The Global State of Harm Reduction in Prisons: Findings from 2018

Cinzia Brentari, Katie Stone

Background: Since 2008, the Global State of Harm Reduction (GSHR) has been tracking the harm reduction response to drug-related harms around the world. While considerable progress has been documented in the broader community, the provision of harm reduction in prison settings has regrettably not advanced in the same way.

Methodology: This study uses data gathered for the Global State of Harm Reduction 2018 report, sourced using international scientific and grey literature, as well as expert consultation with civil society organisations and academics working on drug use, harm reduction and prisons.

Results: This presentation will highlight the extent to which countries are responding to drug-related harms among people who use drugs in the prison setting. It will highlight trends of incarceration, including ‘hyperincarceration’ in the United States, and evidence the syndemic forces behind the so called ‘war on drugs’. The presentation will also provide updated information on the number of countries with NSP and OST provision in prison, naloxone provision, condom provision and accessibility of diagnostics and treatment for HIV, HCV and TB.

Conclusion: Progress on harm reduction in prisons has been far too slow, particularly considering that HIV, HCV and TB disproportionately affect prisoners and the special duty of care that states’ have towards this population. Funding and lack of political support continue to be major obstacles to prison-based service provision, while accessibility to services continues to be obstructed by, for example, restrictive criteria, long waiting times, and/or fear of stigma and discrimination. These barriers must urgently be addressed to allow for the expansion of harm reduction services in these critical settings.