Reducing the drug-induced deaths, infectious diseases, comorbidity and other health consequences are key policy issues within the United Kingdom’s drug strategies.
The structure and organisation of harm reduction services in the United Kingdom is complex. Funding for such initiatives can be through local authorities and specialist treatment services or, sometimes, through related services, such as sexual health clinics and blood-borne virus vaccination services.
Harm reduction intervention in the UK cover activities such as information campaigns on the risks associated with drug use; information on safer injecting and safer sex; provision of free needles, syringes and other equipment; promotion of safe disposal of used equipment; infection counselling; support and testing; vaccinations against HBV; referral to drug treatment; treatment for HIV and HCV infection; and the provision of take-home naloxone and training of drug users and their family members on its use.
In April 2014, updated public health guidance on needle and syringe programmes was issued by the National Institute for Health and Care Excellence (NICE).
Sterile syringes, as well as other injecting equipment, are provided by a wide range of facilities, principally pharmacies and specialist treatment agencies, and are also provided through detached street outreach workers and mobile van units. In Wales, a vending machine is available in a community-based centre for the homeless.
Services are available across all regions of the United Kingdom. The latest available estimates of the number of syringes distributed are almost 3.4 million for Wales in 2015/16, 4.4 million for Scotland in 2015/16 and almost 290 000 for Northern Ireland in 2014/15; data on syringes distributed in England are not available. The vast majority of the PWID in the UAM survey indicated that they had used needle and syringe programmes in 2015.
National naloxone programmes are implemented in Scotland, Wales and Northern Ireland; these allow the use of naloxone in non-clinical settings, such as hostels, and facilitate the distribution of naloxone kits to those at risk of overdose and to their families and carers.
The United Kingdom has a targeted hepatitis B vaccination programme that is focused on the most at- risk population groups, including PWID. The most recent surveys show that around three quarters of PWID report uptake of hepatitis B vaccination.
National naloxone programmes are implemented in Scotland, Wales and Northern Ireland
Availability of selected harm reduction responses
NBYear of data 2016.