The Canadian Prison System: Realities and Innovative Practices

April 22, 2021

Today, harm reduction is slowly making its way into prison settings. However, in reality, this approach is not sufficiently implemented, and often poorly thought out for incarcerated people who use substances. With a critical eye, we will revisit harm reduction policies in prisons, while presenting Canadian examples of innovative projects and programs.


Hard Time: Harm Reduction Policy in Federal Prisons

Real Talk

In-Reach and Prison Needle Exchange Program (PNEP): A PASAN Perspective

  • Nicole Alexander et Chris McNab, Federal In-Reach Community Development Coordinators, PASAN

Harm Reduction in Ontario Provincial Jails

  • Lindsay Jennings, Provincial Hep C Program Coordinator, PASAN

A Project for Access to Naloxone in a Context of Incarceration



  1. Website: Prison Health Now
  2. Website: PASAN is a community-based prisoner health and harm reduction organization that provides support, education and advocacy to prisoners and ex-prisoners across Canada.
  3. Website: HIV Legal Network’s work on Prisons

Resources & Articles (2011-18)

  1. Improve Access to Naloxone in Federal Prisons, September 6, 2018
  2. The “Problem of Health Care” in Canada’s Federal Prisons, March 2018
  3. Journal Article: Health in correctional facilities is health in our communities, March 12, 2018
  4. Journal Article: HIV and hepatitis C virus infections in Quebec’s provincial detention centres: comparing prevalence and related risky behaviours between 2003 and 2014-2015, May 11, 2017
  5. Report: Indigenous Communities and HIV and HCV in Federal Prisons: Questions and Answers, April 2017
  6. Clinical Review: Health status of prisoners in Canada, 2016
  7. Report: UN Experts Make Historic Recommendations to Canada: End Unjust HIV Criminalization, Repeal Law Restricting Supervised Consumption Services, and Implement Needle and Syringe Programs in Prisons, November 18, 2016
  8. Journal Article: Health status of prisoners in Canada, March 2016
  9. Office of the Correctional Investigator: Access to Physical and Mental Health Care, March 14, 2016
  10. Report: ON POINT: Recommendations for Prison Based Needle and Syringe Programs in Canada, January 2016
  11. Journal Article: Prison health care inequality, April 2, 2013
  12. Journal Article: Incidence and risk factors for non-fatal overdose among a cohort of recently incarcerated illicit drug users, February 7, 2012
  13. Journal Article: Peer health promotion in prisons: a systematic review, 2011

Resources & Articles (2019-21)

  1. COVID-19 Prisoner Emergency Support Fund: Support prisoners re-entering the community and the families of those still behind bars
  2. Journal Article: Correctional services during and beyond COVID-19, April 8, 2021
  3. Video: Overcoming stigma and violence against incarcerated and drug using women, March 24, 2021
  4. Correctional Service of Canada fails to track employees accused of sexual assault in prisons, March 8, 2021
  5. Hepatitis C infection secondary to illicit drug use for prisoners within the correctional system, March 3, 2021
  6. Houses of hate: How Canada’s prison system is broken, February 28, 2021
  7. Report: No Turning Back: [Canadian Bar Association] Task Force Report on Justice Issues Arising from COVID-19, February 17, 2021
  8. Ontario Prisoners’ Resource Guide, January 2021
  9. Journal Article: Sexual and Reproductive Health Outcomes among Incarcerated Women in Canada: A Scoping Review, January 28, 2021
  10. Transitioning from incarceration to the community: Reducing risks and improving lives of people who use substances, November 23, 2020
  11. Report: Decriminalizing People Who Use Drugs: A Primer for Municipal and Provincial Governments, November 12, 2020
  12. Human Rights Groups File Legal Challenge Citing Canada’s Failure to Protect Prisoners’ Health in the Context of COVID-19, October 14, 2020
  13. Report: Office of the Correctional Investigator Annual Report 2019-2020, June 16, 2020
    • Recommendation 5: I recommend that CSC review independent Patient Advocate models in place in Canada and internationally, develop a framework for federal corrections and report publicly on its intentions in 2020-21 with full implementation of an external Patient Advocate system in 2021-22.
  14. Journal Article: Recent incarceration and risk of first-time injection initiation assistance: A prospective cohort study of persons who inject drugs, April 29, 2020
  15. A Public Health Failure: Former Prisoner and HIV Gropus in Court Suing the Government of Canada for Failing to Provide Effective Access to Prison Needle and Syringe Program, March 5, 2020
  16. Report: Focus on Harm Reduction for Injection Drug Use in Canadian Prisons: A supplement to CNA’s Harm Reduction Discussion Paper
  17. Prison Needle Exchange Program, August 28, 2019
  18. Prison – Based Needle and Syringe Programs, July 11, 2019
    • Policy Brief on the Correctional Service of Canada’s Prison Needle Exchange Program
    • Fact Sheet that Dispels Some of the Common Myths
  19. Open Letter to the Government of Canada on the Evaluation of its “Prison Needle Exchange Program”, March 25, 2019


  1. Journal Article: “My first 48 hours out”: drug users’ perspectives on challenges and strategies upon release from prison, March 12, 2021
  2. Prisons Are a Public Health Crisis — and the Cure Is Right in Front of Us, October 13, 2020
  3. Incarceration Should Not Be a Death Sentence, July 21, 2020
  4. Journal Article: Prison-based needle and syringe programmes (PNSP) – Still highly controversial after all these years, June 15, 2015