Realistic Responses to OutbreaksRealistic Responses to Outbreaks in People Who Use Drugs

Emma Hamiltonemmah@sdf.org.uk A national resource of expertise on drug issues

National resource onresource on drug issues

Improving Scotland’s response to problem 

Outbreaks

drug use

Reduce Training and D l

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harmDevelopment

Clostridium N i Clostridium Group A Novyi Clostridium 

Botulinum

pStreptococcus

Bacillus  Staphylococcus Anthracis

S ap y ococcusAureus HIV

2000 20172009 2014 2015 2016

3Scottish Outbreak Time Line

What are the risk factors?

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Realistic Responses to Bacterial/ Viral outbreak

Local/ National policies

C ltCulture

Structural

Interpersonal

Individual

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Individual

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Interpersonal

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StructuralSafer Consumption Facility

Heroin?PreP?

Talk to me about safer injecting practices..... How is your injecting sites?PreP?

Antibiotic Prophylaxis? How is your injecting sites?

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Culture

STIGMA9

Local/ National Policies

•Decriminalisation•Ending homelessness•Welfare reform•Safer consumption facilities•Heroin Assisted Treatment

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BibliographyEMCDDA R id i ti D l t d i f ti di i• EMCDDA – Rapid communication. Drug related infectious diseases in Europe. Update from the EMCDDA expert network. Nov 2016

• Public Health England et al. Shooting Up Report 2015. Nov 2016• NHS National Services Scotland, Health Protection Scotland. Guidelines for 

the Public Health Management of tetanus, botulism or anthrax among people who inject drugs 2017people who inject drugs. 2017

• Yeung A, Weir A, Austin H et al. Assessing the impact of a temporary class drug order on ethylphenidate‐related infections among people who inject drugs in Lothian, Scotland: an uninterrupted time‐series analysis. doi: 10.1111/add. 13898

• Dunleavy K, Munro A, Roy K, et al. Spore forming bacteria infections and 

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y , , y , p gpeople who inject drugs: implications for harm reduction. Submitted for publication.  

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