers mental health counselling, access to naloxone to counter opioid overdose effects and preventive treatments, such as pre-exposure prophylaxis — medicine taken to prevent getting HIV.

All of these efforts has led to a decrease in infections, said Marie-Pierre Gendron, an epidemiologist at Correctional Service Canada. She said HIV infection among inmates nationally is down from 2.02 per cent of the prison population in 2007 to 0.93 per cent in 2020; and hepatitis C is down from 21 per cent in 2010 to 3.2 per cent in 2021.

Lynne Leonard, a University of Ottawa associate professor who was contracted by the agency to evaluate the programs, said during a Tuesday morning panel that both programs have had “significant beneficial outcomes” for inmates, and she saw “eventual successful institutional adoption” despite initial pushback from staff.

Preliminary results from her study found that the program seemed to lead to a significant decrease in HIV infections at the institutions that put it into place. Overdoses at Drumheller were down more than 50 per cent overall since its supervised consumption site opened.

“I’m encouraged by the way they’re describing the program as something they’re proud of,” says Sandra Ka Hon Chu, co-executive director of the HIV Legal Network.

But a major “red flag” that could be leading to lower participation is the fact that security personnel are involved in the process, she said. That’s not the case in other countries’ prison needle exchange programs, some of which are fully anonymous or even offer syringes in automated dispensing machines.

“It’s really a critical flaw in the program,” she said.

Inmates are subject to a threat assessment by security and approval by a warden before being able to access programs, as officials described the process. Almost a quarter of requests to participate in the program have been rejected, according to statistics presented at the conference.

Shawn Huish, the warden at Mission Institution in British Columbia, said it was a challenge to shift the mindset of correctional workers accustomed to searching for drugs, confiscating them and trying to stop inmates from taking them — while at the same time reassuring inmates that participating in the program would not affect their release.

There was a lot of “fake news” to battle, Huish said, including a billboard erected outside the prison that painted the program in a negative light.

“Our biggest focus was talking, educating, breaking down the fear. Having a needle acknowledged in jail can be scary for folks,” he said. “You’re afraid you’re going to get needle sticks. So we looked at the records. In two and a half years, we’ve had one staff member get pricked, and it was while searching, and it was a thumb tack.”

Leah Cook, the regional manager of public health for the Prairies, oversaw the implementation of the supervised injection site at Drumheller and said it is “the only known service of its kind in a correctional setting on the world stage, for which I am incredibly proud.”

Cook said a “safe zone” was created so that participants in the program could carry their own drug supply to the observation room without the fear of being searched — and it’s been nicknamed the “yellow brick road.”

Although it is not clear whether the agency plans to expand the overdose prevention service to other institutions, Leonard’s research found that staff members at Drumheller preferred it to the needle exchange program and thought it was safer and more successful.

Correctional Service Canada did not immediately respond to questions sent over the weekend.

This report by The Canadian Press was first published Aug. 2, 2022.

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COVID-19

HIV spike among B.C. drug users associated with COVID-19 lockdown, research says

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By Brieanna Charlebois in Vancouver

A new study says reduced access to HIV services during early COVID-19 lockdowns in British Columbia was associated with a “sharp increase” in HIV transmission among some drug users.

The study by University of British Columbia researchers says that while reduced social interaction during the March-May 2020 lockdown worked to reduce HIV transmission, that may not have “outweighed” the increase caused by reduced access to services.

The study, published in Lancet Regional Health, found that fewer people started HIV antiretroviral therapy or undertook viral load testing under lockdown, while visits to overdose prevention services and safe consumption sites also decreased.

The overall number of new HIV diagnoses in B.C. continues a decades-long decline.

But Dr. Jeffrey Joy, lead author of the report published on Friday, said he found a “surprising” spike in transmission among some drug users during lockdown.

Joy said transmission rates for such people had previously been fairly stable for about a decade.

“That’s because there’s been really good penetration of treatment and prevention services into those populations,” he said in an interview.

B.C. was a global leader in epidemic monitoring, which means the results are likely applicable elsewhere, Joy said.

“We are uniquely positioned to find these things,” he said. “The reason that I thought it was important to do this study and get it out there is (because) it’s probably happening everywhere, but other places don’t monitor their HIV epidemic in the same way that we do.”

Rachel Miller, a co-author of the report, said health authorities need to consider innovative solutions so the measures “put in place to address one health crisis don’t inadvertently exacerbate another.”

“These services are the front-line defence in the fight against HIV/AIDS. Many of them faced disruptions, closures, capacity limits and other challenges,” Miller said in a news release.

“Maintaining access and engagement with HIV services is absolutely essential to preventing regression in epidemic control and unnecessary harm.”

The Health Ministry did not immediately respond to requests for comment.

Researchers said the spike among “select groups” could be attributed to a combination of factors, including housing instability and diminished trust, increasing barriers for many people who normally receive HIV services.

British Columbia is set to become the first province in Canada to decriminalize the possession of small amounts of hard drugs in January, after receiving a temporary federal exemption in May.

Joy said this decision, alongside measures like safe supply and safe needle exchanges, will make a difference preventing similar issues in the future.

“The take-home message here is, in times of crisis and public health emergency or other crises, we need to support those really vulnerable populations more, not less,” he said.

“Minimally, we need to give them continuity and the access to their services that they depend on. Otherwise, it just leads to problems that can have long, long-term consequences.”

This report by The Canadian Press was first published Sept. 24, 2022.

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Tragedies unite Humboldt Broncos mom and James Smith Cree Nation artist

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By Mickey Djuric in Regina

Celeste Leray-Leicht received many condolence gifts after the Humboldt Broncos bus crash that claimed the life of her son, but it was a beaded green and yellow ribbon with a white heart that stood out.

Leray-Leicht wore it for years after her son Jacob Leicht died. It now lives on her vehicle’s visor, next to a photo of her children when they were little, alongside a poppy.

She always felt a connection to the beaded ribbon because of the heart.

“My son Jacob, he was a Valentine baby, so I’m drawn to hearts,” Leray-Leicht said from her home in Humboldt, Sask., east of Saskatoon.

On April 6, 2018, near Tisdale, Sask., 16 people were killed and 13 were injured when an inexperienced truck driver ran a stop sign, crashing into a bus that was taking the Humboldt Broncos junior hockey team to a playoff game.

Leray-Leicht’s son played with the Broncos and was 19 when he died in the crash.

She never knew who gifted her the beaded pin, but she found out when she headed out to James Smith Cree Nation, northeast of Saskatoon, to drop off food and other donations earlier this month.

Bernard Constant Community School on the reserve has become a gathering hub after a stabbing rampage on Sept. 4 that killed 10 people, nine of whom were James Smith Cree Nation members. Eighteen others were injured. Both suspects have died.

The school is where funerals and wakes were held, where volunteers continue to cook throughout the day to keep members fed as they recover. It’s also where people come to pray.

On Sept. 11, it became the place where two women, dealing with devastating loss, came face to face for the first time.

While in the school’s gym, Leray-Leicht met Lissa Bear, who is a member of James Smith Cree Nation, and has been grieving alongside her community.

She’s also the Indigenous artist who anonymously gifted her the beaded ribbon that had always reminded Leray-Leicht of Jacob.

To Leray-Leicht’s surprise, Bear had approached her saying she had sent her the pin years ago.

“And I said ‘I just looked at that pin half an hour ago,” Leray-Leicht said. “We were kindred spirits. We instantly hit it off.”

Leray-Leicht said it was remarkable to meet Bear, despite the tragedies that unite them.

“I think God is in the details and I don’t really believe in coincidences too much. I think we’ll become good friends,” said Leray-Leicht. “It was just so special to me.”

Bear declined to comment, but gave consent to Leray-Leicht to share the story.

Humboldt and James Smith Cree Nation are 125 kilometres apart, but are connected through their grief.

Since the mass stabbing, families from Humboldt have silently attended funerals, donated food and offered support to people in the Indigenous community.

“As adults and leaders in the community, it’s our responsibility to try and find as many supports as we can for our youth and for our adults without reliving the trauma over and over again,” Leray-Leicht said.

Students in Humboldt wrote messages of hope on hearts for James Smith Cree Nation, something a nearby community did for them in 2018 after the bus crash.

At a vigil in Humboldt on Sept. 14, the hearts were placed in baskets alongside chocolate Hershey hugs, and were given to James Smith Cree Nation Chief Wally Burns. They asked him to pass them along to the youth of his community.

“When asked ‘what do you need?’ and they say prayers, I can relate,” said Leray-Leicht, who helped plan the vigil. “That’s all I remember thinking — ‘That’s what we needed, too.’ Prayers to lift us up to survive this devastating loss.”

This report by The Canadian Press was first published Sept. 24, 2022.

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september, 2022

tue27sep10:00 am4:00 pmCACPC Annual SHRED Event10:00 am - 4:00 pm MST The Central Alberta Crime Prevention Centre, 4311-49 Ave Event Organized By: The Central Alberta Crime Prevention Centre

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