Harm reduction: policy and practice

First published: 29 March 2019 | Last updated: 20 May 2019

Dr Vivian Hope

Vivian is a Principal Scientist at Public Health England’s Centre for Infectious Disease Surveillance and Control, where he is the scientific lead for the surveillance of infections among people who inject drugs.  He also holds an Honorary Senior Lectureship at the Centre for Research on Drugs and Health Behaviour at the London School of Hygiene and Tropical Medicine.  He has been involved in a number of research studies related to drug use and also with projects for the European Monitoring Centre for Drugs and Drug Addiction, the European Centre for Disease Control, and the WHO Regional Office for Europe.  He is an author on over 50 scientific papers.  His research interests include infections among people who use drugs and the epidemiology of problem drug use.

Harm reduction: policy and practice

Patterns of injecting drug use – who is injecting and the drugs being injected – change over time.  An example of such a change in the United Kingdom was the emergence of crack-cocaine injection, usually in combination with heroin, a decade ago.  Changes in injecting drug use can happen rapidly and can lead to increased levels of harm; as is currently being seen in Romania, where changes in the drugs being injected is one of the factors associated with an on-going HIV outbreak.

This presentation will examine how the extent and nature of both bacterial and viral infections among people who inject drugs in the United Kingdom have changed over recent decades.  It will then explore changes in the nature of injecting drug use.  In particular it will consider the apparent growth in the injection of image and performance enhancing drugs and the indications of a recent increase in the injection of ‘club’ drugs and amphetamine-type stimulants.  The potential impacts of these recent changes in the nature of injecting drug use on infections will be explored, and the implications of these for research, service provision, and harm reduction considered.


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