NICE pushes for more comprehensive needle exchange services for people who inject drugs
Free needle and syringe exchange schemesare an important and cost effective way of tackling the spread of viruses such hepatitis C and HIV among people who inject drugs. Viruses which, in turn, can be spread among society at large.
Just at important, the schemes also help people who inject to seek treatment for their addiction and can lead to them quitting drugs altogether.
However, provision varies across the country. Where services do exist, opening times and working practices can also vary considerably, according to research carried out for‘Needle and syringe programmes', our first guidance on the subject.
The guidance, which was published in February, recommends that NHS and other local planners ensure a balanced mix of these services are available across the country and tailored to meet local need.
For example, apart from free sterile needles and syringes, people using these services should be offered treatment to help them to stop injecting - or to come off drugs altogether - as well as support to address their other health needs.
As a matter of course, sharps bins should be provided, along with advice on how to dispose of used equipment safely.
Above all, services should be available ‘for a significant period of time' during any 24 hours and in a range of locations, to ensure they are as accessible as possible.
“About 25% of the estimated 200,000 people in England and Wales who inject illegal drugs share their needles. This puts them at high risk of contracting hepatitis B and C or HIV,” said Professor Mike Kelly, Public Health Excellence Centre Director.
“The evidence indicates that needle and syringe programmes are effective in tackling blood-borne viruses among injecting drug users.”
According to Professor Kelly, it costs the NHS around £35,000 to care for someone who injects drugs over their lifetime.
“If needle exchange schemes are run well, they can help doctors, nurses and pharmacists make direct contact with people who are injecting and who often have no other contact with health services. This is an important first step towards encouraging them to seek treatment, to think about using non-injecting methods of drug use or quitting their habit altogether.
A comprehensive needle exchange service with additional treatment services would help keep in check the epidemic of hepatitis as well as the potential epidemic of HIV. It could also lead to greater numbers of people quitting drugs,” he said.
This, in turn, would mean even greater savings for society at large: taking into account the high cost of drug-related crime, this risesto an estimated average of £480,000 over an injecting drug user's lifetime.
Dr David Sloan, Vice Chair of the Public Health Interventions Advisory Committee which helped develop the guidance, said that it is important to ensure the local community is closely consulted when planning new or reconfigured needle and syringe programmes.
"People do have fears about having these programmes in their community. We believe these recommendations will protect communities, but they need to understand what the benefits to them might be."
Needle and syringe exchange schemes have been offering free sterile injecting equipment to people who inject illicit drugs, as well as advice on safer injecting techniques and safe disposal of equipment, for over 20 years. The majority are run by pharmacies and drug services.
‘Needle and syringe programmes' relates to people over 18 who inject illicit substances and non-prescribed anabolic steroids.
Issued: 16 March 2009
This page was last updated: 11 May 2010