Transcript document

Glasgow Involvement Group
Views from injecting drugs users in
Glasgow
Pathways to Treatment and Care Conference
Stirling Royal Infirmary
30th September 2004
Study Background
 Catchment Group
 Existing Users of Needle Exchanges
 Previous Users of Needle Exchanges
 IDUs who have never used Needles Exchanges
 Methods
 Structured Outreach Interviews
 Self Completion Survey
 Focus Groups
Sample Profile
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Sample size was N= 76
76% were male
Average age was 33
Majority (52%) didn’t have own accommodation
The main sources of income in the preceding six
months were
 Unemployed with regular income from Government (81%)
 Illegal Activities (47%)
Current Drug Use
Illicit Drug Use
 All using heroin
 The next most commonly illicitly obtained drugs are
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Valium (68%)
Cocaine (39%)
Cannabis (37%)
Crack (14%)
DFs (12%)
Current Drug Use
Prescribed
 47 (62%) were being prescribed substitute drugs
 All prescribed methadone with 25% prescribed
more than one drug.
 Majority prescribed methadone was between 60
and 120 mls – range from 18-160 mls
Risk Behaviour
Injecting
 Only one person was not currently injecting heroin
 49 [65%] of those injecting heroin originally smoked it
 22 [45%] of those who initially smoked, moved to injecting within
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6 months
48% were injecting at least twice a day
27 out of 30 [90%] using cocaine were injecting it
Most common reason for injecting was peer pressure (33%)
Three quarters stated that it was a “spur of the moment” when
first injected
Only four (5%) said that they had ever been shown how to
safely inject but 64% would access safer injecting training if
available
Risk Behaviour
Sharing
 Needles/Syringes
 70% [n=52] had shared needles/syringes
 34% of these had shared in the previous 3 months
 Injecting Paraphernalia
 87% [n=65] had shared paraphernalia
 68% of these had shared in previous 3 months
Blood Borne Viruses
 Information
 Types of information - leaflets, advice from a worker and a
booklet
 47% had been given information
 Information Rating
25% good to very good
56% OK
19% poor to very poor
 Tests:
 HIV
 Hep B
 Hep C
– 58%
– 54%
– 67%
(0) tested positive
(2) tested positive
(26) tested positive
Blood Borne Viruses
 Knowledge Transmission Routes
 Needle risk – 97% easy to catch HIV/Hep C from “dirty
needles”
 Injecting Paraphernalia risk
— HIV
- 40% [no risk, not easy, don’t know]
— Hep C
- 15% [no risk, not easy, don’t know]
Needle Exchange
Accessibility
 50% were using pharmacy needle exchanges but the
most common needle exchange used was GDCC
(37%)
 82% stated that opening hours were suitable and only
2 people saw opening hours as barrier to accessing
NXs
 56% of those who expressed a view believed there
were sufficient places to get clean equipment.
Needle Exchange
Quality of Service
 Information Provision
 “Very Poor” was the most common response to rating the
information provided by NX
 Staff Attitudes
 Positive response with 46% rating the staff’s attitude as good
or very good
 10% of responses poor or very poor.
 Privacy/Confidentiality/Safety
 Majority (65%) stated that there was sufficient privacy at NX
 76% believe that the information provided is treated in
confidence
 20% had concerns about their safety when attending NX
Needle Exchange
 Return Policy
 76% say that they always return used needed/syringes
 Over half the sample [51%] stated the return policy is a good policy
 Barriers to Needle Exchanges
 29% stated that there were no barriers
 The four most common barriers were:
 Privacy (30%)
 Police (20%)
 Stigma (17%)
 Fear of losing script (16%)
Needle Exchange
 Service Improvement
5 most frequently identified items that the respondents
would like to be provided with are:
 Sterile Injecting Equipment (59%)
 Acidifiers (41%)
 Access to Community Rehabilitation (37%)
 Spoons (34%)
 Injectable Drugs (34%)
Training
 63% would like safer injection training
 50% would like first aid training
 79% would like overdose training
Pharmacy NX / Addiction Service NX
 Rating of service
 Staff attitudes
 Privacy
 Safety
 Rating information provision
 Injecting Techniques
 Physical Health needs
 Sexual Health Needs
 Abscesses/Wound advice
 General Drug Information
Addiction Service NX rated more positively on all topics bar safety
Pharmacy NX / Addiction Service NX
 BBV Information
 Pharmacy
- 82% positively rated
 Addiction Service
- 78% positively rated
Prescribed V Non Prescribed
Impact on risk behaviour& injecting practises
 Prescribed
 76% sharing needles
 91% sharing paraphernalia
 54% shared needles in last month
 Non prescribed
 59% sharing needles
 79% sharing paraphernalia
 29% shared needles in last month
Conclusions
 Information Provision needs to be improved
 Issues still around lack of knowledge re BBVs and high
risk injecting practises
 NXs need to play a more prominent role in reducing harm
associated with drug injecting
 More training needed on safer injecting /fatal overdose
provision
 Better screening and case management is required for
those on substitute prescribing programmes
 For this group of drug users, the Substitute Prescribing
Programmes may not be achieving its key treatment
objectives
 Full report due December
www.sdf.org.uk