Evidence of Increase in Injecting Drug Use Found in 190 Countries

Two new reviews led by researchers at the National Drug and Alcohol Research Center (NDARC) and the Kirby Institute at UNSW Sydney found evidence of an increase in injecting drug use (IDU) in 190 countries. The reviews highlight the need for improved coverage of interventions to prevent and manage drug-related harms among people who inject drugs (PWID).

IDU documented in 190 countries

The first review, published in The Lancet Global Health, found evidence of IDU among people aged 15 to 64 years in 190 countries that comprise more than 99% of the global population. This is an increase of 10 countries since the previous review in 2017. This included eight countries in sub-Saharan Africa and two in the Caribbean.

Lead researcher, NDARC's Scientia Professor Louisa Degenhardt, said that the landscape had changed since the last review, including increased support for research across multiple low-income and middle-income countries, shifts in patterns of drug use, and the inclusion of drug dependence treatment as one of the United Nations Sustainable Development Goals.

The review looked at the prevalence of HIV, hepatitis B virus (HBV), and hepatitis C virus (HCV) infection, the characteristics of PWID, and patterns of drug use and risk history. The results show that PWID are at risk of police arrest, incarceration, sex work, and the experience of homelessness or unstable housing. All of these risk environments are associated with increased blood-borne virus transmission.

Estimating harm reduction programs

The second review, also published in The Lancet Global Health, updates 2017 estimates of global coverage of harm reduction services that target PWID. The review found 90 countries are implementing opioid agonist treatment (OAT) and 94 countries are implementing needle and syringe exchange programs (NSPs).

Only five countries are providing high coverage of both services. Far fewer countries are implementing supervised consumption facilities, drug checking services, and take-home naloxone (THN) programs.

"Globally, most PWID do not have access to harm reduction services designed to reduce the public health burden and improve quality of life," said Prof. Degenhardt.

Journal Information: Louisa Degenhardt et al, Epidemiology of injecting drug use, prevalence of injecting-related harm, and exposure to behavioural and environmental risks among people who inject drugs: a systematic review, The Lancet Global Health (2023). DOI: 10.1016/S2214-109X(23)00057-8

Samantha Colledge-Frisby et al, Global coverage of interventions to prevent and manage drug-related harms among people who inject drugs: a systematic review, The Lancet Global Health (2023). DOI: 10.1016/S2214-109X(23)00058-X