New report: peer-based needle exchange service in London

January 14, 2022

With 43% of people who inject drugs reporting sharing needles or works in 2020, the overall level of hepatitis C transmission changing little in recent years and infections amongst people who inject drugs increasing, there is clearly a need for renewed investment and innovation in harm reduction services.

Funded by Hackney Council as part of the ADDER (addiction, diversion, disruption, enforcement and recovery) Accelerator project, the report explores the feasibility, acceptability, and practical considerations of developing a peer-based needle exchange service. It draws on focus groups with people who use needle exchange services and peer support workers, interviews with experts from services and commissioning bodies, and international evidence.

Peers are people who have lived experience of injecting drug use who use their shared experiences to deliver education, advice, information or services on safer injecting practices to others. A peer-based service embeds peer leadership and delivery throughout the service, in order to ensure their experiences shape the service, although the service may not be exclusively led and delivered by peers.

The report finds that:

• There is strong support among people who inject drugs, peers who work with people who inject drugs, commissioners and health specialists for an innovative peer-based needle exchange service in London.
• This would be a welcoming service where people could access all the equipment they need (both in type and amounts), and be signposted to other support where appropriate.
• Stigma is often faced by people who inject drugs when they access high-street pharmacy services – a peer-based service would be non-judgemental, respectful, inclusive and more attractive to people who inject drugs.
• Peer leadership should be embedded in the development and design of the service, alongside other stakeholders, in a steering committee.
• Peers, including both people who currently are injecting drugs and people who have previously injected drugs, should deliver the service in a range of clearly-defined roles with training and supervision, including both paid and volunteer roles.
• Monitoring and evaluation mechanisms should be clearly embedded in the service to enable service improvements and to allow learnings for other future similar peer-based services.
• An initial 3-5 year funding commitment could provide stability and a pan-London approach to commissioning could enable access across borough lines.

Read the full report: