Vol. 18, ed. 8

April 2022

Download PDF

Does having a zero-tolerance drug policy help, or does it hinder? In universities, it’s definitely the latter, according to a report issued last month by the Higher Education Policy Institute (HEPi) in the UK.

A survey conducted by HEPi has found that only three in 10 British students feel confident disclosing drug use to their institutions without fearing punishment.

“Drug-related deaths, which occur every year within universities, are largely preventable if the right policies and practices are in place,” the report says. “If zero tolerance means fewer people coming forward for help, and potentially life-saving information not [being] communicated to those unwilling or unable to cease illicit drug taking, then for us that is a matter of concern.”

In Australia, The Kirby Institute has tackled a very different question, asking “How effective is treatment-as-prevention for hepatitis C in a prison setting?”

Five years of research conducted across two maximum-security and two medium-security correctional centres in NSW has provided some highly encouraging insights.

In all, 3,691 people took part voluntarily in the Surveillance and Treatment of Prisoners with hepatitis C (SToP-C) study – 19pc had an HCV infection, 61pc were uninfected but at primary risk of infection, and 20pc had been infected previously. Thirty per cent of participants reported injecting drugs while incarcerated.

Prisoners with HCV received standard-of-care treatment for the first three years and then, in 70pc of cases, direct-acting antiviral (DAA) treatment from mid-2017.

During the study period, the incidence of HCV almost halved, dropping from 8.31 per 100 person-years in October 2014 to 4.35 per 100 person-years in September 2019. Primary infection decreased from 6.64 per 100 person-years to 2.85, and re-infection fell from 12.36 to 7.27, leading the researchers to conclude that their findings “support broad DAA treatment scale-up within incarcerated populations”.

As we welcome the results of this focus on harm reduction in NSW, spare a few minutes’ thought for those currently detained in Ukraine. While more than two million Ukrainians have already left their country as refugees, prisoners are unable to flee, despite being desperate in many cases to find urgent, ongoing medical treatment for substance use disorder and/or blood-borne viruses such as HIV.

We pay tribute this month to the fortitude of frontline workers such as Oleksii Kvytkovskyi as they maintain their unwavering support for people who use drugs in Ukraine.


John Ryan
CEO, Penington Institute