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  • Rapid Decline in HCV Incidence among People Who Inject Drugs Associated with National Scale-Up in Coverage of a Combination of Harm Reduction Interventions

    Posted on August 21st, 2014 TimB No comments

    Government policy has precipitated recent changes in the provision of harm reduction interventions –injecting equipment provision (IEP) and opiate substitution therapy (OST) – for people who inject drugs (PWID) in Scotland.

    We sought to examine the potential impact of these changes on hepatitis C virus (HCV) transmission among PWID. We used a framework to triangulate different types of evidence: ‘group-level/ecological’ and ‘individual-level’. Evidence was primarily generated from bio-behavioural cross-sectional surveys of PWID, undertaken during 2008-2012. Individuals in the window period (1–2 months) where the virus is present, but antibodies have not yet been formed, were considered to have recent infection. The survey data were supplemented with service data on the provision of injecting equipment and OST. Ecological analyses examined changes in intervention provision, self reported intervention uptake, self-reported risk behaviour and HCV incidence; individual-level analyses investigated relationships within the pooled survey data. Nearly 8,000 PWID were recruited in the surveys. We observed a decline in HCV incidence, per 100 person-years, from 13.6 (95% CI: 8.1–20.1) in 2008–09 to 7.3 (3.0–12.9) in 2011–12; a period during which increases in the coverage of OST and IEP, and decreases in the frequency of injecting and sharing of injecting equipment, were observed. Individual-level evidence demonstrated that combined high coverage of needles/syringes and OST were associated with reduced risk of recent HCV in analyses that were unweighted (AOR 0.29, 95%CI 0.11–0.74) and weighted for frequency of injecting (AORw 0.05, 95%CI 0.01–0.18).

    We estimate the combination of harm reduction interventions may have averted 1400 new HCV infections during 2008–2012.

    This is the first study to demonstrate that impressive reductions in HCV incidence can be achieved among PWID over a relatively short time period through high coverage of a combination of interventions.

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  • The National Drug-Related Deaths Database (Scotland) Report: Analysis of Deaths occurring in 2012

    Posted on March 25th, 2014 TimB No comments

    This is the fourth report from the National Drug-Related Deaths Database (NDRDD) for Scotland which presents data for the calendar year 2012 and trend data back to 2009. The NDRDD was established to collect detailed information regarding the nature and social circumstances of individuals who have died a drug-related death. This report analyses a cohort of drug-related deaths in Scotland already reported by the National Records of Scotland (NRS), formerly known as the General Register Office for Scotland.
    The NRS and NDRDD gather their information separately but since both sets of data concern drug-related deaths in Scotland, there is a great deal of overlap and therefore it is useful to draw comparisons. The NRS have identified an upward trend in drug-related deaths in Scotland since 1997 [1]; the NDRDD reports have sought to contextualise these deaths in relation to the social circumstances of the deceased. Dissemination of NDRDD findings informs policymakers and practitioners as to the potential for harm reduction and therapeutic interventions to reduce drug-related deaths in Scotland.

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  • Injecting Equipment Provision in Scotland Survey 2011/12

    Posted on June 28th, 2013 TimB No comments

    This publication reports on the findings of the survey of injecting equipment provision (IEP) to people who inject drugs and relates to the financial year 2011/12. The survey was carried out by the Information Services Division (ISD) of NHS National Services Scotland. The survey was originally commissioned in the context of Phase II of the Scottish Hepatitis C Action Plan1, which was funded by the Scottish Government and coordinated by Health Protection Scotland (HPS) The use of performance and image enhancing drugs (PIEDs) in Scotland is posing a new challenge for the NHS after figures released today exposed their soaring use.

    According to statistics from ISD Scotland, people injecting PIEDs now account for around a tenth of those who report to health services. It stated 93 per cent of injecting equipment provision outlets in Scotland now deal with such users, while the number of heroin addicts appears to be falling.

    The Scottish Conservatives have warned that, if more people are taking performance enhancing drugs, the Scottish Government has to be ready for it. Despite the apparent drop in heroin use, nearly four million needles were handed out last year by the NHS, and this does not include the bulk of NHS Lothian’s figures, whose pharmacies did not submit data.

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  • Anthrax team raises heroin supply issue

    Posted on January 6th, 2012 TimB No comments

    A repor into an anthrax outbreak which killed 14 heroin addicts suggests officials should consider prescribing the drug during any future contaminations.

    The National Anthrax Outbreak Control Team (NAOCT) claims the Scottish Government could “usefully give this aspect further consideration” as guidance on the issue would be helpful for Outbreak Control Teams (OCTs) and addiction services.

    Report author Dr Colin Ramsay, chairman of NAOCT, said prescribing heroin was suggested as a control strategy during the year-long outbreak – which began in Glasgow in December 2009 – but NAOCT considered the suggestion to be outwith its remit.

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  • Epidemiological update: Anthrax outbreak among drug users in UK and Germany

    Posted on April 19th, 2010 TimB No comments

    A total of 33 cases of anthrax infection have been confirmed in Scotland since the beginning of December 2009 among heroin users, including 11 fatal cases; the latest case was reported on 12 April 2010 from the Lothian NHS board and is alive.

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  • Methadone: ‘There is little evidence of any real progress’

    Posted on March 26th, 2010 TimB No comments
    Although there is considerable political will to wean former drug addicts off the heroin substitute methadone, there is little evidence of any real progress being made. It is two years since the SNP revealed a strategy to move the 20,000 people who had become dependent on methadone to treatments focusing on recovery rather than on programmes that continued the cycle of addiction.

  • Heroin on NHS plans to go before council

    Posted on February 25th, 2010 TimB No comments

    A specialist clinic could be established in the north-east to treat addicts by injecting them with a pure form of the drug.

    Drug addicts could be prescribed heroin on the NHS under new proposals being considered by Aberdeen councillors.

    The radical plans would see a specialist clinic established in the north-east to treat addicts by injecting them with a pure form of the drug. Supporters claim the scheme is a solution to what they say is a failing methadone programme.

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  • Anthrax warning over illegal drugs – Galloway Scotland

    Posted on February 25th, 2010 TimB No comments
    Drug users in Galloway are in danger of contracting the killer disease anthrax after the first case was confirmed this week in Dumfries.On Tuesday, an NHS Dumfries and Galloway official said: “We can confirm that the male was admitted to DGRI last Tuesday, February 16, and transferred for further treatment to Glasgow Royal Infirmary on Sunday night.”

  • Anthrax fears mean more methadone

    Posted on February 25th, 2010 TimB No comments
    The Scottish Government has sanctioned an increase in methadone programmes across the country to halt the spread of anthrax among injecting drug users.

    The outbreak has already claimed ten lives in Scotland, prompting an increase in demand for drug treatment services from heroin addicts desperate to avoid potentially infected needles.

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  • Plans to offer heroin on the NHS in Aberdeen have moved a step closer to becoming reality.

    Posted on February 21st, 2010 TimB No comments

    Plans to offer heroin on the NHS in Aberdeen have moved a step closer to becoming reality. Aberdeen City Council’s top social worker has recommended councillors discuss prescribing heroin through NHS Grampian with the health board. Fred McBride, the authority’s director for social care and wellbeing, said in a report that the plans are worth further consideration.

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