We’re talking about harm reduction in correctional facilities, and one specific, evidence-based service that could make a real difference: prison-based Needle and Syringe Programs, or PNSPs.
Now, let’s be clear from the outset — NSPs are not about promoting or encouraging drug use. What they are about is reducing harm. This includes minimising the transmission of blood-borne viruses like hepatitis C, which is high among prison populations.
Despite stringent rules and security measures, drug use does occur in prisons. And when it does, access to clean injecting equipment is nonexistent. That forces people to share needles — a major pathway for hepatitis C transmission. It’s a health crisis inside the walls, and it doesn’t stay there. Because when people leave prison, they return to families, communities, and workplaces — often carrying the same health risks they faced inside.
But PNSPs can help change that.
These programs provide sterile injecting equipment in a confidential and controlled way — not unlike the services already offered in the broader community across Australia.
And here’s what’s important: the data shows they work.
In countries like Switzerland, Spain and Germany, where prison-based NSPs have been trialed or implemented, the benefits are clear — reduced hepatitis C transmission, fewer injuries from makeshift injecting tools, and crucially, no increase in drug use or violence among inmates. Staff safety is a concern as well and to date there have been no reported needle stick injuries to staff from an NSP anywhere in the world.
Professor Alison Ritter, AO, Director of the Drug Policy Modelling Program at UNSW Sydney, explains it plainly:
“Harm reduction is effective at reaching the most marginalised members of society… and it has also been proven to improve prison safety for both detainees and staff.”
So, what is harm reduction exactly?
It’s about practical, non-judgmental support. Meeting people where they’re at — not where we wish they were. It acknowledges that abstinence, while valuable, isn’t the only path to better health outcomes. In prison environments, where risk is high and support is limited, harm reduction becomes not just useful — but essential.
Recently, the Harm Reduction in Prisons Working Group convened by the Kirby Institute UNSW, released a consensus statement, bringing together national experts in public health, drug treatment, research, and advocacy. Their message is compelling: Australia must do better inside our prisons if we want to meet our public health goals — including the target to eliminate hepatitis C by 2030.
Melanie Walker, CEO of the Australian Alcohol and other Drugs Council, doesn’t mince words:
“The spread of blood-borne viruses in prison is like a hole in the rabbit-proof fence of our national strategy. And right now, we’re ignoring it.”
She’s right. Australia has been a global leader in providing NSPs to the general public. But when it comes to people in prison — we’ve fallen behind.
Let’s look at the bigger picture. Prisons are more than just punishment — they’re also an opportunity. For people who’ve had limited or no access to health services on the outside, prison may be the only time they can connect with care. Harm reduction in this setting isn’t just about the individual — it’s about the broader community.
Because most people in prison eventually return to the community.
By offering tools like NSPs, we’re giving them a better shot at staying healthy. And we’re also reducing the risk for their families, their partners, and the people they live and work with.
Professor Ritter puts it plainly:
“From a public health perspective, it doesn’t even matter whether you care about prisoner health or not. The fact is, what happens in prison doesn’t stay in prison.”
The consensus is clear: if we’re serious about eliminating hepatitis C and protecting our communities, then we must apply harm reduction measures inside prisons — just as we do outside.
Link to the Consensus Statement:
https://www.unsw.edu.au/research/sprc/research/dpmp/strengthening-injecting-related-harm-reduction-prisons
