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This study explores the experiences and behaviors of injecting drug users (IDUs) in Glasgow, based on a comprehensive survey involving 76 participants. Key findings reveal a significant number of IDUs engage in high-risk injecting practices, with 70% reporting needle sharing and a prevalent use of substances like heroin and cocaine. The study highlights the importance of needle exchange programs, with 50% utilizing pharmacy exchanges. However, barriers such as privacy concerns and stigma persist. Recommendations include enhancing access to safer injecting training, sterile equipment, and community rehabilitation services.
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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 • 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 • Valium (68%) • Cocaine (39%) • Cannabis (37%) • Crack (14%) • DFs (12%)
Current Drug Use Prescribed • 47 (62%) werebeing 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 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 – 58% (0) tested positive • Hep B – 54% (2) tested positive • Hep C – 67% (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 ExchangeAccessibility • 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 ExchangeQuality 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