Problematic and injecting drug use – findings from the Harm Reduction Database (HRD)

Presenter: Josie Smith, Health Protection, PHW

Estimates of problematic and injecting drug useEMCDDA• Problematic drug use – “injecting drug use or long duration or

regular use of opioids, cocaine and/or amphetamines” • UK estimates indicate around 1% or 10 per 1000 population aged

15 – 64 years• Translates to around 20,000 individuals in Wales

• Injecting drug use – UK estimates indicate around 0.4% of population aged 15 – 64 years

• Translates to around 8,000 individuals in Wales

Wales HRD data 1/09/10 – 31/03/11 7277 individuals registered

with needle exchange

• Female – 1004 (14%)• Male – 6273 (86%)

Would expect:25% female75% malePharmacy?

• What is the extent of secondary / peer distribution?

Profile of service provision 2011Area Specialist PharmacyBetsi Cadwaladr APB (North Wales) 12 + 3 mobiles 72Powys Teaching APB 4 9Hywel Dda APB (West Wales) 0 31

Abertawe Bro Morgannwg University APB (South West Wales) 5 +1 mobile 29Cardiff & Vale APB 4 +1 mobile 12Cwm Taf APB 4 21Aneurin Bevan APB (Gwent) 3 18

Number of individuals registered

Wales data – Age profile by genderData from all sites: Activity 01/09/10 to 31/03/11

Profile of substances used by APB

Details available for analysis• Age • Gender• Year of first injecting• Area of residence• Housing status• Substances used• Blood borne virus monitoring• Injecting equipment reuse and sharing

behaviour

Uses of data / reporting mechanisms• Provider activity data

– Planning of opening times, additional services for young people, females, steroid users

– Address additional health / other needs– Address specific risk behaviours with service users

• Local planning (APB/CSP/SMARTs)– Coverage – Quality– Nature of local injecting (and wider problematic drug use)

behaviours

• National planning (WAG, Public Health)

Next steps: Improving data quality• Some services completing client details• Other services completing bare minimum - visits to

sites reinforcing need to complete client details/assessment in order to provide quality service

ABMU 46%Aneurin Bevan 52%Betsi Cadwaladr 76%Cardiff & Vale 68%Cwm Taf 25%Hwyel Dda 67%Powys 68%

Recording rate for substances used

Next steps : rolling out to pharmacy

• Working in conjunction with Pharmacy WAG to implement in existing community pharmacy services across Wales (2011)

• Addition of take home Naloxone section – stat and voluntary sector

Thank you!

• All service users and staff from voluntary and statutory services

• Regional co-ordinators• WAG• Public Health