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Guidelines for services providing injecting equipment: Best practice recommendations for commissioners and injecting equipment provision (IEP) services in Scotland



1. Scottish Government (2008) Hepatitis C Action Plan for Scotland Phase II: May 2008 - March 2011. Available from: www.scotland.gov.uk/Publications/2008/05/13103055/0 .

2. Scottish Government (2008) The road to recovery. A new approach to tackling Scotland's drug problem. Available at: www.scotland.gov.uk/Publications/2008/05/22161610/0 .

3. Hay G, Gannon M, Casey J, McKeganey N (2009) Estimating the national and local prevalence of problem drug misuse in Scotland. Executive report. Centre for Drug Misuse Research, University of Glasgow. Available at: www.drugmisuse.isdscotland.org/publications/local/Prevalence_2009.pdf .

4. Health Protection Agency, Health Protection Scotland, National Public Health Service for Wales, CDSC Northern Ireland, and the CRDHB (2008). Shooting Up: Infections among injecting drug users in the United Kingdom 2007. London: Health Protection Agency. Available at: www.hpa.org.uk/web/HPAwebFile/HPAweb_C/1224833091550 .

5. Roy KM, Hutchinson SJ, Wadd S, Taylor A, Cameron SO, Burns S, Molyneaux P, McIntyre PG & Goldberg DJ (2007) Hepatitis C virus infection among injecting drug users in Scotland: a review of prevalence and incidence data and the methods used to generate them. Epidemiology and Infection, 135(3): 433-442.

6. Jones L, Pickering L, Sumnall H, McVeigh J & Bellis MA (2008) A review of the effectiveness and cost-effectiveness of needle and syringe programmes for injecting drug users. Final full report - revised Oct 2008. Available at: www.nice.org.uk/guidance/index.jsp?action=download&o=42477 .

7. Palmateer N, Kimber J, Hickman M, Hutchinson S, Rhodes T & Goldberg D (2008) Evidence for the effectiveness of harm reduction interventions in preventing Hepatitis C transmission among injecting drug users: a review of reviews. Health Protection Scotland.

8. World Health Organisation (2004) Effectiveness of sterile needle and syringe programming in reducing HIV/AIDS among injecting drug users. Available at: http://www.who.int/hiv/pub/idu/pubidu/en/index.html .

9. Loxley W, Toumbourou J, Stockwell T, Haines B, Scott K, Godfrey C, Waters E, Patton G, Fordham R, Gray D, Marshall J, Ryder D, Saggers S, Sand L & Williams J (2004) The prevention of substance use, risk and harm in Australia: a review of the evidence. National Drug Research Institute, Commonwealth Department of Health and Ageing, Government of Australia. Available from http://espace.library.curtin.edu.au. (See Chapter 14: Harm Reduction).

10. Commonwealth Department of Health and Ageing (2002). Return on investment in needle and syringe programs in Australia: Summary report. Commonwealth of Australia. Available from www.drugpolicy.org/docuploads/roifinal.pdf .

11. Vickerman P, Hickman M and Judd A (2007) Modelling the impact on Hepatitis C transmission of reducing syringe sharing: London case study. International Journal of Epidemiology, 36: 396-405.

12. Patrick DM, Tyndall MW, Cornelisse PG, Li K, Sherlock CH, Rekart M, Strathdee SA, Currie SL, Schechter MT, O'Shaughnessy MV (2001) Incidence of hepatitis C virus infection among injection drug users during an outbreak of HIV infection. Canadian Medical Association Journal, 65(7): 889-895.

13. Health Protection Scotland and the University of the West of Scotland (2008). The Needle Exchange Surveillance Initiative ( NESI): Prevalence of HCV, HIV and injecting risk behaviours among injecting drug users attending needle exchanges in Scotland, 2007. Glasgow: Health Protection Scotland. Available at: www.hps.scot.nhs.uk/bbvsti/publicationsdetail.aspx?id=38071 .

14. Information Services Division Scotland (2008). Drug Misuse Statistics Scotland 2008. Tables A1.29 and A1.31. Available from www.drugmisuse.isdscotland.org/publications/08dmss/08dmss-000.htm

15. Information Services Division Scotland (2006). Drug Misuse Statistics Scotland 2006. Tables A1.34 and A1.37. Available from: www.drugmisuse.isdscotland.org/publications/06dmss/06dmssb.htm

16. Rhodes T, Davis M, Judd A (2004) Hepatitis C and its risk management among injectors in London: Renewing harm reduction in the context of uncertainty. Addiction, 99: 621-633.

17. Taylor A, Fleming A, Rutherford J & Goldberg D (2004) Examining the injecting practices of injecting drug users in Scotland. Scottish Executive Effective Interventions Unit. Available from: http://www.scotland.gov.uk/Publications/2004/02/18871/32890

18. Scott J (2008) Safety, risks and outcomes from the use of injecting paraphernalia. Scottish Government. Available from: http://www.scotland.gov.uk/Publications/2008/03/14133736/0

19. Griesbach D, Abdulrahim D, Gordon D & Dowell K (2006) Needle exchange provision in Scotland. A report of the National Needle Exchange Survey. Scottish Executive. Available at: http://www.scotland.gov.uk/Publications/2006/06/16110001/0

20. Tempalski B, Cooper HL, Friedman SR, Des Jarlais DC, Brady J, Gostnell K (2008) Correlates of syringe coverage for heroin injection in 35 large metropolitan areas in the US in which heroin is the dominant injected drug. International Journal of Drug Policy, 19 Suppl 1:S47-58.

21. Heller DI, Paone D, Siegler A & Karpati A (2009) The syringe gap: An assessment of sterile syringe need and acquisition among syringe exchange program participants in New York City. Harm Reduction Journal, 6:1. January.

22. Several reviews undertaken as part of the process of developing needle exchange guidelines for England are available from NICE at: www.nice.org.uk/guidance/index.jsp?action=byID&o=11829

23. Dolan K, MacDonald M, Silins E & Topp L (2005) Needle and syringe programs: A review of the evidence. Canberra: Australian Government Department of Health and Ageing. Available at: www.hepatitisc.org.au/resources/documents/nspreviewofevidence.pdf

24. Queensland Needle and Syringe Program (2007) Queensland needle and syringe program policy. Revised 2007. Available at: www.health.qld.gov.au/qnsp/pdf/QNSP_Policy.pdf

25. Victorian Department of Human Services (2001) Victorian needle and syringe program. Operating policy and guidelines. Health Protection Services Unit, Public Health. Available at: www.health.vic.gov.au/drugservices/pubs/needle.htm

26. Strike C, Leonard L, Millson M, Anstice S, Berkeley N, Medd E (2006) Ontario needle exchange programs: Best practice recommendations. Available at: http://www.ohtn.on.ca/compass/Best_Practices_Report.pdf

27. British Columbia Centre for Disease Control (2004) Harm reduction supply services policy and guidelines. Available at: http://www.bccdc.org/download.php?item=1040

28. Welsh Assembly Government (2005) IEP service framework. Available at: wales.gov.uk/dsjlg/publications/commmunitysafety/submisusetreatframework/needleexchangee.pdf?lang=en

29. Health Protection Scotland (2007) Scotland's action plan for Hepatitis C Phase I, September 2006 - August 2008: First year progress report. Available from www.hepcscotland.co.uk/action-plan.html

30. Garden J, Roberts K, Taylor A & Robinson D (2003) Evaluation of the provision of single use citric acid sachets to injecting drug users. Scottish Executive Effective Interventions Unit. Available from: http://www.drugmisuse.isdscotland.org/eiu/pdfs/citric_acid_full.pdf

31. Taylor A, Allen E, Hutchinson S, Roy K, Goldberg D, Ahmed S & Roberts K (2005) An evaluation of the Lord Advocate's Guidance on needle exchange. Scottish Executive Drug Misuse Research Programme. Available from: http://www.scotland.gov.uk/Publications/2005/05/18114615/46165

32. Cattan M, Bagnall A-M, Akhionbare K & Burrell K (2008) Injecting equipment schemes for injecting drug users. Qualitative evidence review. Final full report - revised Aug 2008. Available at: http://www.nice.org.uk/guidance/index.jsp?action=download&o=42476

33. Matheson C, Bond CM, Mollison J (1999) Attitudinal factors associated with community pharmacists' involvement in services for drug misusers. Addiction, 94(9): 1349-59.

34. Matheson C, Bond CM & Tinelli M (2007) Community pharmacy harm reduction services for drug misusers: national service delivery and professional attitude development over a decade. Journal of Public Health Medicine, 29: 350-357.

35. Hall S & Matheson C (2008) Barriers to the provision of needle-exchange services: A qualitative study in community pharmacies. International journal of pharmacy practice, 16: 11-16.

36. Gowing LR, Proudfoot H, Henry-Edwards SM, Teesson M (2001) Evidence Supporting Treatment. The Effectiveness of Interventions for Illicit Drug Use. Woden: Australian National Council on Drugs.

37. Coyle SL, Needle RH, Normand J (1998) Outreach-based HIV prevention for injecting drug users: A review of published outcome data. Public Health Reports, 113(Supplement 1):19-30.

38. Islam MM & Conigrave KM (2007) Assessing the role of syringe dispensing machines and mobile van outlets in reaching hard-to-reach and high-risk groups of IDUs: A review. Harm reduction journal, 4(14).

39. National Institute on Drug Abuse (2000) A Manual to Conduct Community-based Outreach. A manual to reduce the risk of HIV and other blood-borne infections in drug users. Available at: www.drugabuse.gov/CBOM/Index.html

40. Forth Valley Substance Action Team (2004) Central Scotland Police needle replacement scheme for prisoners, Falkirk Police Station. In Substance, vol. 1(1), p. 2. Available at: www.drugmisuse.isdscotland.org/dat/forthvalley/substance1.pdf

41. Information Services Division Scotland (2008). Drug Misuse Statistics Scotland 2008. Table C3.1. Available from www.drugmisuse.isdscotland.org/publications/08dmss/08dmss-000.htm

42. Scottish Prison Service (2008) Prisoner Survey 2008. Eleventh survey bulletin. Available at: www.sps.gov.uk/MultimediaGallery/8bb1f9db-4681-440d-ba30-5f07ed8d09a7.pdf

43. Heller-Murphy S (2005) The direction of harm reduction in the SPS: From chaotic drug use to abstinence. Scottish Prison Service. Available at: www.sps.gov.uk/MultimediaGallery/dcac7216-c6a7-4531-a674-b2c004e58737.pdf

44. Lorvick J, Bluthenthal RN, Scott, A, Gilbert ML, Riehman KS, Anderson RL, Flynn NM & Kral AH (2006) Secondary syringe exchange among users of 23 California syringe exchange programs. Substance Use & Misuse, 41: 865-882.

45. Carruthers S (2007) The organization of a community: Community-based prevention of prevention of injecting drug use-related health problems. Substance use & misuse, 42(12-13): 1971-1977.

46. Australia Injecting and Illicit Drug Users' League (2006) A framework for peer education by drug-user organisations. Canberra. Available at: www.aivl.org.au/files/FrameworkforPeerEducation.pdf

47. Latkin CA (1998) Outreach in natural settings: the use of peer leaders for HIV prevention among injecting drug users' networks. Public Health Reports, 113 Suppl 1: 151-159.

48. Griesbach D and Taylor A (2009) Educational interventions to prevent hepatitis C: A review of the literature and expert opinion, NHS Health Scotland. Available at: www.healthscotland.com/uploads/documents/10433-Hep_C_Report.pdf

49. Broadhead RS, Heckathorn DD, Weakliem DL, Anthony DL, Madray H, Mills RJ & Hughes J (1998). Harnessing peer networks as an instrument for AIDs prevention: results from a peer-driven intervention. Public Health Reports, 113 Suppl 1: 42-57.

50. Elford J, Sherr L, Bolding G, Serie F & Maguire M (2002) Peer-led HIV prevention among gay men in London: process evaluation. AIDS Care, 14(3): 351-60.

51. Islam M, Wodak A & Conigrave KM (2008) The effectiveness and safety of syringe vending machines as a component of needle syringe programmes in community settings. International Journal of Drug Policy, 19(6): 436-41.

52. McDonald D (2008) The evaluation of a trial of syringe vending machines in Canberra, Australia. International Journal of Drug Policy, September 12.

53. Tudor M & Gordon D (2008) Interim research into the efficacy of an out-of-hours needle exchange vending machine at The Bridge, Southampton. Presentation at the 2008 National Conference on Injecting Drug Use. Available at: www.exchangesupplies.org/conferences/ncidu/2008_NCIDU/speakers/david_gordon.html

54. Department for Environment, Food and Rural Affairs (DEFRA) (2005). Tackling drug-related litter. Guidance and good practice. At: www.defra.gov.uk/environment/localenv/litter/pdf/drugrelatedlitter.pdf

55. Sutton AJ, Gay NJ, Edmunds WJ, Hope VD, Gill ON, Hickman M (2006) Modelling the force of infection for hepatitis B and hepatitis C in injecting drug users in England and Wales. BMC Infectious Diseases, 8(6): 93.

56. Jeal N & Salisbury C (2004) Self-reported experiences of health services among female street-based prostitutes: a cross-sectional survey. British Journal of General Practice, 54(504): 515-519.

57. Gore SM, Bird AG, Cameron SO, Hutchinson SJ, Burns SM, Goldberg DJ (1999) Prevalence of hepatitis C in prisons: WASH-C surveillance linked to self-reported risk behaviours. QJM: An international journal of medicine, 92(1): 25-32.

58. Matheson C, Anthony GB, Bond C, Rossi MK (2008) Assessing and prioritising the preferences of injecting drug users in needle and syringe exchange service development. Journal of Public Health, 30(2): 133-138.

59. Scottish Executive (2002) Needle and syringe exchange schemes. NHS Health Department Letter (HDL) (2002) 90. Available at: http://www.sehd.scot.nhs.uk/mels/hdl2002_90.pdf

60. National Needle Exchange Forum, UK Harm Reduction Alliance & Exchange Supplies (2006) Reducing injecting related harm: Consensus statement on best practice. Available from: www.ukhra.org/statements/consensus_statement_on_best_practice.html

61. Crofts N, Caruana S, Bowden S & Kerger M (2000) Minimising harm from hepatitis C virus needs better strategies. BMJ, 321: 899. (October 7).

62. De P, Roy E, Boivin JF, Cox J, Morissette C (2008) Risk of HCV transmission through drug preparation equipment: a systematic and methodological review. Journal of viral hepatitis, 15(4): 279-292.

63. LE Thorpe, Ouellet LJ, Hershow R, Bailey SL, Williams IT, Williamson J, Monterroso ER, Garfein RS (2002) Risk of hepatitis C virus infection among young adult injection drug users who share injection equipment. American journal of epidemiology, 155(7): 645-653.

64. H Hagan, Thiede H, Weiss NS, Hopkins SG, Duchin JS, Alexander ER (2001) Sharing of drug preparation equipment as a risk factor for hepatitis C. American journal of public health, 91(1): 42-46.

65. Jenny Scott, Winfield A, Kennedy E, Bond C (2000) Laboratory study of the effects of citric acid and ascorbic acid on injections prepared with brown heroin. International journal of drug policy, 11(6): 417-422.

66. Personal communication, Glasgow Drugs Crisis Centre.

67. The Misuse of Drugs (Amendment) (No.2) Regulation 2003 (Statutory Instrument No. 2003, No. 1653). See regulation 6A. Available at: www.opsi.gov.uk/si/si2003/20031653.htm

68. The Medicines for Human Use (Prescribing) (Miscellaneous Amendments) Order 2005 (Statutory Instrument No. 2005, No. 1507). See part 3. Available at: www.opsi.gov.uk/si/si2005/20051507.htm

69. Scottish Executive (2006) National quality standards for substance misuse services. Available at: http://www.scotland.gov.uk/Publications/2006/09/25092710/0

70. Neale J, Sheard L & Tompkins CN (2007) Factors that help injecting drug users to access and benefit from services: A qualitative study. Substance abuse treatment, prevention and policy, 2: 31.

71. Rhodes T, Briggs D, Holloway G, Jones S & Kimber J (2006) Visual assessments of injecting drug use. Research briefing 13. National Treatment Agency for Substance Misuse, London. Available at: www.nta.nhs.uk/publications/documents/nta_visual_assessments_injecting_drug_use_2006_rb13.pdf

72. Latka M, Hagan H, Kapadia F, Golub ET, Bonner S, Campbell JV, Coady MH, Garfein RS, Pu M, Thomas DL, Thiel TK, Strathdee SA (2008) A randomised intervention trial to reduce the lending of used injection equipment among injection drug users infected with Hepatitis C. American Journal of Public Health, 98(5): 853-861.

73. Neale J, Tompkins C & Sheard L (2008) Barriers to accessing generic health and social care services: a qualitative study of injecting drug users. Health and Social Care in the Community, 16(2):147-54.

74. Effective Interventions Unit (2002) Integrated care for drug users. Principles and practice. Scottish Executive. Available at: www.sehd.scot.nhs.uk/publications/icdu/icdu-00.htm

75. Hutchinson SJ, Bird SM & Goldberg DJ (2005) Modeling the current and future disease burden of Hepatitis C among injection drug users in Scotland. Hepatology, 42: 711-723.

76. Royal College of General Practitioners (2007) Guidance for the prevention, testing, treatment and management of hepatitis C in primary care. At: www.smmgp.org.uk/download/guidance/guidance003.pdf

77. Cullen BL, Hutchinson SJ, Roy KM, Schofield J, Hawkins G, McDonald S, Weir A, McLeod A, Goldberg D (2008) Needs assessment of Hepatitis C testing, treatment, care and support services in Scotland: Overview report. Glasgow: Health Protection Scotland. Available from: HPSHCVActionPlan@nhs.net

78. Scottish Intercollegiate Guidelines Network ( SIGN) (2006) Management of hepatitis C. SIGN Guideline 92. Available at: www.sign.ac.uk/guidelines/fulltext/92/index.html

79. Department of Health (2006) Immunisation against infectious diseases (The Green Book). Available at: www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_079917 See Chapter 18 (Hepatitis B).

80. Dolan K et al (2005) Needle and syringe programs: A review of the evidence. Citing Libois A, Fumero E, Castro P, Nomdedeu M, Cruceta A, Gatell J-M and Garcia F (2005) Transmission of hepatitis C virus by discarded-needle injury. Clinical Infectious Diseases Journal 41: 129-130.

81. Personal communication, Health Protection Scotland.

82. See Control of Substances Hazardous to Health ( COSHH) Regulations 2002. Available at: www.opsi.gov.uk/si/si2002/20022677.htm.