1. Needle Replacement in Scottish Prisons: Practical Issues for Implementation Stephen Heller-Murphy Addiction Policy Development Scottish Prison Service

2. Practical Issues For Implementation What We Propose Recommendations to SPS board Prisoner Need Prisoner Survey data Management Acceptance Issues Consultation Q & A Staff Attitude Basic Training

3. Recommendations to SPS Board, March 2005 Bleach tablets continue to be available. Clean injection equipment is stored on reception and returned to prisoner on release. Wider availability of substitute prescribing, prioritisation of IDUs. Distribution of sterile injecting equipment within prisons as part of a phased, risk assessed process subject to the needs of prisoners.. No punishment for prisoners holding legitimate injecting equipment or reduction of cessation of substitute prescription. Literature and training available to staff and prisoners. Introduction of paraphernalia care plans.

4. Prisoner Need: 8th prisoner survey data (July 2005) Sample 6,274 77% response rate 1417 used in the previous month 943 used heroin in the previous month 126 injected in the previous month 73 shared injecting equipment

5. Management Q & A (reflects staff attitude) In-prison needle exchange means uncontrolled numbers of dirty needles in prisons Unconvinced that clean needles reduce staff risk Injecting equipment provision condones drug use If we supply prisoners with equipment when they have a script they will be at risk of overdose

6. Management Q & A Injecting and heroin use is not prevalent in our jail Avril Taylors research on injectors suggests community needle exchange is not effective and despite provision users still share No evidence presented against provision

7. Staff Attitude Anecdotally we know that attitude is poor among frontline staff towards drug using prisoners A culture of punishment over treatment for being a drug user but punishment for a +ve drug test has now stopped and its replacement is under review Will awareness training and a change of system be enough to change attitudes?

8. Contact stephen.heller-murphy@sps.gov.uk SPS HQ Calton House 5 Redheughs Rigg Edinburgh EH12 9HW 0131 244 8636