Hepatitis C & Needle and Syringe Programs Drug use in Australia • 2 in 5 Australians over 14yrs have used an illicit drug • 330,000 Australians have injected drugs in their lifetime (about 1.9%) • 73,000 Australians have injected drugs in the past 12 months (0.4%) • Almost 10% of the Australian population has used speed or amphetamine type substances 2010 National Drug Strategy Household Survey (AIHW, 2011) A national perspective • 50% to 60% hepatitis C prevalence amongst injecting drug users. • The national prevalence is approximately 1%. • This prevalence rate creates significant health and economic burden on individuals also the greater community. • This drug related harm is preventable National Drug Strategy: Mission • An overall policy statement which aims to : “Build safe and healthy communities by minimising alcohol, tobacco and other drug-related health, social and economic harms among individuals, families and communities.” National Drug Strategy, 2010-2015 Harm Minimisation: In 1985 Australia adopted a pragmatic approach to drug use. Harm Minimisation Overarching framework Supply Reduction e.g. legislation, border patrols Demand Reduction e.g. detox/rehab, school education Harm Reduction e.g. NSP, opioid replacement programs The NDS does not condone drug use, rather it accepts that drug use exists and aims to prevent or reduce drug-related harm (not necessarily eliminate it). What are Needle Syringe Programs? NSP provide access to sterile injecting equipment NSP can also provide access to: • Other safer injecting equipment (including swabs, filters, spoons, ampoules of water, tourniquets) • Disposal, collection and exchange services • Education and health information • Referral to other medical, legal, social and treatment services NSP are one of Australia’s most successful public health initiatives • 1st Australian NSP began in Sydney in 1986 • Australia was one of the 1st countries to introduce NSP’s in response to the rising prevalence of HIV in Australia. • Now we have one of the lowest rates of HIV in the world and this is largely due to the early implementation of NSP. • Less than 5% of HIV from IDU, only 1% new HIV from IDU • Edinburgh – NSP restricted – 50% IDU’s HIV + • Glasgow – NSP not restricted –1% IDU’s HIV + Needle & Syringe Programs (NSP) • NSP is one of Australia’s most successful health promotion initiatives • Australia has over 3,000 outlets – 500 pharmacies in WA – Approximately 95% • NSP is legal – the WA Poisons Amendment Act (1994) allows approved organisations to provide sterile injecting equipment to people who use drugs Injecting Drug Use Harms: BBV’s • Hepatitis C • Hepatitis B • HIV 91% of NEW Hep C infections are the result of people sharing their drug injecting equipment... Why so high?? • HCV levels amongst IDU’s • Efficiency of syringes at passing on blood • HCV transmitted through other injecting equipment • Resiliency of the HCV • Lack in the availability of sterile injecting equipment • Lack of education • Current circumstances of PWID BBV prevalence in NSP’s Injecting Drug Use Harms; Hep C • Hep C is a virus that affects the liver • Transmitted by blood to blood contact Other Injecting Drug Use Harms • • • • • • • • • Vein damage and collapse Tracks and bruising Abscess Cellulitis Embolism Endocarditis Fungal infections Septicaemia Thrombosis NSP in WA • Primary outlets • Core business is Needle & Syringe Exchange Program (NSEP) • Run by NGOs: WASUA and WAAC • Provide safer injecting equipment as well as condoms • Secondary outlets • One aspect of a broader health service • HepatitisWA, Population health units, emergency departments, community health centres, nursing posts • Limited provision of free Fitpacks • Referrals to other services NSP in WA cont. • Mobile/Outreach services • NSEP van (operated by WAAC in Perth & WASUA in the South-West) • Pharmacy NSP • 95% of WA pharmacies provide some form of NSP • Account for 40% of needle and syringe distribution in WA • Often first point of contact PWID have with a health service • Other Vending machines in Kalgoorlie, Esperance, Geraldton and Busselton (cost recovery basis) Myth: NSP doesn’t work Fact: NSP have prevented thousands of cases of HIV and hepatitis C infection. 2000 to 2009 an estimated – 32,050 new HIV infections prevented – 96,667 new HCV infections prevented Myth – NSP are not cost effective Fact NSP save money From 2000 to 2009, approximately 243 million dollars was invested in NSP Net present value of NSPs is $5.85 billion (including treatment cost and loss of productivity) IN OTHER WORDS, for every one dollar invested in NSPs $27 is returned in cost savings Cost-effectiveness of Australian NSP’s, 2009 Myth – NSP create more discarded needles Fact: • No evidence to support claim • NSP help to reduce number of discard needles • Majority will dispose correctly – it is the minority which attracts attention • NSP encourage safe disposal by providing containers and educational info on safe disposal Need more information? Provides information, support, referral, and education services for people in WA affected by hepatitis • • • • • • • • • • Hepatitis Help line Information and support officer Nurse – Free testing and Hep A/B vaccination NSP Workforce Development Hep B Community Development Community Education and Marketing Community Development Prison Project Pharmacy Project www.hepatitiswa.com.au 134 Aberdeen St Northbridge 6003
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