"Taking away the chaos": a health needs assessment for people who inject drugs in public places in Glasgow, Scotland

Tweed, E. , Rodgers, M., Priyadarshi, S. and Crighton, E. (2018) "Taking away the chaos": a health needs assessment for people who inject drugs in public places in Glasgow, Scotland. BMC Public Health, 18, 829. (doi: 10.1186/s12889-018-5718-9) (PMID:29973179) (PMCID:PMC6030790)

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Background: Public injecting of recreational drugs has been documented in a number of cities worldwide and was a key risk factor in a HIV outbreak in Glasgow, Scotland during 2015. We investigated the characteristics and health needs of people involved in this practice and explored stakeholder attitudes to new harm reduction interventions. Methods: We used a tripartite health needs assessment framework, comprising epidemiological, comparative, and corporate approaches. We undertook an analysis of local and national secondary data sources on drug use; a series of rapid literature reviews; and an engagement exercise with people currently injecting in public places, people in recovery from injecting drug use, and staff from relevant health and social services. Results: Between 400 and 500 individuals are estimated to regularly inject in public places in Glasgow city centre: most experience a combination of profound social vulnerabilities. Priority health needs comprise addictions care; prevention and treatment of blood-borne viruses; other injecting-related infections and injuries; and overdose and drug-related death. Among people with lived experience and staff from relevant health and social care services, there was widespread – though not unanimous – support for the introduction of safer injecting facilities and heroin-assisted treatment services. Conclusions: The environment and context in which drug consumption occurs is a key determinant of harm, and is inextricably linked to upstream social factors. Public injecting therefore requires a multifaceted response. Though evidence-based interventions exist, their implementation internationally is variable: understanding the attitudes of key stakeholders provides important insights into local facilitators and barriers. Following this study, Glasgow plans to establish the world’s first co-located safer injecting facility and heroin-assisted treatment service.

Item Type:Articles
Additional Information:Also funded by CSO Clinical Academic Fellowship CAF/17/11.
Glasgow Author(s) Enlighten ID:Priyadarshi, Dr Saket and Tweed, Dr Emily
Authors: Tweed, E., Rodgers, M., Priyadarshi, S., and Crighton, E.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > MRC/CSO SPHSU
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:BMC Public Health
Publisher:BioMed Central
ISSN (Online):1471-2458
Copyright Holders:Copyright © 2018 The Authors
First Published:First published in BMC Public Health 18:829
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
727651SPHSU Core Renewal: Measuring and Analysing Socioeconomic Inequalities in Health Research ProgrammeAlastair LeylandMedical Research Council (MRC)MC_UU_12017/13IHW - MRC/CSO SPHU
727671SPHSU Core Renewal: Informing Healthy Public Policy Research ProgrammePeter CraigMedical Research Council (MRC)MC_UU_12017/15IHW - MRC/CSO SPHU