Clinical wastes in the community: local authority management of discarded drug litter

Abstract

Despite comprehensive multi-agency management of complex social, criminal and health issues surrounding illicit drug use, substance abuse continues to escalate. Previously limited to deprived inner city areas, most communities now record rising numbers of intravenous drug users (IDUs) with increases of drug litter carelessly discarded in the environment, particularly in parks, gardens and public toilets. Bloodborne virus transmission with Hepatitis B (HBV) and Hepatitis C virus (HCV), and Human Immunodeficiency Virus (HIV) is the primary hazard. Needlestick injuries continue to occur, often involving children. Seroconversion and life-threatening infection is uncommon, although post-exposure prophylaxis and extensive follow-up is necessary and this may precipitate prolonged and debilitating stress for the victim and family group. Local authorities must maintain strategies to ensure the prompt and safe retrieval of drug litter. To evaluate the effectiveness of these services, an audit was undertaken to review information on the websites of each county, borough and district council and unitary authority throughout England (n 1⁄4 439), Northern Ireland (n 1⁄4 29), Scotland (n 1⁄4 37) and Wales (n 1⁄4 21). These 526 sites were accessed using search strategies described pre-