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

5of this research, in December 2001 pharmacy exchanges in Greater Glasgow startedoffering 100mg single use sachets of citric acid to IDUs and, in March 2002, pharmacy andneedle ex changes in Lana rkshire follo we d suit. This pro vision was introduced with thesupport of Greater Glasgow and Lanarkshire DATs, the Home Office, Strathclyde Police,Grea te r Glasgo w P rimary Ca re Trust and the Ro ya l Pha rmaceutica l So cie ty in Sco tland.The 100mg single use citric acid sachets provided are manufactured and packed insurroundings that comply with the pharmaceutical industry standards of GoodManufacturing Practice (GMP). The sachets themselves are made from a combination ofpaper, plastic and aluminium foil, which ensures they remain airtight, water resistant andfree from contamination.As the sachets are designed for single use, they decrease the risk of contamination fromsharing between IDUs and encourage hygienic injecting techniques. In addition, it ishoped that providing citric acid sachets in this way will increase both the number of peopleattending and the number of visits to the needle exchange. Despite these clear benefits,citric acid, like a ll a cidifie rs, is not designed fo r inje cting a nd ca n lead to ve in damage . It isthe re fo re impo rtant tha t the smalle st po ssible amount is used. Tex t on the ex te rio r o f thesachets advises IDUs to use as little citric as possible and to discard whatever remains.Each sachet also carries the warning that injecting citric acid can damage veins. Thisinformation and further injecting advice is also offered to IDUs on the small flyer suppliedwith the sachets and on the box in which the sachets are sometimes supplied to users.(Furthe r info rmatio n o n the sa chets, leafle ts a nd info rmation distribute d ca n be fo und inAppendices C and D.)While the pro vision o f citric a cid sa che ts in the UK is rela tive ly ne w, a sim ila r se rvice ha sbeen available in some European countries for some time now. There it has increased theuse of needle exchange services, reduced the use of more dangerous acidifiers, beenpo pula r with IDUs and impro ved the ir re latio nship with needle ex cha nge staff (P resto n &Derricott, 2002). A small pilot study carried out by the Hungerford Mobile Exchange Teamin London has also produced positive results (Wilkinson, 2002).The Effective Interventions Unit (Scottish Executive), Greater Glasgow Primary Care NHSTrust and Lanarkshire Primary Care NHS Trust provided the funding necessary toinvestiga te if the provisio n o f citric a cid is just a s successful in Grea te r Gla sgo w andLanarkshire.