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  • Study on the prevalence of drug use, including intravenous drug use, and blood-borne viruses among the Irish prisoner population

    Posted on April 10th, 2014 TimB No comments

    Accurate up-to-date data on the extent of drug use and the prevalence of blood-borne viruses among the prisoner population are a necessary pre-requisite for health and social service planning and policy development. The most recent national study assessing the prevalence of blood-borne viruses, along with self-reported drug use within Irish prisons (Allwright et al., 1999), was carried out over a decade ago.

    This study was commissioned by the National Advisory Committee on Drugs (NACD)* in 2010 with the following objectives: to describe the nature, extent and pattern of consumption for different drugs among the prisoner population; to describe methods of drug use, including intravenous drug use, among the prisoner population; to estimate the prevalence of blood-borne viruses among the prisoner population and to identify associated risk behaviours; and to measure the uptake of individual drug treatment and harm reduction interventions (including hepatitis B vaccination) in prison.

    This study confirms that drug use, including injecting drug use, is a significant problem among prisoners in Ireland and suggests that drug-related factors are important in the acquisition of blood-borne viruses. The findings also show that prisoners who need services, such as the range of addiction services and detoxification, are very willing to use them when they are available. ‘In-prison’ uptake of testing and vaccination services confirms that prisons are appropriate settings for the provision of preventive, diagnostic and treatment services for drug users. It is hoped that the evidence provided in this study will facilitate service and policy development in this important area.

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  • Barriers and facilitators of hepatitis C screening among people who inject drugs: a multi-city, mixed-methods study

    Posted on January 16th, 2014 TimB No comments

    People who inject drugs (PWID) are at high risk of contracting and transmitting and hepatitis C virus (HCV). While accurate screening tests and effective treatment are increasingly available, prior research indicates that many PWID are unaware of their HCV status.

    The  results suggest that drug-injecting individuals who reside in non-urban settings, who have poor access to primary care, or who have less education may encounter significant barriers to routine HCV screening. Expanded access to primary health care and prevention services, especially in non-urban areas, could address an unmet need for individuals at high risk for HCV.

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  • A Costly Turn On”: Patterns of use and perceived consequences of mephedrone based head shop products amongst Irish injectors

    Posted on December 17th, 2013 TimB No comments

    Mephedrone injecting has recently been reported in Romania, Slovenia, Guernsey and Ireland. The research reported here aimed to describe the experiences of a group of Irish injecting drug users, who were injecting mephedrone based headshop products prior to the introduction of legislative controls in Ireland, with particular focus on pre- and post-legislative use, effects of injecting mephedrone, settings and contexts for injecting, polydrug use and serial drug injecting, risk perceptions and harm reduction practises.

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  • Prevalence of, and risk factors for, human immunodeficiency virus, hepatitis B and hepatitis C infections among men who inject image and performance enhancing drugs in England & Wales.

    Posted on April 23rd, 2013 TimB No comments

    Dr Vivian Hope of Public Health England told the British HIV Association conference yesterday that injection of image- and performance-enhancing drugs is rising in England and Wales. Moreover, his research suggests that men may be acquiring bloodborne viruses through this route – 1.5% had antibodies to HIV, 8.8% had antibodies to hepatitis B and 5.5% to hepatitis C.

    Dr Hope said that across the world, only three previous studies have been conducted on HIV prevalence among people who inject drugs which are taken to enhance body image, physical strength or performance. One of these three was conducted in the UK in the mid-1990s and did not find any HIV infections in those surveyed.

    There are reports of increased numbers of people injecting these drugs who present to needle and syringe exchanges. However, not all syringe exchanges have the skills and experience to meet their needs. The injecting process is different to that of opiates ­– these drugs are normally delivered in a sealed vial, and are not usually injected into a vein, but into a muscle or beneath the skin.

    Moreover, the social profile of injectors of image- and performance-enhancing drugs is different to that of opiate injectors – younger, more likely to be employed, less likely to have had problems with the criminal justice system.

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  • Infectious diseases continue to disproportionately affect drug users

    Posted on November 9th, 2012 TimB No comments

    A report from the Health Protection Agency (HPA) has found that half of people who inject drugs are infected with hepatitis C, one in 100 have HIV and a third have a bacterial infection as a result of their injecting. Almost a quarter of younger injectors (those aged under 25) continue to share needles and syringes.

    In 2011, one in six people who inject drugs were found to have been infected with the hepatitis B virus at some point in their lives. This is a large fall from 2001 when over a quarter had been infected. This fall is due to a programme of hepatitis B vaccination which has specifically targeted this group and in 2011, 76 per cent of injectors accepted the vaccination, up from 37 per cent in 2001.

    The report, ‘Shooting Up – Infections among people who inject drugs in the UK 2011’ which was recently published .

    People who inject drugs are vulnerable to a wide range of viral and bacterial infections which can result in a high level of illness and death. The most common viral infections seen in drug users are hepatitis B and C. Both of these cause inflammation of the liver and are caused by contact with infected blood. In drug users this contact is caused by the sharing of needles and syringes and other equipment used in injecting drugs.

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  • Seven ways to reduce infections among people who inject drugs

    Posted on October 13th, 2011 TimB No comments

    Seven interventions, one aim: no infections among people who inject drugs. In a new guidance document, EU agencies ECDC and the EMCDDA have joined forces to identify seven interventions to reduce and prevent infectious diseases in this vulnerable population. Many European countries have achieved substantial progress in recent years in preventing drug-related infections. Drug injecting, however, remains a major cause of infectious diseases across Europe. The interventions proposed range from the supply of injection equipment, testing and vaccination to the treatment of infections and drug dependence. These are best applied in combination and ideally in the same venue for maximum effect.

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  • Why Russia Needs Gender-Sensitive Harm Reduction

    Posted on August 7th, 2011 TimB No comments

    In Russia, as in many countries, women who use drugs face  profound structural and individual challenges to access essential health care. According to the UN Office of Drugs and Crime, Russia is home to 1.6 million injecting drug users and women are estimated to make up as many as 40 percent. Meanwhile, more than one third of the country’s people who inject drugs are believed to be living with HIV. Yet local groups who provide harm reduction services report as few as one in six of their clients are female.

    Poverty, stigma, domestic violence, police harassment, and fear of losing custody of their children are only some of the barriers preventing women who use drugs from seeking medical and counseling services.  And if they do come for medical care, they are likely to be denied access or receive substandard services from doctors and nurses who are not trained and not prepared to deal  with their issues.

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  • Women who inject drugs: A review of their risks, experiences and needs

    Posted on January 12th, 2011 TimB No comments

    Women who inject drugs have substantially different needs and face higher risks of disease and violence than do men who inject drugs.  Given this difference, it is surprising that much of the literature on injection drug users (IDU) does not distinguish between men and women when discussing prevalence, needs, risks and outcomes of injection.

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  • Understanding femoral injecting — part 1 of 2

    Posted on August 14th, 2010 TimB No comments

    Part 1 of an interview with Tim Rhodes about femoral injecting

  • Knowing the score: a doctor addict tells his story

    Posted on July 29th, 2010 TimB No comments

    The vein stands up, proud and inviting. The syringe sits on the bedside table, the new orange needle gleaming expectantly.One of the small benefits of being a doctor and an addict is that clean needles are easily available, and the risk of HIV and hepatitis B or C infection is low. I had used a green needle to draw up the drug, a needle that can reach right to the bottom of the ampoule, so that not one drop will be missed. Beside the syringe lies the empty packet of Cyclimorph; the red and blue packaging is so distinctive to me that if it was lying on the road a mile away I would spot it.

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