School of Public Health, Georgia State University, Atlanta, Georgia.
Am J Drug Alcohol Abuse. 2021 May 4;47(3):273-279. doi: 10.1080/00952990.2021.1872587. Epub 2021 Feb 17.
Despite efforts to prevent illicit substance use in prisons, inmates in many countries still have access to them, along with associated paraphernalia. In the United States, a large proportion of people in prison are there due to drug-related charges. The secretive nature of illicit substance use in prison and the opposition to implementing harm reduction interventions such as needle exchange programs have put prisoners who engage in such practices at high risk for infectious bloodborne diseases. While states have their reasons for opposing the implementation of needle exchange programs in prisons, evidence shows that keeping illicit substances out of prisons is difficult. Programs allowing needle exchange programs are currently illegal in the United States. The authors propose that states reconsider their stance on needle exchange programs as the implementation of such programs in several penal institutions worldwide have proven to be successful in reducing bloodborne diseases and promoting and preserving the health of prisoners. By prohibiting needle exchange programs in prison states are not only denying prisoners' access to health care but are also violating prisoner's right to health as recommended by international instruments on prisoner rights. This article advocates for the implementation of needle exchange programs in the United States prison system with a focus on states. It does this by drawing attention to the effectiveness of such programs around the world and to the fact that incarceration does not necessarily reduce illicit substance use.
尽管各国都在努力防止监狱内的非法药物使用，但许多国家的囚犯仍能获得这些药物及相关用具。在美国，很大一部分囚犯是因毒品相关指控入狱的。监狱内非法药物使用的秘密性质以及对实施减少伤害干预措施（如针具交换计划）的反对，使从事此类行为的囚犯面临感染血源性病原体的高风险。虽然各州反对在监狱实施针具交换计划有其自身的原因，但有证据表明，防止非法药物进入监狱是困难的。目前，在美国，允许实施针具交换计划的州是违法的。作者建议各州重新考虑其对针具交换计划的立场，因为在全球范围内，在一些监狱机构实施这些计划已被证明可成功减少血源性疾病，并促进和维护囚犯的健康。通过在监狱内禁止实施针具交换计划，各州不仅剥夺了囚犯获得医疗保健的机会，而且还侵犯了囚犯的健康权利，这是囚犯权利国际文书所建议的。本文主张在美国监狱系统中实施针具交换计划，并重点关注各州。它通过关注世界各地此类计划的有效性以及监禁不一定能减少非法药物使用的事实来做到这一点。
