Scotland's NHS (08/04/14)



Here's a report from the BBC which tells you something about the prevailing culture within Scotland's NHS where, up until recently, drug addicts were provided with 'needle kits' in packs of 20 rather than just one at a time, resulting in huge waste.

Now I'm all in favour of imaginative policies to deal with drug abuse and the samples given from Canada seem well worth exploring, but at the same time surely the goal must always be getting people clean and off drugs altogether. 

Although I see little evidence that this is really happening with Scotland's methadone programme, for example, which seems to have grown into a cottage industry, if you ask me.  

Thousands of syringes found on Scotland's streets

By Marc Ellison & Eleanor Bradford

BBC Scotland

A bloodied syringe found discarded at Glasgow's Union Place, just metres from the bustling Gordon Street

More than 3,900 discarded needles were reported in nine of Scotland's largest towns and cities over two years.

The figure was revealed by a series of freedom of information requests to the local authorities covering Aberdeen, Cumbernauld, East Kilbride, Dundee, Edinburgh, Glasgow, Hamilton, Kirkcaldy, Livingston, and Paisley.

A total of 86 reports were made of needles in parks and close to schools.

The greatest numbers of needles were in Glasgow (2,438), and Aberdeen (532).

Despite having the tenth largest population in Scotland, Kirkcaldy reported the third highest number of discarded syringes (320).

You can see where the estimated 3,909 discarded needles were reported, as well as a description of where they were found, using the interactive map developed by BBC Scotland.
Interactive map showing the location and number of discarded needle reports in Scotland's 10 largest towns and cities over a two-year period.

BBC Scotland asked Scotland's 10 largest local authorities how many reports they had received of discarded needles between 1 January 2012 and 31 December 2013.

The figures for the total number of needles reported to each of the local authorities have been deliberately under-estimated due to the vagueness or absence of descriptions in the reports. A report with an incomplete or missing description was treated as one needle, a report of "needles" as two, and if a range was given then the lower figure would be used.

Dundee was the only local authority not to provide data. The BBC was told it did not keep records of discarded needles. However, two of Dundee's eight local community planning partnerships recorded in their quarterly reports the recovery of 403 needles in the last 12 months.

The number of discarded needles in Edinburgh (193) and Paisley (217) are also likely to be higher because the data released did not include any report description.

The data reveals reports of discarded syringes between 2012 and 2013 declined significantly in Aberdeen, Edinburgh, Glasgow, Hamilton, and Livingston. But reports in Cumbernauld and Kirkcaldy increased by 150% and 7% respectively over the two-year period.

BBC reporters found seven discarded needles in just one half-hour period on Glasgow's back streets.

The bulk of syringes were reported in the heart of Glasgow - on St Vincent Street (55), Gordon Street (23), Trongate and Sauchiehall Lane (23 each), and Buchanan Street and Sauchiehall Street (20 each).

Number of needles reported (population ranking in brackets)

2,438 - Glasgow (1)
532 - Aberdeen (3)
320 - Kirkcaldy (10)
217 - Paisley (5)
193 - Edinburgh (2)

But David Liddell, director of the Scottish Drug Forum, said this discarded needle report data could serve to reinforce prejudice against a stigmatized and marginalized group.

"There are 60,000 people with drug problems [in Scotland] and within that you've got a proportion who continues to inject," he said.

"Those in this vulnerable population tend not to be that young and have been around for some time."

recent NHS report stated that less than 3% of users had been using intravenous drugs for less than a year. By comparison, 40.9% of users had been using syringes for 11 to 19 years.

"Despite what the public might think, these users wouldn't just discard injecting equipment indiscriminately - they would be relatively careful about that," Mr Liddell said.

"If they were doing it, with the size of the population, then you would see a massive problem.
A discarded needle found in Glasgow's Sauciehall Lane.

"Some of these needles could be from more recreational users who maybe don't know how to dispose of them safely."

Mr Liddell said needle exchanges have been working hard to encourage users to return their equipment and that, while still a public safety concern, the number of discarded needles is quite small.

Targeting communities

report released by the NHS in June 2013 reported the distribution of 3.95 million needles in 2011-2012.

The number of needles reported in Glasgow eclipses the 571 reported over an 18-month period in the Canadian city of Toronto - a city with 2.2 million more residents.

Other Canadian cities like Vancouver have taken a proactive approach in dealing with its well-documented battle with drug use, particularly on its Downtown Eastside. The city provides a supervised injection site and conducts regular needle sweeps in high drug-use neighbourhoods.

Similarly in Ottawa, the country's capital, the health authority there has implemented a Needle Hunters program which recovered 7,645 needles and 1,421 crack pipes just last year. The number of needles retrieved by these sweeps is far greater than the 751 reported by citizens to the city council.

Dr Carole Hunter, lead addiction pharmacist with NHS Greater Glasgow and Clyde, said the Canadian model was certainly worth exploring.

She explained: "We also realised that a lot of the discarded equipment was actually unused, so we now supply just what they need in individual one hit kits rather than the packs of 20."

Dr Hunter added that there's been a reduction in the number of needle pickups, and an increase in returned needles due to targeted community outreach efforts.


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