Author: Nigel Brunsdon

The United Kingdom’s first unsanctioned overdose prevention site; A proof-of-concept evaluation

Research based on the overdose prevention site which was opened by Peter Krykant in Glasgow in 2020. With no financial or other support from local or national governmental agencies, he acquired a second-hand minibus and equipped it with basic first-aid equipment, needles and sterile equipment, and naloxone. It opened on 31st August 2020 (International Overdose Awareness Day), parked at a single site in Glasgow city centre.

Results

The service operated for nine months without permission or funding from official sources. We report on the 894 injections supervised and recorded, and nine successful interventions with overdose events (seven opioid/two cocaine). Powder cocaine injection predominated either alone (60.6%) or with heroin (22.1%). Injection was mostly in the groin (68.0%) or arm (16.8%). More injections were recorded by males (70.1%). Around 65% of injection events featured an individual who was on a buprenorphine/methadone prescription.

Conclusion

It is feasible for an overdose prevention service to operate successfully in the UK without being shut down by the police or with negative consequences for the community. Future sites in the UK must tailor to the substances used by their potential clients, international trends (e.g. for fentanyl use) did not apply here. There is an urgent need and demand for these services in the UK to reduce harm, prevent and intervene during overdose, and provide vital psychosocial support for health and wellbeing in a highly marginalised population.

National Wound Care Guide (Scotland)

This resource aims to help people working within harm reduction and injection equipment provision (IEP) services, and anyone who works with people who inject drugs, to assess injection sites and identify potential complications arising from injecting street drugs.

The guide discusses different types of injuries and wounds, signs and symptoms of infection, prevention and simple treatments. It also describes problems with the lower limb which can occur as a result of injecting.

Contents

  1. Wound Healing and Assessment
  2. Common Injecting Injuries
  3. Peripheral Vascular Disease
  4. Infections
  5. Life Threatening Conditions
  6. Blood Borne Viruses
  7. Top 10 Tips and Practical Resources
  8. Glossary of Terms
  9. Bibliography

Shooting Up: Infections among people who inject drugs in the UK

People who inject drugs (PWID) are vulnerable to a wide range of viral and bacterial infections. These infections can result in high levels of illness and in death, so public health surveillance of infectious diseases and the associated risk and protective behaviours among this group are important. This Public Health England publication reports on the extent of infections among people who inject drugs (PWID) in the UK.

The Shooting Up report is produced annually and we at the NNEF believe that all groups working to support PWID in the UK should use this document to inform their practice and ensure the information they provide people is accurate and up to date.

The PHE page for the Shooting Up report also includes an archive of previous year’s reports.

Injecting Equipment Provision in Scotland

New good practice guidance on the provision of injecting equipment in Scotland has been published. This is the first such publication in Scotland since the 2010 Guidelines for services providing injecting equipment: Best practice recommendations for commissioners and injecting equipment provision services in Scotland.

Since then, there have been significant changes in what drugs people use, in the way drugs are being used, as well as research on the role and provision of IEP services. These factors mean that there has long been a need for new guidance.

Minimum Standards for Needle Exchanges and Harm Reduction Services

The charity Humankind has launched a new minimum standards document for their organisations harm reduction services. The new standards are intended to improve equitable access to needle and syringe provision and reduce the stigma and discrimination faced by people who use substances.

The new guidelines have been welcomed by others working in the sector. “I am delighted to see drive to improve the care we offer to some of our most vulnerable members of society”, said Professor Graham Foster, Professor of Hepatology at Queen Mary University of London and National Clinical Chair for the Hepatitis C Delivery Networks.

“Preventing avoidable harms by high quality needle exchange is one of the most effective ways of improving health and reducing costs and this initiative will help in our goals to build back better after the pandemic”, Foster added.

Low Dead Space Injecting Equipment: A Briefing

Maximising the Effectiveness of Needle Exchange with low dead space syringes and prevention of accidental sharing, this briefing by Exchange Supplies is a free 24 page book that is a comprehensive guide to addressing these two key areas of injecting related risk.

Giving full descriptions of the advantages of low dead space injecting equipment and reducing accidental sharing, it is aimed at drug user activists, practitioners, commissioners and people who use drugs.

Low Dead Space Posters and Leaflet

Exchange Supplies and Michael Linnell have produced a collection of posters and a colourful leaflet to promote the use of reduced dead space equipment.

Low dead space injecting equipment has less space between the needle and the plunger after injecting. Blood and drug remain in this space, so if equipment is shared the risk of spreading blood-borne viruses, such as HIV and hepatitis C, is higher when there’s more blood left in the equipment.

The poster topics were informed by the information gathering stage of the project, and cover the subjects most commonly requested as in need of additional information.

The posters can be used together or in rotation, with a different message every month or so being highlighted.

Chemsex and Harm Reduction for Gay Men Who Have Sex With Other Men

Chemsex briefing from Harm Reduction International. Using substances for sex and socialising is not a new phenomenon. Drug use was documented among gay men and other men who have sex with men long before the term “chemsex” was coined. Chemsex, which has come to the attention of public health professionals in the past decade, involves both sexual and drug-related high risk behaviours such as multiple sexual partners, the use of multiple drugs together, and injecting drug use.

There are many definitions of chemsex, but most agree that it involves the following:

  • Sex between men
  • Substance use to facilitate, prolong or enhance sex
  • Use of a specific set of substances (mainly stimulant drugs)
  • Casual sexual partners and often group sex
  • Events which last for an extended period of time
  • Often facilitated by digital technology.

HIV in the UK

HIV epidemiological reports based on PHE data on HIV testing, diagnosis and care in the UK.

Public Health England produce this annual report reviews data for 2019 on new HIV diagnoses, people accessing care in the United Kingdom (UK) and HIV testing in England. It is associated with a set of data tables and a slide set for presentations.

The data show that in 2019 the UK, nationally, met the Joint United Nations Programme on HIV and AIDS (UNAIDS) 90-90-90 targets for the third consecutive year, with London achieving the most significant improvements in diagnosis, treatment and viral suppression.

Global State of Harm Reduction Reports

Harm Reduction International’s flagship publication is the biennial Global State of Harm Reduction report. First published in 2008, it involves a coordinated effort across practitioners, academics, advocates and activists to map global data and responses to HIV and hepatitis C epidemics related to unsafe injecting and non-injecting drug use.

It is the only report to provide an independent analysis of the state of harm reduction in the world and has become the go-to source on global harm reduction developments for researchers and advocates in our sector and beyond.


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