It’s no secret that despite ongoing supply and demand reduction efforts drugs are still being smuggled into and being used inside Australia’s prisons. The link between illicit drug use and incarceration is well established with numerous studies showing high incarceration rates among problematic drug users. The NSW Inmate Health Survey of 2001 found that 74 percent of female and 67 percent of male inmates had used illicit drugs regularly in the twelve months before entering prison.

Caroline Gillespie is a Drug and Alcohol Counsellor and the Team Leader for the Brosnan Centre’s Bridging the Gap Program in Victoria, which assists 17 – 25 year olds upon release.  She said the picture of drug use was very similar for Australia’s young offenders.

“We know that there is a lot of cannabis and heroin use as well as people diverting buprenorphine to be injected,” she said.

“We also know that prescription medication, such as benzos and psychiatric medications are fair game.

“People need to understand that life inside prisons is all about currency and power.

“Drugs, buprenorphine and prescription medications can be traded for things like cigarettes or people stand over others to get access to their medications.

“Some people might choose to go on methadone but are pressured to take buprenorphine because it can be easily diverted.

“They then either trade their dose or it is supplied to someone who has power over them.

Caroline said the result of drug use inside prisons was needle sharing.

“The issue of sharing is very real,” she said. “One needle tends to be used by a lot of people.”

“The result of that sharing is already obvious –we mainly see cases of hepatitis C – a trend that is already well documented.

“Some people will make a decision not to use while inside because of the issues around sharing but it isn’t a deterrent for most.

“Most people will continue to use and some will come out with a full habit.”

Each state and territory in Australia is responsible for the health of people who have been incarcerated and, while each state’s response to drug use is different, it is clear that all invest most energy in supply and demand reduction programs.

The Australian National Council on Drugs issued a discussion paper titled, Supply, Demand and Harm Reduction Strategies in Australian Prisons: Implementation, Cost and Evaluation, in July 2004.

Representing the first attempt to document the nature and breadth of drug strategies that have been developed by prison authorities the paper highlighted the need for a more consistent approach.

All states and territories use sniffer dogs and urinalysis programs as supply reduction measures.

Detoxification, opioid maintenance therapies and inmate counselling are commonly used demand reduction initiatives.

While no Australian prison offers a needle and syringe program the different states and territories have integrated some harm reduction measures.

All states and territories except Queensland provide inmates with harm reduction education; three states provide peer education programs and five states and territories offer bleach/detergent programs. Procedures for blood borne virus testing vary in each state and territory. For example, in NSW blood borne virus testing occurs as part of a screening program for at-risk prisoners, whereas in South Australia and Western Australia it is provided on a voluntary basis. Tasmania ceased compulsory testing for HIV during 2003.

Queensland’s Sister’s Inside has now managed to organise a hepatitis C education program for female inmates in the state.

Debbie Kilroy said the program provides, “health messages within a harm minimisation framework”.

“The program teaches the women how to grow their own herbs and fruit and vegetables to help lead a healthier lifestyle,” she said.

“We don’t tell people not to use drugs but make sure they know that there are dangers, especially around hepatitis C, and offer drug education.”

“If people aren’t going to stop then they need to know how to reduce the harm.”