5 Recommendations for research
The Public Health Advisory Committee (PHAC) recommends that the following research questions should be addressed. It notes that 'effectiveness' in this context relates not only to the size of the effect, but also to cost effectiveness and duration of effect. It also takes into account any harmful or negative side effects.
All the research should aim to identify differences in effectiveness among groups, based on characteristics such as socioeconomic status, age, gender and ethnicity.
5.1 How can needle and syringe programmes encourage specific groups of people who inject drugs to use the service effectively? Examples include: those who have recently started injecting; women; sex workers; ex-prisoners; people who are homeless; people who occasionally inject drugs; and people who inject novel psychoactive drugs.
5.2 What are the most effective and cost-effective ways of delivering needle and syringe programmes to:
young people aged under 18
users of image- and performance-enhancing drugs?
5.3 What type of behaviour-change interventions delivered by needle and syringe programmes are effective in promoting safer drug use practices and reducing the incidence of overdose (apart from providing needles, syringes and other injecting equipment)?
5.4 What types of injecting equipment (including low dead-space syringes), paraphernalia and non-injecting equipment (for example, crack pipes or foil) effectively and cost effectively reduce the harm associated with injecting drug use?
5.5 Do needle and syringe programmes have any unintended consequences:
Do they increase the uptake, frequency and length of injecting drug use?
Does the provision of disposal facilities (for example, drop-boxes) affect the amount of drug-related litter in an area?
Do they have a negative impact on the local community, for example, in terms of crime rates or the fear of crime?
More detail identified during development of this guidance is provided in gaps in the evidence.