One of the readings for today's class was this article on drugs and sex in prison:
Seal DW, Belcher L, Morrow K, Eldridge G, Binson D, Kacanek D, Margolis AD, McAuliffe T, Simms R; Project START Study Group. A qualitative study of substance use and sexual behavior among 18- to 29-year-old men while incarcerated in the United States. Health Education & Behavior 31(6):775-789.
Without going into too much detail, the paper states that drugs are widely available in prison and that people absolutely do them, and it shows that those who use injection drugs do so unsafely, i.e., re-using needles without cleaning them, sharing needles, etc. While this was all surprising for me to read, what I need to get off my chest is the reaction I found myself having to its policy implications. Obviously if people are shooting drugs in prison, they should have clean needles made available to them - after all, that's a most reasonable course of action outside of prison. But the idea didn't immediately sit right. Ultimately, of course, it seemed like the way to go, but on first read, there was this sense of "Uhhh...Imma have to think about that one" that I can't quite reconcile with the values I thought I had. I'm not proud of it, but I AM curious about it. Where does this double standard come from, and why do I, as a harm reduction advocate, have it?? So I started coming up with reasons why availability of clean needles in prison would send a confusing message, and quickly realized that they are identical to the reasons people have for criminalizing and condemning drug use outside of prison - reasons I usually try to talk people OUT of. For example, prisons are supposed to be sheltered, controlled environments, so admitting that contraband penetrates their walls (built with OUR money) undermines this status. Well, isn't our country supposed to be a sheltered, controlled environment too, with tons of money going to border control? Policy ideals and rhetoric are being shattered in both cases, so why do I forgive the real world its porous borders and cry harm reduction, but recoil from accepting drug availability in prisons as a reality to be dealt with? Or maybe it's the sense of surprise, that I had no idea drug use was so prevalent in prisons, so I'm going to need a minute to sit with this idea. Well, not everyone was a raver or outreach volunteer or addiction researcher and has been around drug users half their life -- many in the real world probably also have no idea about the actual extent of the problem, and need to be granted some time to come to terms with it and realize its impact. Or maybe I'm afraid of a sense of spite or disregard on the part of prisoners for rules that they, as part of their punishment, have been required to obey. But as citizens and productive members of society, people in the real world also have a set of rules and laws to obey -- and I don't necessarily see it as an act of subversion or spite when they break these laws by using drugs. Or maybe it's because many of the people in prison were sent there for the very purpose of not doing drugs anymore (not that treatment is available there, but that's another story...), so supporting them in doing it anyway is a bit of a slap in the face - but then I'm just another jerk who thinks themself morally superior and wants to teach a lesson and places conditions on reaching out a helping hand. In the real world, I despise these kinds of attitudes; when it comes to prison, I have them?? I don't know -- there isn't an answer, but it's certainly painful to find limits to one's sense of immediate empathy.
Having thought about it, I'm of course all about supplying needles (and condoms) to people in prison. But I don't like having observed this side of me that had to give it any thought at all. On the brighter side, I wonder what proportion of knee jerk reactions to needle exchanges and other harm reduction programs in the real world could be reversed by just giving people a minute to let it percolate and an opportunity to articulate (and potentially realize the folly of) their concerns.