The Global State of Harm Reduction in Prisons

Area of Science:

• Public Health
• Infectious Disease Epidemiology
• Criminal Justice Health

Background:

• A significant portion of the global prison population comprises individuals who use and inject drugs.
• Drug use within correctional facilities is a major concern.
• High prevalence of HIV and hepatitis C (HCV) exists among incarcerated populations worldwide.

Purpose of the Study:

• To review the current state of harm reduction in prisons globally.
• To present evidence supporting harm reduction for people who use drugs in carceral settings.
• To assess the availability, accessibility, and quality of key harm reduction services within prisons.

Main Methods:

• Literature review of drug-related incarceration, prison drug use, and infectious disease prevalence.
• Analysis of scientific, legal, and economic arguments for harm reduction.
• Global overview of harm reduction services in prisons, including needle and syringe programs, opioid substitution therapy, naloxone provision, and HIV/HCV/tuberculosis care.

Main Results:

• Harm reduction services remain severely limited in most prison settings globally.
• Despite evidence, legal, and economic rationale, implementation is inconsistent.
• Key services like needle/syringe programs and opioid substitution therapy are scarce.

Conclusions:

• There is a critical need to expand harm reduction services within prisons to address public health crises.
• Implementing comprehensive harm reduction strategies is essential for the well-being of incarcerated individuals and the wider community.
• Increased access to diagnosis, treatment, and care for HIV, HCV, and tuberculosis is paramount.