More evidence or stronger political will: exploring the feasibility of needle and syringe programs in Ukrainian prisons

Abstract

Introduction In 2007, the World Health Organization (WHO) recommended for prison authorities to introduce prison needle and syringe programs (PNSP) if they have any evidence that injecting drug use is taking place in prisons. This article presents descriptive evidence that injecting drug use takes place in Ukrainian prisons, it discusses how (denial of) access to injection equipment is regulated in the current system and what changes should be considered in order to implement PNSP. Background Ukrainian prisons still live by the laws and policies adopted in the Soviet Union. Besides laws and regulations, these legacies are replicated through the organization and infrastructure of the prison’s physical space, and through “carceral collectivism” as a specific form of living and behaving. Inviolability of the prison order over time helps the prison staff to normalize and routinely rationalize punishment enforcement as a power “over” prisoners, but not a power “for” achieving a specific goal. Methods The Participatory Action Research approach was used as a way of involving different actors in the study’s working group and research process. The data were gathered through 160 semi-structured interviews with prison health care workers, guards, people who inject drugs (PWID) who served one or several terms and other informants. Results The “expertise” in drug use among prisoners demonstrated by prison staff tells us two things—they admit that injecting use takes place in prisons, and that the surveillance of prisoner behavior has been carried out constantly since the very beginning as a core function of control. The communal living conditions and prison collectivism may not only produce and reproduce a criminal subculture but, using the same mechanisms, produce and reproduce drug use in prison. The “political will” incorporated into prison laws and policies is essential for the revision of outdated legacies and making PNSP implementation feasible. Conclusion PNSP implementation is not just a question of having evidence of injecting drug use in the hands of prison authorities. For PNSP to be feasible in the prison environment, there is a need for specific changes to transition from one historical period and political leadership to another. And, thus, to make PNSP work requires making power work for change, and not just for reproducing the power itself.

“That’s Not Rehabilitation, That’s Enabling”: Correctional Officer Perspectives on the Prison Needle Exchange Program

“…These positions were informed by political challenges and opposition to select evidence-informed harm reduction programs correctional systems endured from the Conservative-led government of Canada (2006Canada ( -2015Elliott, 2007;Iafrate, 2015). Research in the United States and Ukraine support how the success of PNEP implementation relies on political context, leadership, and an effective transition from one historical period to another (Bluthenthal, 1998;Dmitrieva et al, 2021;Showalter, 2018).…”

Managing Opioid Agonist Therapy in the Post-Soviet Limbo

“… 2. A similar narrative on the intervention’s role in the division between the Western world and Russia (or Soviet order) was one of the common ones among prison staff members while we were studying the feasibility of needle and syringe programs in Ukrainian prisons in 2018–2019 (Dmitrieva et al, 2021). …”