- Number of NSPs: 132 (+800 estimated pharmacies)
- Syringes distributed in 1999-2000: 5,300,000 (+5,000,000 estimated through pharmacies)
- Approximate cost: $1,678,000
HistoryThe enabling legislation for Needle and Syringe Programs in Queensland was enacted in the Drugs Misuse Act (as amended) 1989. The amendment allows for the supply of needles and syringes to any person for any lawful purpose. It also allows for the supply of needles and syringes to any person by medical practitioners, pharmacists and persons approved by the Minister of Health for the purposes of illegal drug use. This requires the Minister of Health to approve all staff or staff positions involved in NSPs. To obtain approval, staff are required to attend and successfully complete a 4-hour training program, upon which their names or positions are submitted to the Minister for final approval.
Prior to 1989, single syringes were sold commercially through pharmacies. The original Queensland NSP (known then as the Statewide HIV/AIDS and IDU Program) was located within the Sexual Health Unit of Communicable Diseases. In 1997, following a review of needle and syringe availability, the management of NSPs was shifted to Alcohol, Tobacco and Other Drugs Services.
Distribution of needles and syringes has tripled over the past six years (1996-2001). There has been an explosion of amphetamine use over this time (there are now an estimated 85,000 amphetamine users in Queensland) and it is likely that many people who use amphetamines are injecting on a casual basis. Use of heroin is not as dominant as it is in some other states; even so it is estimated that Queensland has approximately 17,000 heroin-dependent persons.
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Types of programsQueensland has 132 needle and syringe programs currently operational, which distribute around 5,000,000 needles and syringes per annum. The program has two primary Queensland Health operated sites (Brisbane and Cairns) and 130 secondary and NGO sites. In addition, outreach services are provided through some of the NGOs. Brisbane City Council and Queensland Health are in the process of establishing an after-hours street-based service to distribute equipment within the Fortitude Valley area. Biala, located in Brisbane, is the largest NSP in Australia and accounts for approximately 34% of the total number of syringes distributed in Queensland each year. It is a 24hour/7days per week alcohol and drug service with a full range of services including a methadone clinic and an AIDS medical unit. It is Queensland Health policy that every health service district must provide at least one NSP within its area. In addition, Accident and Emergency Services in all publicly funded hospitals are strongly encouraged to operate NSPs. However, some hospitals do not operate NSPs, while others operate the program without uniformity of service or with little enthusiasm.
Like programs in all states, the range of activities that each service engages in is commensurate with their degree of specialisation. The primary sites, NGOs and larger secondary sites provide a comprehensive range of services (greater range of injecting paraphernalia, provision of condoms, BBV testing, referrals, support and information), whereas the smaller programs are more likely to only provide basic services.
In addition to the provision of equipment, all Queensland Health NSPs provide used sharps collection and disposal facilities. Brisbane City Council has also recently installed 300 disposal bins in and around the city. Many other local councils have already, or are in the process of installing sharps disposal bins in appropriate locations.
The legislation automatically authorises all pharmacists to sell syringes. There are approximately 1,000 retail pharmacies in Queensland and it is estimated that around 80% of them sell needles and syringes at a retail price of between $2 and $5 for a five pack (average price is $3). It is estimated that these pharmacies distribute about 5,000,000 syringes per annum (approximately the same number as the NSP). However, as this commercial operation takes place without any government involvement or regulation, it is difficult to determine exact figures. Queensland Health is in the process of talking directly with wholesalers of injecting equipment to obtain more accurate and detailed information.
Barriers and challengesFrom the outset of operating NSPs in Queensland, the program has experienced a significant level of public antagonism. This is well illustrated by the recent call from the Northern Queensland Local Government Association for the banning of NSPs. As a result, NSPs are continually defending their position and are operating from a position of reactivity rather than acting in accordance with sound evidence-based practice.
The major issue for action in Queensland, is the safe disposal of used needles and syringes. Although 80% of pharmacies sell syringes, almost none accept returned sharps. Queensland Health is currently exploring options with the Queensland Pharmacy Guild to encourage pharmacies to provide sharps disposal facilities. In addition to pharmacies, Queensland Health is working in partnership with local government to deal with disposal issues. This has resulted in the creation of a collaborative project between Queensland Health and the Local Government Association of Queensland within the framework of the Queensland Public Health Partnership Protocols. The first concrete result being the establishment of an 1800 State wide clean needle helpline.
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