Assessing the impact of a temporary class drug order on ethylphenidate‐related infections among people who inject drugs in Lothian, Scotland: an interrupted time–series analysis

Yeung, Alan; Weir, Alan; Austin, Hannah; Morrison, Kirsty; Inverarity, Donald; Sherval, Jim; Henderson, Naomi; Joshi, Shruti; Ure, Roisin; McAuley, Andrew

doi:10.1111/add.13898

Cited by 12 publications

(9 citation statements)

References 33 publications

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“…Firstly, the inclusion of an NPS specific question in the survey in 2015-16 may partly explain the increase in NPS use we observed. However, numerous other sources (Griffith et al, 2016;Lafferty et al, 2016;Yeung et al, 2017;Pettie et al, 2018) have also confirmed a rise in NPS injecting in Lothian at this time therefore we are reassured that the increase we observed in our data is reflective of the actual trend occurring at the time.…”

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confidence: 78%

“…This includes adapting content of existing interventions, enhancing their delivery in settings where NPS users are likely to be accessible, and ensuring staff (and peers where appropriate) are adequately trained to deliver them. Legislative changes to specific NPS have been effective at reducing harms in the past within an outbreak situation (Yeung et al, 2017). It remains to be seen whether more universal approaches, such as the recent UK Psychoactive Substances Act, will have a similar positive effect.…”

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confidence: 99%

“…Similarly, it became clear during the course of the outbreak that heroin available in Lothian had been mixed with ethylphenidate, therefore increasing the possibility that individuals were injecting NPS unknowingly (Yeung et al, 2017). This also may have underestimated rates of NPS use, therefore our model estimates should be viewed as conservative which is perhaps even more concerning in public health terms.…”

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confidence: 99%

“…An outbreak of severe skin and soft tissue infections, bacteraemias and infective endocarditis among PWID was detected in the Lothian NHS Board area (henceforth 'Lothian') of Scotland in 2014 (Griffith et al, 2016;Yeung et al, 2017). Those most likely to be affected by this outbreak were former heroin injectors known to be injecting ethylphenidate, a stimulant-type NPS similar in chemical structure to methylphenidate and known to be associated with a high frequency of injecting (Lafferty et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

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Re-emergence of HIV related to injecting drug use despite a comprehensive harm reduction environment: a cross-sectional analysis

et al. 2019

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Background Novel Psychoactive Substance (NPS) use has increased in recent years and generated significant concern within public health. People who inject drugs (PWID) are at increased risk of blood borne viruses, in particular Hepatitis C virus (HCV). However, little is known about the extent of NPS injecting at a national level and its association with HCV. This study provides one of the first epidemiological analyses of the association between NPS injecting and HCV among a population level sample of PWID. Methods Five cross sectional surveys of almost 13,000 PWID attending services providing injecting equipment across Scotland between 2008 and 2016 were analysed. Logistic regression was used to determine associations between NPS injecting and HCV. Results The proportion of PWID reporting that they had injected NPS in the previous six months increased from 0.2% in 2008-09 to 11.0% in 2015-16. Those who reported injecting NPS were considerably more likely to be resident in the Lothian NHS Board area at the time of the study (AOR 5.6 (95% CI 4.1-7.5)) and to have had recent experience of homelessness (AOR 1.4 (95% CI 1.0-1.9)). People who injected NPS were also significantly more likely to be HCV positive (AOR 1.7 (95% CI 1.2-2.4)). In Lothian, HCV prevalence rose from around 30% between 2008 and 2012 to 41% and then 48% in { PAGE \* MERGEFORMAT } 2013-14 and 2015-16 respectively. Increases in prevalent HCV infection in Lothian may be partly attributed to increases in NPS injecting. Conclusion In Scotland, people who had injected Novel Psychoactive Substances were at increased risk of hepatitis C virus. Novel Psychoactive Substance injecting poses a threat to HCV elimination strategies.

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confidence: 78%

Section: { Page \* Mergeformat }mentioning

confidence: 99%

Section: { Page \* Mergeformat }mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Re-emergence of HIV related to injecting drug use despite a comprehensive harm reduction environment: a cross-sectional analysis

et al. 2019

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“…Although these quantitative studies highlight the associations between risk or protective factors and SSTI, qualitative studies are needed to help understand the many explanations within the PWIDs' within NHS Greater Glasgow and Clyde Health Board. These research sites were chosen as these Health Boards have sizeable injecting populations and unpublished survey data indicated the proportion of PWID reporting an SSTI in the past year was 36% and 27% respectively (unpublished University of the West of (Yeung et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

The experiences of people who inject drugs of skin and soft tissue infections and harm reduction: A qualitative study

Dunleavy

Hope

Roy

et al. 2019

International Journal of Drug Policy

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Background: Bacterial skin and soft tissue infections (SSTI) among people who inject drugs (PWID) are considered a public health concern. There is a lack of qualitative research examining the lived experience of PWID who have had SSTI. This paper explores PWID views and experiences of their SSTI, their perceptions on the causes of their SSTI and their harm reduction (HR) behaviours. The implications for HR service delivery and practice will be discussed. Methods: Between October 2015-January 2016, 22 in-depth interviews were conducted with PWID who had experienced a SSTI within the past year. Interviewees were recruited from an injecting equipment provision service and a drug treatment service in Glasgow and Edinburgh respectively. The interview transcripts were transcribed verbatim and underwent thematic analysis. Results: We found that the experience of SSTI can cause strong negative feelings, including panic and stigma and that there was limited knowledge of SSTI prior to first hand experience. The awareness of the unacceptable social and physical consequences of SSTI fostered a sense of personal responsibility and agency which led to the introduction or improved HR uptake. However, when PWID were struggling to inject or when their physical and political environments were compromised there was an increased risk for SSTI and reduced effectiveness of HR. Conclusion: Compared to HCV and HIV, SSTI as an injecting related harm has received less policy attention. Policy makers need to address SSTI HR within enabling environments, such as 'safer environment interventions'. It is recommended that peer based support, improved NSP provision and medically supervised injecting facilities are needed to deliver SSTI HR.

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New Psychoactive Substances in the Homeless Population: A Cross-Sectional Study in the United Kingdom

Coombs

Ginige

Calster

et al. 2023

Int J Ment Health Addiction

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The last few years have seen the emergence of new psychoactive substance among the homeless population, specifically synthetic cannabinoid receptor agonists. The purpose of this study is to investigate the knowledge and experiences of new psychoactive substances amongst users from the homeless population. An explanatory research design was applied using a semi-structured questionnaire with the focus on gaining insights on the prevalence, motivations and effects. Participants were recruited through convenience sampling from support organisations and charities UK-wide. Descriptive statistics and logistic regression were applied to analyse the data obtained from participant surveys. A total of 105 participants met the inclusion criteria and were in the age range of 18 to 64 years old. Almost 70% consumed new psychoactive substance products, which “Spice” was the most prevalent substance. Homeless users had consumed new psychoactive substance to escape reality and to self-treat themselves and stopped consumption due to the adverse effects. Adverse events were reported from the majority of the participants and led to more than 20% of the participants requiring medical treatment following hospitalisation. Findings from this study can contribute to the development of guidelines and policies that specifically address the needs of the homeless population who use new psychoactive substances.

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Assessing the impact of a temporary class drug order on ethylphenidate‐related infections among people who inject drugs in Lothian, Scotland: an interrupted time–series analysis

Abstract: The UK government's 2015 temporary class drug order on ethylphenidate was effective in reducing infections among people who inject drugs during an outbreak situation in Lothian, Scotland.

Cited by 12 publications

References 33 publications

Re-emergence of HIV related to injecting drug use despite a comprehensive harm reduction environment: a cross-sectional analysis

Re-emergence of HIV related to injecting drug use despite a comprehensive harm reduction environment: a cross-sectional analysis

The experiences of people who inject drugs of skin and soft tissue infections and harm reduction: A qualitative study

New Psychoactive Substances in the Homeless Population: A Cross-Sectional Study in the United Kingdom

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