Annex F

Implementation in Wales and Northern Ireland

1 Our report, and the conclusions and recommendations in it, apply to the UK as a whole. In this annex we make some brief comments about priorities for implementation in Wales and Northern Ireland.

Wales

2 There is evidence that the extent of injecting drug misuse is quite significant in some parts of Wales but, as yet, prevalence of HIV amongst drug misusers appears to be low. A major opportunity to prevent widespread infection amongst drug misusers therefore exists and must be seized immediately. Community-based services are quite well developed in many parts of Wales and provide a good base for future developments along the lines described in Annex C. Psychiatric back-up for these services appears to be less well developed with only one district having a consultant psychiatrist specialising in this field, and one further specialist planned. Moreover, in a number of areas there is a dearth of doctors who are willing to consider selecting appropriate treatment from the full range of options including prescribing. The availability of sterile needles and syringes in Wales is patchy and there are no official syringe exchange schemes.

3 We see an improvement in psychiatric input, a wider recognition of the value of prescribing in appropriate cases, and measures to increase the availability of injecting equipment, as particular priorities in Wales.

Northern Ireland

4 Although all available statistical information suggests that the prevalence of both drug misuse and HIV infection in Northern Ireland is lower than in other parts of the United Kingdom we feel that it is essential to take every possible step to ensure that HIV infection is not spread via injecting drug misusers. We therefore consider that the arguments and recommendations in this report are as relevant to Northern Ireland as they are to other parts of the United Kingdom.

5 The number of regular drug injectors in Northern Ireland appears to be fairly small and it may well be that the greater risk of spreading HIV could come from experimental or occasional drug injectors. The development of accessible, community-based services giving harm-reduction advice (as described in Annex C) is therefore particularly important. Such services, combined with outreach work, are likely to be the best way of making contact with experimental or occasional injectors and we therefore see the development of such services as a particular priority for Northern Ireland.