CURRENTLY SCOTLAND HAS THE HIGHEST PER PERSON MORTALITY FROM DRUG-RELATED DEATHS IN EUROPE
Over the years, IEP has progressed to include a range of delivery models including the provision of equipment through community pharmacies, dedicated/fixed outlets, backpacking/outreach and mobile and home delivery services.
Aims of this guidance document The aim of the guidance are to provide a framework which can be used to support the consistent delivery of high-quality IEP services across Scotland through: • Promoting good practice that improves the accessibility, quality and consistency of IEP services
• Improving the accessibility of appropriate harm reduction equipment and advice to people who inject drugs and are at risk of BBV infection or other drug-related harm
• Promoting joint work and partnership between IEP and other services for people who use drugs, including in the primary and secondary health sectors
• Promoting a pragmatic, person-centred approach to improving the health of people who use drugs
Action steps Once the needs assessment has been completed, then the suggested steps include: 1. Focus groups or one-to-one interviews with practitioners and members of the target population.
2. Profiling existing services and target populations.
3. Gathering the experiences and opinions of the target population.
4. Gathering the experiences and opinions of service providers and practitioners through short surveys or face-to-face engagement will canvass the various views.
5. Analysis, interpretation and communication of the assessment.
6. Taking action: a strategic process in which the available needs and resources are ranked to decide which needs will be met first.
7. Monitoring and evaluation: this will determine whether the changes made as a result of the recommendations made at the needs assessment stage.
COMMENT
John Campbell, IEP Manager, ADRS Pharmacy Addiction Team
Since the publication of the last IEP guidelines ten years ago, there have been significant improvements in both the range of injecting equipment we provide. There has also been improvements in our models of distribution; including mobile IEP vans, home in-reach and specialist clinics for sub populations such as those who inject Image and Performance Enhancing Drugs.
Our community pharmacies have been at the heart of many ground-breaking developments and watched as they have opened their doors to work in partnership with specialist services. The contribution community pharmacies have made to the success of the programme over the past three decades should never be underestimated.
However, there remains real disparity across the country with some IEP outlets choosing not to provide foil, water or more worryingly Naloxone. The new guidelines reiterate the need for every IEP, regardless of model, to provide the full range of equipment. Not to offer this in a time where drug deaths are at their highest level ever, HIV outbreaks continue and injecting related complications remain common place would be wrong. We hope the guidelines provide policymakers, services and individuals with the tools and structure needed to ensure we continue to provide a world leading programme.
STATISTICS
• In Scotland, there are an estimated 15,000– 20,000 people who inject drugs
• Heroin continues to be the most prevalent drug injected, with over 90 per cent of those interviewed in the 2017-18 Needle Exchange Surveillance Initiative (NESI) survey reporting injecting heroin in the past six months
• Reported injection of powder cocaine increased markedly from nine per cent in 2010 to 29 per cent in 2017-18, with levels highest in the NHS Greater Glasgow and Clyde (NHSGGC) area
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