Development, implementation and evaluation of harm reduction techniques for drug users.

Scott, Jennifer

Abstract

Recent strategies within health and social care state policies and interventions should be selected on the basis of evidence available to demonstrate their benefits. The provision of services for drug users is no exception to this. Harm reduction is a broad term used to describe drug policies and interventions that aim to reduce the risks to the individual and society, recognising that drug use is an inevitable part of society. Arguably, attention has largely focused on establishing the evidence of the benefits of harm reduction interventions that affect society, with little attention paid to those that are for the benefit of the individual alone. The work presented here explores two aspects of harm reduction interventions, using a combination of pharmaceutical science and social science. The first is a laboratory-based study that gathered evidence to establish the role of filters and acidifiers in the injection preparation processes. No previous work had been done in this field, yet anecdotal evidence shows that such materials are being provided by some UK drugs services. The illegal nature of drug use means that the results from this work cannot be taken as absolutes. Instead, they are indicators of the consequence that will result from using such paraphernalia. The results suggest that providing syringe filters to injecting drug users could reduce the incidence of health problems cause by the injection of insoluble materials, because the filters were found to greatly reduce the content of insoluble particles in injections prepared with street drugs and tablets, simulating techniques established from information collected from injecting drug users, drugs workers and published materials. Makeshift filters were also tested. These were cigarette filters, hand rolling cigarette filters and cotton bud tips. They caused some reduction in particle content, to a lesser extent than that seen with the syringe filters. There is concern regarding their use due to them not being designed for this purpose and the potential risk of fibre shedding from their fibrous materials. The work also illustrated the need for acidifiers to promote the solubility of street heroin obtained in the base form. However, this also raises questions around their use and safety, indicating the pathway of future work. The second aspect of this work was a case study to explore the provision of a pharmacist-led information and advice service at a voluntary sector drugs agency. This work was done because much emphasis is placed on the importance of multidisciplinary teamwork within drugs services. However, the benefit of including an expert on drugs, namely the pharmacist, has been previously overlooked. This work was undertaken as a field study, monitoring and evaluating the role of a pharmacist within a voluntary sector drugs service. The environment in which the work was conducted and the combination of factors and people involved will have Influenced the work of the pharmacist and the findings. Therefore the results can be Interpreted to show that it is possible to implement such a service and future study should expand on such service provision to investigate this matter further in a multi-centred study. Further work should also pay more attention to establishing the benefits or otherwise of such services to the team and clients. Overall, this work has provided foundation evidence to support the provision of certain harm reduction interventions that have previously been unexplored. It also illustrates how the knowledge and skills of pharmacists can be used to conduct unique research in this field.

Citation

SCOTT, J. 2000. Development, implementation and evaluation of harm reduction techniques for drug users. Robert Gordon University [online], PhD thesis. Available from: https://openair.rgu.ac.uk

• Thesis Type: Thesis
• Deposit Date: Nov 4, 2020
• Publicly Available Date: Nov 4, 2020
• Keywords: Drug use; Drug abuse; Healthcare interventions; Evidence-based care
• Public URL: https://rgu-repository.worktribe.com/output/981836
• Award Date: May 31, 2000