Needle Exchange

Question 1

Needle exchange

Answer 1

Only 61% have access to clean equipment, 15% report needle sharing. High HIV and hep C risk. Exchanges offer safe injection advice, sterile equipment, place to explore alternatives to injection. Brief advice.
No evidence it increases drug use.

Question 2

Drug consumption rooms

Answer 2

Provide sterile equipment and a safe environment with medical supervision. Lowers overdoses, gives brief advice, screening tests, can recommend other services.

Question 3

Heroin assisted treatment

Strang 2015

Answer 3

Supervised heroin injection. Prescribed in a clinical setting when they don’t respond to other treatments. Systematic review suggests it lowers illicit use, has greater treatment retention and lowers side effects.
X requires clinical attention to manage
X safety issues
X doesn’t help quit.

Question 4

Portugal

Answer 4

Decriminalised possession 2001. Lowered levels of HIV, opiate related deaths and showed a 147% increase in OST (doesnt reflect increase use as no increase in deaths)
Freed up police resources, if caught are sent to rehab not charged.

Question 5

MAST

Answer 5

Drug checking to reduce harm of party drugs. General population can submit drug for testing, aim to monitor festival drugs. Assist with emergency service provision. Info based early warning system. Gives access to hard to reach groups. Can discuss harms and refer to treatment.

Question 6

Does MAST reduce harm

Answer 6

Very controversial, find 20% variance in what users were sold. 27% variance if bought on site. 3 types of misspelling, sold cheaper drugs, cutting agents and inactive substances. All are dangerous.
Provide brief advice to everyone. 1/25 festival goers use MAST, 1/5 use drugs. If everyone told 5 friends reach blanket capacity.

Question 7

Issues with drug checking

Answer 7

Encourages use
Gives dangerously inadequate results.  
Focus on substance not risky behaviour.
Step towards decriminalisation.
Focus purely on party drugs.

Question 8

Reagant testing kit

Winstock 2001

Answer 8

Used for MDMA testing. Doesn’t give info on other substances in the drug, difference in strength or the true psychoactive effect. May actually increase harm as users think it’s safe and don’t prep for other harms. Traditional approaches are preferred.

Question 9

Advisory Council on the Misuse of Drugs.

Answer 9

Produced government recommendations for harm reduction eg needle exchange which led to lowest HIV rates in Europe. Identified 16 types of harms, 0-100 scale of harm. Heroin is 100 due to LD50. Tobacco is 90. Ratings don’t correlate to legal classification.
X doesn’t account for benefit of drugs.