Abstract
Injecting drug use is highly prevalent in London and is associated with specific physical health problems. These problems are related to the toxicity of the substances, their mode of consumption and as a consequence of the drug taking lifestyle. Hepatitis B and C viral infections are common among drug users due to sharing of both needles and other drug taking paraphernalia. Hepatitis B infection can be prevented by immunisation. Hepatitis C infection can interact with alcohol consumption to accelerate liver damage. Sharing of drug injection equipment is high (up to 78%). Injecting drug users (IDUs) that live close to needle exchanges are significantly less likely to engage in sharing activities than those that live further away. Drug users are at particular risk of developing poor dental health, which is associated with morbidity and mortality, particularly cardio-vascular conditions and respiratory disease. Many female drug users have been involved with the commercial sex industry and are at risk of contracting blood borne viruses. Drug users who also use alcohol have an increased likelihood of physical morbidity and injury / trauma. Problem drug users have an increased likelihood of experiencing physical morbidity, but are less likely to engage with primary care services. Barriers to accessing primary care include convenience (access), apathy, procrastination and “self-medication”. Drug users are more likely to report physical health complications at an Accident & Emergency department (AED) than at a GP practice. Further investigation of local AEDs is required to ascertain their potential for assessing and referring drug users to specialist services and other primary care providers. Integration of primary care and drug treatment services may encourage drug users to engage in treatment for physical morbidity and promote retention within addictions services. Physical health of drug users may be assessed as part of a formal induction to treatment services, or opportunistically as appropriate. Drug users presenting to primary care services for prescriptions related to their addiction may not experience such an assessment. Increasing GPs knowledge and skills can lead to greater implementation of screening practices. The provision of primary care services to clients attending addiction treatment centres can lead to improvements in drug users’ physical health and enhanced treatment outcomes.