Evaluation Of The Provision Of Single Use Citric Acid Sachets To ...

APPENDIX A: Information SheetEvaluation of the Provision of Single Use Sachets of Citric Acid toInjecting Drug UsersBackgroundInformation SheetStreet heroin in the UK tends to be brown and is sold in poorly soluble base form. Inorder to make the heroin soluble, an acid must be added to convert the base into asalt. Acids that can be used to facilitate solubility include citric, ascorbic, acetic andlactic acids. Injecting drug users have tended to use readily available forms of theseacids such as processed lemon juice, fresh lemon juice, vinegar and other householdproducts. Although these products are used to promote solubility, they are in factoften a source of harm themselves, and can lead to eye and heart infections.Due to the kno wn risks asso cia te d with using more dange rous a cidifie rs, 100mg singleuse sachets of citric acid are now being offered at pharmacy exchanges in GreaterGlasgow and La na rkshire . Citric a cid is be lie ved to be the safest a cidifie r to use for thepre pa ra tion of bro wn he ro in fo r inje ctio n. It is ho ped tha t providing citric a cid sa che tsin this way will increase both the number of people attending and the number of visitsto pharmacy exchanges.The Effective Interventions Unit (Scottish Executive), Greater Glasgow NHS Board andLanarkshire NHS Board have provided funding to:• To assess if the amount of citric acid is sufficient to dissolve the amount ofheroin used per injection.• To assess if the pro vision of one sa che t pe r one needle/syringe is adequa te fo rthe needs of injectors.• To assess the number of citric burns experienced using the sachets.• To assess if the uptake of needles/syringes from pharmacies has increasedsince the introduction of the sachets.MethodologyThree hundred and sixty injecting drug users who attend pharmacy exchanges will bere cruited to the s tudy (120 from Lana rks hire NHS Boa rd a nd 240 from Greate rGlasgow NHS Board) over a three month period. Injectors will be interviewed by atrained researcher using a structured questionnaire. The schedule contains questionson respondents’ demographic characteristics, drug injecting habits and use of thecitric acid sachets. All interviews will be confidential and anonymous and should lastno more than ten minutes. Respondents will be offered a chocolate bar and a can ofjuice fo r taking the time to comple te the inte rvie w.