Injecting declines but remains a challenge for public health policies

Information from drug treatment and other sources indicates that the overall long-term trend in injecting as a route of administration continues to be downward. Among heroin users entering specialised drug treatment for the first time in their life, for example, reports of injecting are now at their lowest point for over a decade, although considerable variation exists between countries. Some of the health-harm indicators linked to this route of administration, particularly rates of new HIV diagnoses attributed to injecting drug use, have shown a parallel decline. This does not mean, however, that concerns have disappeared in this area. Although the 1 233 new HIV infections reported in 2016 were the lowest for more than two decades, this still represents a significant public health problem. Moreover, there have been recent outbreaks in some vulnerable populations and among users who are injecting stimulants and new psychoactive substances.

There is also evidence that blood-borne infections are often diagnosed relatively late among people who inject drugs, compared with other groups, thereby reducing the opportunity for successful intervention. Late diagnosis is also important in respect to HCV infection, which is often found at high rates among those who have injected drugs. In the past few years, the possibilities for the treatment of viral hepatitis have improved greatly, with the arrival of a new generation of medicines, which are highly effective. The eradication of this disease can now be seen as both an opportunity and a challenge for general healthcare providers and specialised drug services.