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Community sharps bins: a public health solution to drug related litter
Lloyd Baron, IAD Researcher, Centre for Public Health, Liverpool John Moores University

Abstract
Drug Related Litter (DRL) is an issue that affects many communities within the UK. The majority of DRL comprises lighters, packaging, paper, stericups and other paraphernalia which do not pose a direct public health risk, although a smaller proportion comprises used needles, posing a public health risk to members of the community. Regardless of the public health risk, DRL in all its guises induces fear amongst local communities serving as a visible and unsightly reminder of a wider drugs problem within the community. The risk of needle stick injuries from discarded needles compounds community fears and leads to further stigmatisation of injecting drug users.

Community Sharps Bins (CSBs) are one of a number of methods that can be used to deal with DRL. CSBs have been evidenced both nationally and internationally as an effective measure when dealing with DRL, if they are implemented by liaising with local communities and managed correctly once they are in use. In 2005 DEFRA recommended partnerships should fully explore the potential for CSB use in public toilets and DRL hotspots. In 2009 NICE issued guidance on applications to establish needle and syringe programmes. This guidance states that local drug partnerships should ensure adequate disposal mechanisms are in place when dealing with DRL. NICE suggest local strategic partnerships develop plans relating to DRL management in line with the 2005 DEFRA guidance. Yet despite this clear guidance, the use of CSBs in the UK is a contentious issue and many areas do not incorporate CSBs as part of their DRL management policy despite having ongoing DRL issues.

The reasons for not using CSBs are numerous. Often there is a perception that there will be strong public opposition and further concerns relating to management of CSBs can deter local authorities from utilising CSBs. In the first stage of an ongoing exploration of DRL and its successful management, we surveyed 105 individuals working within the drugs field across the UK on the DRL situation in their area, how their local authority dealt with DRL and how they felt CSBs would complement their services. A number of individuals who were directly involved in the process of implementing CSBs were interviewed to gather information relating to the barriers they faced, how these were overcome by community engagement and how they have used CSBs to successfully manage the problem of DRL in their local area.

This session will present the findings of the research and will describe how by following government guidelines, in conjunction with lessons learnt from UK local authorities, CSBs can be implemented openly with community and public services support. We will discuss how CSBs can be designed to accommodate other paraphernalia as well as used sharps. We will also demonstrate how service user involvement and appropriate management of CSBs are vital to ensuring CSBs are used as an effective tool by the local authority when dealing with DRL.

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Biography
Lloyd has worked as an Inter Agency Drug Misuse Database (IAD) researcher at the Centre for Public Health in Liverpool John Moores University (LJMU) since February 2008. His main responsibility is to provide quarterly reports to several Drug And Alcohol Action Teams (DAATs) across Cheshire and Merseyside. This is primarily data relating to Injecting Drug Users (IDUs) including data gathered from agency and pharmacy needle exchange programmes, the Drug Interventions programme
(DIP), the National Drug Treatment Monitoring System (NDTMS) and Connexions youth service.

Lloyd has been involved in other ad -hoc research with a focus on Injecting Drug Users (IDUs) including service provision for female IDUs and homeless individuals with substance use issues. He is also conducting a research project looking at the health implications for older IDUs. Lloyd works for Liverpool PCT in a voluntary capacity as an outreach worker providing needle exchange and sexual health advice to street sex workers in the Merseyside area. Lloyd also lectures applied human biology to undergraduates studying for a BSc in Public Health at LJMU and has been involved in delivering drug awareness seminars to sixth form students at Liverpool Community College. Lloyd's academic background is in Neuroscience and Psychology with a special emphasis on molecular neuroscience. Lloyd has been supervised on all aspects of this research by Mr Martin Chandler, Inter - Agency Drug Misuse Database Manager at the Centre for Public Health.