We’re thrilled to announce that our Harrow service has successfully reached the impressive milestone of Hepatitis C micro-elimination!
NHS England has a target to eliminate the virus by 2025 and Via services are aiming to do this in their local areas by the end of 2023.
Hep C is a blood borne virus which, left untreated, can cause liver cancer and liver failure. It usually displays no symptoms until the virus damages the liver enough to cause liver disease. People who inject drugs are at the highest risk of becoming infected.
As of November 2023, our team in Harrow has reached the following targets with the people who use their service:
- 100% of those in treatment have been offered a Hep C test
- 100% of people who currently inject or have previously injected have been tested for Hep C
- 90% of individuals who currently inject or have previously injected have been tested in the last 12 months
- 90% of people who were diagnosed with Hep C at the service have started treatment
By meeting these targets, we’re proud to report that Via – Harrow has formally achieved Hep C micro-elimination!
This is Via’s first service to reach micro-elimination, and the third West London service and the sixth London borough to reach this incredible milestone.
In partnership with Gilead Sciences, staff and volunteers at all our Via services have been working tirelessly to promote testing and treatment with the people they work with, on their journey to micro-eliminate Hep C, and we hope to be able to announce more micro-elimination wins soon!
Oasis Azeez-Harris, Senior Public Health Commissioner for Sexual Health and Substance Misuse from Harrow Council said: “Congratulations to the Via Harrow staff team for working hard to achieve the micro-elimination of the Hep C Virus through a substance misuse service, this is a huge achievement to be celebrated as we, as a system work towards World Health Organisation’s (WHO) ambition to eliminate viral Hepatitis by 2030. It is wonderful to see Via Harrow leading the way, being a beacon for others to learn from. This would not be possible without Via Harrow’s close working arrangements with other stakeholders, for example the Hep C Trust amongst others – this shows that joint work leads to better outcomes of people using services on their recovery journey. Well done Via Harrow staff team – keep up the fantastic work to maintain and exceed this success for Harrow residents using your services!”
Prof Ashley Brown, Clinical Lead at West London HCV Operational Delivery Network said: “Another milestone has been reached in our aim to eliminate Hepatitis C with the announcement that Harrow drug services have achieved their micro-elimination targets. Huge congratulations and thanks go to the team at Via working in collaboration with the clinical nurse specialists from Northwick Park Hospital, peers from the Hep C Trust, and the clients within the service in bringing this about”.
Anna Whitton, CEO at Via said: “This is a really positive and important outcome, which has made a tangible difference to many people. Our team has worked hard to make Hep C information, testing and treatment as easy to access as possible and we are really proud of this achievement.”
Vanessa Duke, Area Director at Via said: “Access to testing, treatment and ongoing recovery focused care is so important to our service users and everyone in the Via Harrow service is 100% committed to providing that! I am so proud of the team in Harrow for all of their hard work in achieving Hep C micro-elimination, this is a great outcome for our service users and for the community as a whole. The success we have seen in Harrow is not wholly down to Via, we are so thankful to the local ODN (operational delivery network) and our colleagues from Northwick Park Hospital who deliver clinics from our service, providing access to Hep C treatment in a place where our service users feel safe. Breaking down the barrier of having to attend another clinic or the local hospital has been key to supporting people to commence and complete Hep C treatment.”
Allen Quine, Service Manager at Via Harrow said: “We’re really proud to have achieved micro-elimination in Harrow; the team have worked hard for this and excellent communication has helped us hit our goal. We’ve worked closely with our local Infectious Diseases Team for a long time and this was a great starting point for us. Adding in very proactive input and support from the Hep C Trust, our data team and Marlon (our Hep C Lead) has been fantastic. Communication and co-ordination have been absolutely key – from identifying where (and who) to focus and following this through with that larger team’s involvement up to and including outreach. I like to see the public health implications in a simplistic way. The health impacts of Hep C can be terrible with a big social impact. If no one had Hep C, there wouldn’t be anyone who can pass it on. I am pleased to say that by achieving micro-elimination, this multi-disciplinary team have brought Harrow closer to that new reality.”
Dr. Vivienne Gosnell, Clinical Lead at Via Harrow said: “Achieving micro-elimination in Harrow has very much been a joint effort. The crux was having reliable, up-to-date data, shared regularly with our team, so that opportunities to test wouldn’t be missed. We worked closely with Northwick Park Hospital infectious diseases unit and The Hepatitis C Trust to host in-service Hep C clinics. Our infectious diseases nurse worked flexibly with those service users who were reluctant to engage, and our Hepatitis C Trust mentors provided fantastic support, taking medication to service users, and providing testing at home. In addition, we co-ordinated testing drives in the service and in partnership with University College London Find & Treat Community Van, where incentives like vouchers, Via’s Capital Card reward scheme and pop-up shop events were used. Successful Hepatitis C treatment not only prevents long term health complications such as cirrhosis and even liver cancer for those affected, but also stops transmission to others. We want to thank everybody involved for their hard work and dedication in achieving this goal.”
Faye Martin, Peer Lead, The Hep C Trust said: “Collaborating closely with Marlon, the Hep C Coordinator at Via, has significantly enhanced my effectiveness in my role as the West London Peer Lead. Together, we’ve successfully conducted joint training sessions on Hep C awareness and skilfully guided Via Recovery Practitioners in performing dry blood spot tests (DBST) for service users. Our partnership has not only contributed to the positive well-being of Harrow service users but also played a crucial role in supporting them throughout their treatment journey. As a testament to our joint efforts, we’ve successfully achieved micro-elimination of Hepatitis C in Harrow, marking a milestone in our commitment to improving healthcare outcomes.”
Marlon Freeman, Hepatitis C Coordinator at Via said: “Via – Harrow through a remarkable journey has reached Hepatitis C micro-elimination and is Via’s first service to do so. This success story is a testament to the unwavering commitment to improving health in our boroughs, particularly among a community battling substance misuse. Via Harrow’s achievements stand as a symbol of transformation, proving that through compassion, resilience, and innovative solutions, we can pave the way for a healthier and more equitable future for all free of Hepatitis C.”
Via is delighted by the enlightened approach of the authorities in Glasgow in giving the official go-ahead for the UK’s first safe drug consumption room.
There’s a misconception that a harm minimisation policy leads to condoning the use of illicit drugs – but the evidence from across Europe and Canada is to the contrary.
Such services reduce accidental overdose deaths and help by linking individuals to structured treatment with all the associated benefits.
Their introduction is a measured and incremental response to the present drug death crisis and will facilitate and enhance the effectiveness of other interventions. Consumption rooms are one component of a multifaceted toolkit, which could save many lives.
Chair of Via, Yasmin Batliwala MBE, states that “This is an important step in the right direction and Via supports it and its adoption across the UK”.
Additionally, Executive Medical Director at Via, Dr Yasir Abbasi, states that “Safe consumption rooms are tried and tested in many other countries and has evidence to support that they minimise harm and reduce morbidity and mortality. Well done, Glasgow!”
To anyone that uses drugs or cares for someone who does:
The drugs available in the UK seem to be changing lately. As services that provide support to people who use drugs and their loved ones, we have come together to issue a shared statement about some of the new drugs being used by the people we support and the risks they present.
Today is International Overdose Awareness Day, and in honour of all those who have been affected by overdose and in light of new information about synthetic opioids, we have updated our joint statement.
In the last two years, new opioids called “nitazenes” have arrived in the UK. They have recently been found mixed with heroin, with some being sold as illicit oxycodone pills and illicit ‘Xanax®’ powders.
Nitazenes can be at least as strong as fentanyl and can be hundreds of times more potent than heroin. They are known to have led to accidental overdoses and the deaths of people across the UK in recent weeks.
If you use drugs, this information could help you and your friends to stay safer. If you know people who use drugs but do not use drugs yourself, the following information could help you to keep people alive.
Because of how dangerous these contaminated drugs are, the way you use drugs may need to change to avoid overdose. We have updated the following information, in line with harm reduction guidance issued by EuroNPUD, with additional information provided to aid those living in the UK:
1. Carry naloxone
- Always carry naloxone. It’s available from all drug services.
- If you live in Scotland: Scottish Families Affected by Alcohol and Drugs offers a ‘click & deliver’ service
- If you live in Wales: Barod offers a ‘click & deliver’ service
- Nitazenes have been found in non-opioid drugs (like illicit Xanax®), so even if you or your friends don’t normally use opioids, it is still worth carrying naloxone.
- Carry extra naloxone – in some cases, it has taken multiple doses of naloxone to reverse overdoses involving heroin contaminated with synthetic opioids. Carry two yellow cases of intramuscular naloxone or two double packs of nasal naloxone. More advice is provided in point six (overdose response).
2. Don’t use alone
- Try not to use drugs alone, and don’t let your friends use them alone either. Watch out for signs of overdose in others. The signs include difficulty breathing, blue or grey colouring to the lips or fingertips (the former in lighter skinned people, and the latter in darker skinned people), unresponsiveness, and limp limbs.
- If you are going to use drugs, reach out to someone to let them know your plans and ask them to check up on you.
- If you are using with others, avoid all using at the same time. More advice on this is provided in point five (stagger your dose).
3. Check your drugs
- Submit an anonymous sample of the substance to the WEDINOS Project for analysis. It will take a few days to get the results back, so go easy in the meantime.
- Fentanyl strips do not test for nitazene.
4. Start low, go slow
- Start with a lower dose and wait for the peak effects to pass
- If you’re using illicit pills, consider splitting them and starting with a fraction of the pill. If you can’t split the pill, you might want to consider using the crush, dab, wait method. This was designed for MDMA users and is more applicable to powder or crystal form drugs, but could also keep you safer when using other pills.
5. Stagger your dose
- Make sure you are with a friend and one or both of you have naloxone.
- If one person uses their drugs first, wait until the peak effects have worn off before the other person uses. This makes it much more likely that there is someone who can respond in the case of an overdose.
6. Overdose response
- If someone overdoses, administer naloxone and call an ambulance.
- Recent overdoses have required multiple doses of naloxone. You do not need to give doses at a faster rate, but you might need more than one naloxone kit. Continue to administer naloxone as you were trained to, and do not give multiple doses at once.
- Aim to restore breathing rather than consciousness. As well as synthetic opioids, drugs may be contaminated with other substances such as benzos or xylazine, which can lead to heavy sedation.
- Overdose symptoms returning is more likely with nitazenes, so make sure you observe someone for longer than you would with a normal heroin overdose.
- Naloxone only works on opioids. It’s best to use naloxone if you think someone has overdosed, even if you’re not sure what they’ve taken – naloxone will not harm them.
- While mixing different drugs is common, it is more likely to cause an overdose. Try to use one drug at a time. If you are going to mix drugs, use less of each.
7. Seek substitute medication and other prescribing support
- If you use opioids every day, your local drug service can support you and prescribe alternatives such as methadone or buprenorphine. Abstinence does not need to be your goal; these alternatives can help to keep you much safer.
- If you are already in treatment for opioid dependence and you don’t want to use on top, speak to your prescriber and make sure you’re getting the right dose for you.
- Check out the SODA tool to help you determine if your dose is right.
- If you do still want to use on top, that is okay too, but be aware that there are higher risks now of overdosing.
- If you don’t use opioids but are worried about your drug use and you take illicit benzos every day, you can also talk to your treatment provider about how they can support you.
Jon Findlay (National Harm Reduction Lead, Humankind)
Deb Hussey (National Safer Lives Lead, Turning Point)
Peter Furlong (National Harm Reduction Lead, Change Grow Live)
Chris Rintoul (Innovation & Harm Reduction Lead, Cranstoun)
Kate Blazey (Interim Medical Director, With You)
Dr. Judith Yates (International Doctors for Healthier Drug Policies – IDHDP)
Shayla S. Schlossenberg (Drugs Service Coordinator, Release)
Mat Southwell (Project Executive, EuroNPUD)
Roz Gittins (Director of Care Standards and Practice Improvement, Via)
Rob Barker (Campaigns and Communications Lead, Barod)
Justina Murray (CEO, Scottish Families Affected by Alcohol and Drugs)
Prof Adam Winstock (Consultant psychiatrist & addiction medicine specialist)