Drug Related Litter - The Issues

Drug use and levels of addiction in the UK are contentious subjects and estimates relating to the number of drug misusers vary greatly.  

The lowest current estimate of drug addiction as stated in the Government’s updated drug strategy is 250,000 but recent Home Office research conducted by York University indicated that this could be as high as 500,000. [1]

Whilst the extent of drug addiction may be disputed, it is clear that drugs and drug misuse are a modern reality.   Recent evidence also suggests that young people are increasingly exposed to drug use in the community. A study conducted by the John Grieve Centre for Policing and Community Safety found that 11% of pupils had been offered drugs in school and went so far as to recommend that sniffer dogs be used to identify and control drug use.

As with the availability of drugs in the community, the incidence of discarded syringes or paraphernalia, otherwise known as Drug Related Litter, is of major concern to both the general public and healthcare professionals alike.

Incidence of found needles

A survey from 2005 among Facilities Managers responsible for premises open to the general public gave an alarming insight into the problem.

Figure 1. 61% of respondents in the UK had found Drug Related Litter
on their premises, compared to 67% in Wales and the South West.

An Edinburgh study reported that every month a child received a needlestick injury from a syringe discarded in an area open to the general public [3].

The report by Keep Britain Tidy in 2001 found that:

· 20,000 discarded needles were found by members of the general public

· Needles are found on 66% of beaches in the UK

· 72% of councils have found needles in parks and playing fields

· 68% of councils have found needles in public toilets

Discarded needles are found in a range of areas and can impact upon commercial businesses as well
as Local Community sites. The Safety Information Sheet prepared by the Occupational Health Unit noted incidence of needle finds in letterboxes, lifts and hedgerows

 Whilst there may be disagreement about the extent of the problem, the dangers associated with discarded drugs and needlesticks are clear. According to Encams, the charity that runs the Keep Britain Tidy campaign, each year over 200 people are tested for blood-borne viruses such as HIV and Hep C following injury from drug-related litter.

Blood borne viruses

The most recent statistics related to blood-borne infections and injecting habits amongst drug misusers are contained within the Health Protection Agency publication “Shooting Up” [4]:

· One in three injectors had shared needles in the last month

· Two in five injectors had been infected with Hep C.

· By the end of 2003 there were 60,000 laboratory-recorded diagnoses of Hep C in the UK.

· Estimated that over half of those drug users with Hep C were unaware of their infection

· Overall HIV infection remains rare among IDU (intra-venous drug users) in the UK, however there is evidence of ongoing and possibly increased transmission

In addition to the HPA report, a recent laboratory analysis that specifically looked at discarded needles found in the community reported that nearly 10% were positive for the Hep B or Hep C virus[2]

Current processes and procedures

Local Authority

Local Authorities, the NHS and Drug Action Teams work hard to ensure that both the general public and drug misusers themselves are protected from the risk of blood-borne viruses. This provision will often include needle exchange schemes, where drug users have access to sterile injecting equipment, advice and support and are actively encouraged to dispose of used syringes in approved sharps containers.

Many councils, London Borough of Camden for example, also operate a rapid response needle removal team which is committed to removing discarded syringes from council operated areas within one hour. In a 6-month period this team in Camden removed 13,000 needles from their streets.

However the Keep Britain Tidy survey in 2001 found that:

· Only 2/3rds of local authorites have a dedicated team to remove discarded needles

· Less than half provided staff training on how to deal with such finds

· 14% didn’t provide adequate clothing and equipment

Even where response teams and co-ordianted action plans exist, councils may be reluctant to promote and publicise this Best Practice approach for fear of highlighting the issue and creating alarm amongst the general public.

Commercial Premises

A recent survey of facilities managers suggested that the commercial sector may be unprepared to deal with the potential dangers of drug related litter. Less than 80% of those who have experience of discarded needles have the appropriate equipment on site to safely and effectively deal with it.

The survey, undertaken by the PHS Group, also found that only the minority of commercial organisations (25% in Wales and the South West, 30% rest of the UK) had received any form of specialist training designed to help them identify and deal with drug related litter. Yet all site managers have a legal obligation under Section 2 of the Health and Safety at Work Act 1974 to protect their employees and visitors whilst on their premises.

For links to other organisations in this field, please click here.

References

[1] Druglink Guide to drugs; a guide to the non-medical use of drugs in the UK. DrugScope. Druglink London; Drugscope, 2004 89p

[2] P Nyiri, T Leung, MA Zuckerman “Sharps discarded in inner city parks and playgrounds – risk of blood-borne virus exposure”, Communicable Disease and Public Health 2004: 7(4): 287-8

[3]Wyatt JP, Robertson CE, Scobie WG. “Out of hospital needlestick injuries”. Ach Dis Child 1994; 70: 245-6

[4] Shooting Up - Infections among injecting drug users in the United Kingdom 2003, An update: October 2004, Health Protection Agency