NEWS 5
ausdoc. com. au 20 MARCH 2026
NEWS 5
‘ They put the needle up their arse and walk around with it’
Public health initiatives prisoner style.
Bella Rough and Paul Smith BAD things happen in prisons, but sometimes the reasons bad things happen are not the fault of the inmates themselves. Take drug use. Australian prisons, specifically the officers working in those prisons, have resisted any move to introduce needle and syringe programs to prevent the spread of significant bloodborne viruses, such as hepatitis C and HIV.
Based on a series of interviews with former inmates who injected while incarcerated, a paper in the February issue of the International Journal of Drug Policy offers a confronting insight into the consequences.
“ I counted 86 people using one needle in one day,” said Todd, 42.“ And we had that needle for six months, 12 months. I’ ve had a needle for two years once.”
In another interview, a former inmate called Robert said:“ You’ ve got 10 guys using the same needle at a table and they’ ll put it up their arse and walk around with it. That’ s where they hide them.”
The interviews as a whole reveal a hidden economy of reused syringes, improvised equipment and routine exposure to bloodborne viruses in all their forms.
It is both alarming and, in many ways, totally what any rational person would expect.
According to the researchers, buprenorphine / naloxone( Suboxone) is the most commonly injected drug in prison, often diverted and resold by inmates with a prescription.
The paper mentions that as part of its opioid substitution treatment, in 2020, Queensland Corrective Services switched from providing sublingual strips to the long-acting buprenorphine injection. Would this measure curtail misuse?“ There was one girl that had the subby [ Suboxone ] injection in her stomach, and after she did the injection, they put a bandaid on it, and then she would mix up the bandaid and share it out between a bunch of girls. Her blood and the subby that leaked out on it,” Katy, 35, said.
In terms of the prison drug economy, two former inmates explained that one milligram of Suboxone can go for $ 100 in prison, and a strip can cost $ 800. For those studying the law of supply and demand, it is worth noting that in the community four Suboxone strips cost about $ 3.50.
What about a new syringe, which in the outside world would probably cost next to nothing? In prison, they can sell for up to $ 300, the former inmates said.
The result of these price barriers, as Adam Smith would have no doubt explained, is innovation: some inmates opt to make their own syringes.
“ One time, I used that fit [ syringe ] that’ s made out of a bread bag, a pen and a sunscreen tube,” said Brian, 42.
“ They shot me up in the side of the foot, and it ended up getting infected, and I got acute hepatitis.”
When you ban access to clean needles, the outcomes are predictable. Fourteen of the interviewees said they contracted hepatitis C during their sentence.
Four participants self-reported an injection-related bacterial infection, but most of the study cohort said they knew others who had one.
The paper, co-authored by researchers from the University of Queensland, concluded by calling for prison needle and syringe programs equivalent to those in the community as a“ moral and health imperative”.
This has been repeatedly requested by public health activists for a generation.
But their arguments have gone nowhere. The opposition comes from the prison officers’ unions. And it is as simple as seeing needles as weapons. Their fears are rooted in the case of Geoffrey Pearce.
In 1990, the 21-year-old custodial officer at Long Bay Correctional Complex in Sydney was stabbed in the buttock with a needle that had been used by an HIV-positive inmate.
He was diagnosed with HIV five weeks later and died seven years later in 1997.
Mr Pearce spent the years following his diagnosis advocating for greater community awareness of AIDS. He was posthumously appointed a Member of the Order of Australia for
‘ I counted 86 people using one needle in one day.’
PHOTO: FACEBOOK his advocacy, and a correctional centre near Windsor, NSW, was renamed in his honour in 2020.
But in 2003, the director of ACT Corrective Services cited his death as one reason a needle program“ remains an industrial issue in corrections”, arguing that inmates commonly used syringes as“ hold-up weapons”.
“ We also contend that the introduction of such a program would lend perhaps tacit support to illegal drug use, raise duty of care and industrial issues, and be difficult to manage in our circumstances,” the then director, James Ryan, told an ACT standing committee on health.
In the two decades since, concerning rates of hepatitis C in incarcerated populations( estimated at around 30 %) have reignited calls for prison needle and syringe programs— only for the calls to stall over safety concerns.
Judged by the brief media debate triggered by the findings of the University of Queensland study, that is not going to change any time soon.
The Community and Public Sector Union restated its“ unequivocal” opposition.
Its deputy secretary Stewart Little told the ABC he did not believe
Geoffrey Pearce. such programs would make officers or inmates safer and warned they could prompt“ a high level of industrial action”.
So where does that leave inmates? They are left to reduce risks as best they can.
Interviewees described limiting the number of people sharing a syringe, rinsing syringes with water three times between uses, or cleaning equipment with disinfectant when available.
Some said they would snort drugs instead of injecting, or smuggle in syringes and never share them.
The threat of punishment also discourages people from seeking medical help.
One 40-year-old woman said she had seen people with swollen arms refuse care because they would be caught for using.
Without effective harm reduction, treatment alone can fall short.
“ Another mate of mine is in hospital now. He can’ t even walk. He’ s got this spinal infection … and he’ s wheelchair bound probably for the rest of his life,” said Toby, 46.
“ If he had been treated, this could have been avoided.
“ The nurses come in the morning, and you line up and you show them your arm. [ The nurse responds with ],‘ Oh, here’ s a bandaid’ or,‘ Here’ s a couple of Panadol,’‘ If it gets any worse, put a form in,’” he added.“ Then what happens is, you’ re learning to live with these infections.” And for now, that remains the reality inside many Australian prisons. That may not disturb those who believe they have broken the social contract.
But even with that view, the social consequences of the needle ban are then borne by their families and the wider community once the inmate’ s sentence is completed and they walk back out of the prison gates.
Int J Drug Policy 2025; 27 Dec.