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England NSP provision‘ increasingly neglected’
NSP provision in England is increasingly neglected and its benefits poorly understood, says a report from the Hepatitis C Trust. The‘ vast majority’ of local authorities do not have an adequate picture of NSP coverage in their area, says Out of reach: declining access to needle and syringe programmes in England and the threat to public health, with only around a quarter of the councils that responded to the trust’ s FOI request meeting the criteria for‘ strong’ understanding of NSP provision. Provision rates are also falling, the report warns, with a third of pharmacies contacted by the trust for its 2023 mapping exercises saying they’ d since stopped providing it. Local intelligence on NSP provision – from drug services, online directories and other sources – was also inaccurate, with less than half of the pharmacies identified as providing NSP actually doing so. The trust’ s research also identified widespread quality issues with NSP services, where national guidance was not being followed, the document states.‘ NSP is one of the UK’ s quiet public health success stories, helping to prevent thousands of infections and reducing the long-term costs associated with blood-borne viruses, drug harms and premature mortality,’ says the report.‘ Yet despite its proven effectiveness NSP provision in England is increasingly neglected.’
The report calls for data collection on NSP to be included in the core data set used by local authorities for their drug service contract monitoring, as well as for OHID to commission
‘ No single route away from cigarettes’
THERE IS‘ NO SINGLE ROUTE AWAY FROM CIGARETTES’ says the latest situation report from the Global State of Tobacco Harm Reduction( GSTHR). Instead, price, availability, culture and consumer preference will determine which products are the most widely used.
Smoking rates can fall even without formal tobacco harm strategies being in place, says the report, which looks at the progress of three countries – Estonia, Ireland and South Korea – that show‘ emerging but different’ shifts away from cigarettes and a concurrent rise in the use of safer nicotine products.
In Estonia smoking rates fell from 26 per cent in 2020 to less than 20 per cent in 2024, while vaping rates have more than tripled. Poorly designed policy, however, risks halting or reversing progress, the document warns, while widespread misconceptions about the safety of alternative products are still a major barrier to switching. Governments and public health organisations need to be sharing accurate harm reduction information aimed at all adults who smoke, it urges.
The next wave of tobacco harm reduction available at gsthr. org
‘ NSP is one of the UK’ s quiet public health success stories.’
a‘ comprehensive national evaluation’ of NSP provision to inform national and local planning.‘ This should seek to capture both current provision and the rate of service closure, as well as understanding the reasons for this,’ it says. DHSC should also set out its‘ clear long-term vision’ for NSP in the context of the elimination of hep C and HIV, including‘ clear resourcing’ to implement and safeguard it.
Report available at www. hepctrust. org. uk. See feature page 13
Half of ketamine samples contain other substances
HALF OF KETAMINE SAMPLES tested by Manchester Metropolitan University’ s GM TRENDS drug monitoring system contained xylazine and medetomidine, posing‘ a significant health risk’. The average ketamine purity per gram ranged from less than 50 per cent to 99 per cent, the researchers say, with an average of 74 per cent.
Almost half of professionals identified an increase in ketamine use in the region, while nearly 40 per cent also identified an increase in the use of THC vapes.
Ketamine seizures at the UK border in the first quarter of this year were more than 40 per cent higher than the corresponding period in 2025 and the highest quarterly total for 15 years, while the most recent wastewater analysis by the Home Office estimated ketamine consumption in England last year at more than 30,000kg – with a market value of just under £ 1bn. Deaths involving the drug have increased 20-fold in just over a decade, many of them occurring in‘ complex polydrug settings’.
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OUTSIDE CHANCE The Outside Edge Theatre Company has received almost £ 320,000 from The National Lottery to run free drama and creative writing workshops over the next three years. The money would‘ ensure that members of London’ s recovery community can continue to access high-quality, evidence-based creative health interventions for years to come,’ said CEO Matt Steinberg.
ULTRA-SOUND ADVICE WithYou has launched a specialist alcohol treatment pilot in Wigan and Leigh, which includes relapse prevention medication, ultrasound liver checks and early screening for alcohol-related brain damage.‘ We are using the newest clinical treatments and guidelines to ensure people get the help they need,’ said director of nursing Ariella Williams.
OPEN DOOR POLICY Forward Trust’ s Clouds House in Wiltshire and The Bridges in Hull are opening their doors as part of the national Open Houses campaign, giving people‘ the opportunity to see for themselves what residential rehabilitation looks like and how it works’, said CEO Mike Trace. www. openhouses. org. uk
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