Pharmaceutical and health care needs of injecting drug users

Community pharmacists usually encounter a relatively narrow spectrum of the drug-using population. By the nature of the services that they provide, they tend to see either people being dispensed medication to assist them to stop using illicit drugs, usually opiates, or people seeking sterile injecting equipment. However, not all illicit drug use leads to problematic drug use and dependence. The use of heroin and cocaine is, however, particularly associated with dependence. Injecting drug users (IDUs) face particular health risks and social problems. Additionally, they may be reluctant to access treatment or services. This can put pharmacists who operate needle and syringe programmes (NSPs) in a unique position, where they have regular contact with this hard-to-reach, vulnerable group. The provision of sterile injecting equipment is in itself an effective intervention to prevent blood-borne virus (BBV) spread. Additional advice and care can reduce or manage injecting-related complications, such as skin and soft-tissue infections. Signposting to specialist treatment services or general practitioners can lead to large reductions in risk to the individual and benets for the wider public, especially through crime reduction. This chapter is focused on information for pharmacists to inform the delivery of effective pharmacy services for IDUs. Best practice guidance, updated in 2014, is published by the National Institute for Health and Care Excellence (NICE) in England (PH52).