The Psychiatrist (2008) 32: 153. doi: 10.1192/pb.32.4.153a
© 2008 The Royal College of Psychiatrists
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Correspondence

Blood-borne virus testing and Hepatitis B immunisation in specialist alcohol and drugs service

Vellingiri Raja Badrakalimuthu, Speciality Registrar

Northumberland, Tyne and Wear NHS Trust, Northgate Hospital, Great Yarmouth NR30 1BU, email: dr_vellingiriraja{at}yahoo.co.uk

Daphne Rumball, Consultant Psychiatrist

Drug and Alcohol Services, Norfolk and Waveney Mental Health Partnership NHS Trust

In the UK, which has among the highest rates of recorded illegal substance misuse in the Western world, 34% of people diagnosed with Hepatitis B, over 90% diagnosed with Hepatitis C and 5.6% diagnosed with HIV were associated with injecting drug use.

In our cross-sectional survey on 150 individuals under active management by the Trust Alcohol and Drug Services based at Great Yarmouth, 3% were diagnosed positive for Hepatitis B, 19% for Hepatitis C and 2% for HIV. About half had no documentation regarding blood-borne viruses; 36 had at least one dose of Hepatitis B vaccine, but only 18 had three doses. Those who showed a trend towards completing Hepatitis B immunisation were in the age group above 30 years old, known to the services for more than 2 years, injectors, those who accepted the offer of immunisation and those positive for Hepatitis C. This is of concern as studies show an emergence of increasing incidence of blood-borne viruses among new, young and vulnerable drug users.

At the time of our study, 22% individuals shared injecting equipment. Injecting is not only a key factor in the transmission of blood-borne viruses, but also plays a significant role in deaths from overdose, accounting for more than 7% of all the deaths among those aged 15–39 years old in 2004 (European Monitoring Centre for Drugs and Drug Addiction, 2006).

We recommend the following: (1) clinicians need to collect, keep, analyse and make effective use of patient data including sexual health and injecting practice; (2) drug and alcohol services should increase awareness of harm from injecting drug use, with particular regard to blood-borne viruses and overdose; and (3) effective treatment goals should include testing, immunisation and treating of blood-borne viruses for all service users.

References

  1. EUROPEAN MONITORING CENTRE FOR DRUGS AND DRUG ADDICTION (2006) Drug-Related Infectious Diseases and Drug-Related Deaths. Annual Report. The State of the Drug Problem in Europe. European Monitoring Centre for Drugs and Drug Addiction (http://www.emcdda.europa.eu/html.cfm/index41529EN.html).




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