Injecting some contreversy into this blog...


I guess it depends on whether you hold a view on this topic or not as to whether you find it controversial or not. But everyone I've spoken to so far seems to hold a strong opinion on it, regardless of whether they've even come across it before or not.

I've worked in a pharmacy for a few years now and we've always done a needle exchange programme (NEP) - that being you give drug users clean needles and other paraphernalia they use and they return the used needles for safe disposal. It started out as what they call pre-packs which contained standard issue equipment. However, after working with the local services, we now have what is called a Pick and Mix system which means that the patient fills out the form below with how much of each item they want and that's what they get.

As you can imagine, this sparked a lot of debate, not only amongst the pharmacy staff but the rest of the store staff. A lot of people couldn't understand why they get as much as they want all for free on the NHS. And at first I have to say that it was hard to get my head around. They can come in a pick up a box off 100 syringes and needles if they so wish and we're not suppose to refuse them. A lot of people feel like it's encouraging them to continue using drugs rather rather give it up. However, if you look into the reasons why NEP's exist then you can start to understand it more.

1ml fixed needles. The needle end snaps off for easier disposal.

1ml and 2ml barrels (no needles)

Needle ends that attach to the barrels, varying sizes for users preference.

Other paraphernalia -
Water vials for cooking drugs and ensuring it is sterile
Safe Snap for breaking glass water vials safely
Stericup for cooking drugs like heroin
Vit C and Citric used for dissolving heroin

So why are NEP's a good idea?

The main idea behind NEP's is that rather than sharing paraphernalia, drug users have their own that they use so blood borne viruses aren't spread easily. This is also made more effective by encouraging users to return their used needles so they aren't left in public places (toilets or parks for example). One way in which our NEP helps users to know which needles are theirs is by making the syringes different colours. So if they inject in a social environment, they know that their needles are the blue ones and someone else has the yellow etc.

By being able to easily differentiate between needles means that users are less likely to share and therefore blood borne viruses such as Hepatitis B and HIV are less likely to be spread between users. By reducing the spread of these viruses, the amount of money the NHS spends on treatments is decreased. Therefore, NEP's are cost effective for the NHS.

As part of the NICE (National Institution for Health and Care Excellence) guidelines, anywhere that has a NEP must also offer advice on how to safely dispose of used needles, including handing out sharp bins. They must also offer advice on safer ways of injecting and on moving onto non-injecting methods of conquering their drug habit such as a methadone programme.

However, it could also be argued that this is encouraging users to abuse substances by giving them the utensils to do so for free. NEP's are another one of those issues that people could debate for hours on end and never really reach a real decision on. I for one, after working with a fair number of users, think they are a good idea but think they could do with adjusting in some aspects - such as only providing clean needles once the used one are returned as this is not a current requirement.

Do you know of any local NEP's?
Are they a good idea or are they simply encouraging substance abuse?

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