10 Information and Research

10.1 Our enquiry has been assisted by a number of pieces of useful research to which we refer at the end of this report. However, it has also been hampered by a lack of information in a number of areas. We recognise that obtaining reliable information in the field of drug misuse can be difficult in view of the illicit nature of the activity. Moreover, information on behaviour, and factors which influence it, may be difficult to extrapolate from one group to another. Problems also exist in relation to information about HIV not least because most of those infected with the virus remain unidentified.

10.2 These difficulties make it all the more important that such information as is readily available should be properly recorded and collated. Yet many agencies which work with drug misusers do not keep even basic confidential records about client numbers and characteristics. In the absence of such records we find it hard to see how the effectiveness and efficiency of the service can be monitored and how future service developments can be planned. We recommend that all agencies providing services for drug misusers should keep basic records which enable them to monitor the effectiveness of their work, particularly with regard to making contact with drug misusers and achieving behaviour change away from risky activities.

10.3 Despite the difficulties outlined in para 10.1, useful research can be undertaken to supplement the information gained from the good record-keeping we advocate above. The following are priority areas for research into HIV and drug misuse:

a. drug misusers who are not in touch with services (examining, for example, their awareness of HIV risk, their behaviour change, factors which influence their non-utilisation of services);
b. factors involved in progression, or not, from non-injecting to injecting drug misuse;
c. the effectiveness of different treatment approaches in achieving risk-reduction;
d. the effectiveness of counselling in achieving risk-reduction;
e. the effectiveness of low threshold prescribing in attracting drug misusers and helping them achieve behaviour change.

10.4 Better information is also needed on the prevalence of HIV amongst drug misusers. Current information, which only covers those who have chosen to be tested, has obvious limitations. We hope it will be possible to undertake studies of groups which are not self-selected so as to provide more reliable epidemiological data. We re-emphasise that testing of individual clients or patients should only take place with their informed consent.