Over a decade of syringe exchange: results from 1997 UK survey

ABSTRACT Aims To describe syringe exchange provision in the United Kingdom . Design Two‐phase cross‐sectional survey: phase I, establishing a sampling frame of syringe exchange coordinators (n = 420); phase II, surveying the coordinators seeking data on the number of syringe exchange outlets, visits and syringes distributed during April 1997 (68% response rate). Setting United Kingdom. Findings In 1997, nearly all Health Authorities in the United Kingdom (96%) operated some form of syringe exchange service, except Northern Ireland. In April 1997, 1 707 000 syringes were reported as being distributed. Assuming that non‐responders coordinated the median number of outlets and distributed the median number of syringes as responders, we estimate that 27 million syringes were distributed annually from over 2000 outlets in the United Kingdom. The number distributed in Scotland was 3–4 times less than in England when measured as a number per adult (15–44), drug user in treatment, or estimated injecting drug user. Conclusions Overall, there has been a 6.5‐fold increase in syringe distribution in England since 1991. The number of syringes distributed in the United Kingdom may be higher than the United States. However, there appears to be unequal distribution of syringes within the United Kingdom, which may be associated with higher levels of HCV among injectors in Scotland compared to England.