Peer distribution of sterile injecting equipment: UNSW and Monash research supports recent change of laws in three Australian jurisdictions

14 Jun 2016

By Prof Carla Treloar

Researchers from UNSW and Monash support changes made to laws in the NT, ACT and Tasmania governing the distribution of sterile equipment used for prevention of blood borne viruses.

The NT and ACT governments recently announced their intentions to change laws to allow members of the community to exchange equipment used in efforts to reduce the transmission of blood borne viruses. The availability of sterile needles and syringes is a key component of efforts to prevent transmission of HIV, hepatitis C and hepatitis B. Australia has supported publicly funded Needle and Syringe Programs since the 1980s. However, until recently, passing sterile needles and syringes between community members has been illegal in all Australian states and territories.

These laws go against what happens in the community. UNSW and Monash researchers have examined these practices in detail. Dr Joanne Bryant and Dr Max Hopwood, from UNSW's Centre for Social Research in Health, were among the first to document that the practice of providing small amounts of sterile equipment to others was a relatively frequent practice among people attending community pharmacies to obtain sterile equipment. The main motivation for this practice was to support other people who inject drugs in their desire to use drugs in the safest way possible. Although frequently occurring, most people provided only a small amount of equipment to their peers. This was further supported by research undertaken by UNSW alumnus Dr Jamee Newland whose PhD project showed that a small number of people can distribute thousands of pieces of equipment each year in more formal and organised ways.

Work conducted by Kari Lancaster and Prof Carla Treloar from UNSW and Dr Kate Seear from Monash University examined the ways in which laws around “peer distribution” of equipment portray people who inject drugs as needing control and oversight. This portrayal undermines the potential to engage people who inject drugs as partners in the prevention of blood-borne viruses. Importantly, these laws have been used in a previous manslaughter prosecution (in NSW) where a person supplied a needle to a second person and that (second) person later died of an overdose. These laws and the use of them in this prosecution could act as a significant barrier to people carrying extra sterile equipment to pass on to those in need, and as a vital cog in the prevention of blood borne virus epidemics.

These changes in the NT and ACT follow changes in Tasmania in 2015 to allow distribution of equipment by those involved in the practice. In doing this, the legal systems of these three jurisdictions have caught up with practices that have long been regarded as normal and vital in the community. These changes mean that it will be possible to properly promote and support peer distribution for improving further still the cost-effectiveness of the NSP and making the program an even better public health investment. Besides the very practical outcomes, these changes provide the potential to position people who inject drugs as powerful actors in achieving better health outcomes.

Related reading

Bryant, J., & Hopwood, M. (2009). Secondary exchange of sterile injecting equipment in a high distribution environment: A mixed method analysis in south east Sydney, Australia. International Journal of Drug Policy, 20, 324-328. http://dx.doi.org/10.1016/j.drugpo.2008.06.006

Lancaster, K., Seear, K., & Treloar, C. (2015). Laws prohibiting peer distribution of injecting equipment in Australia: A critical analysis of their effects. International Journal of Drug Policy, 26, 1198-1206. doi: 10.1016/j.drugpo.2015.05.014

Newland, J., Newman, C., & Treloar, C. (2016). “We get by with a little help from our friends”: Small-scale informal and large-scale formal peer distribution networks of sterile injecting equipment in Australia. International Journal of Drug Policy (2016). doi: http://dx.doi.org/10.1016/j.drugpo.2016.04.005