Substance misuse: Nice warns of patchy access to needle services

The National Institute for Health and Clinical Excellence has warned that access to crucial needle services for intravenous drug users “varies widely” across the UK.

Nice guidance scheduled for publication on 25 Feburary will champion the role of needle and syringe programmes as an important way of tackling the spread of diseases such as Hepatitis C and HIV among the UK’s estimated 150,000-200,000 injecting drug users.

The institute found that the schemes also brought hard-to-reach drug users into contact with services and helped them access further specialist treatment and safer alternatives to injecting.

Patchy availability

However, the patchy availability of needle services – along with differing opening times and working practices between agencies – was blamed for the failure to meet the needs of every drug user.

DrugScope chief executive Martin Barnes said: “It is essential that needle exchanges are available to all those who need them. Drug users across the country should have equal access to sterile injecting equipment. We hope that the guidance will lead to an improvement in the provision of needle and syringe programmes in those areas that are currently not well served.”

Dr David Sloan, vice-chair of Nice’s public health interventions advisory committee, which oversaw the development of the guidance, said that although incidence of HIV among drug users had remained at a relatively low level, the sharing of needles among drug users made the group “extremely vulnerable” to a future outbreak.

Hep C concerns

There have also been concerns over a rise in Hepatitis C among drug users. It has been estimated that 90% of people who contract Hepatitis C in England acquire it by injecting drugs. 

Sloan added: “This is not a time for getting complacent and our guidance on the optimal provision of needle and syringe programmes will help us to ensure the spread of blood-borne viruses, not just within the injecting drug user community but also society at large, remains under control.”

Needle and syringe schemes have been running in England for over 20 years, mainly through pharmacies and other drug services. The guidance includes advice for public sector commissioners and managers on developing schemes by increasing their effectiveness and accessibility.

It also makes recommendations on safe needle and syringe disposal, data collection, service user input and consultation with the local community.

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