In the UK, which has among the highest rates of recorded illegal substance misuse in the Western world, 34% of people diagnosed with Hepatitis B, over 90% diagnosed with Hepatitis C and 5.6% diagnosed with HIV were associated with injecting drug use.

In our cross-sectional survey on 150 individuals under active management by the Trust Alcohol and Drug Services based at Great Yarmouth, 3% were diagnosed positive for Hepatitis B, 19% for Hepatitis C and 2% for HIV. About half had no documentation regarding blood-borne viruses; 36 had at least one dose of Hepatitis B vaccine, but only 18 had three doses. Those who showed a trend towards completing Hepatitis B immunisation were in the age group above 30 years old, known to the services for more than 2 years, injectors, those who accepted the offer of immunisation and those positive for Hepatitis C. This is of concern as studies show an emergence of increasing incidence of blood-borne viruses among new, young and vulnerable drug users.

At the time of our study, 22% individuals shared injecting equipment. Injecting is not only a key factor in the transmission of blood-borne viruses, but also plays a significant role in deaths from overdose, accounting for more than 7% of all the deaths among those aged 15–39 years old in 2004 (European Monitoring Centre for Drugs and Drug Addiction, 2006).

We recommend the following: (1) clinicians need to collect, keep, analyse and make effective use of patient data including sexual health and injecting practice; (2) drug and alcohol services should increase awareness of harm from injecting drug use, with particular regard to blood-borne viruses and overdose; and (3) effective treatment goals should include testing, immunisation and treating of blood-borne viruses for all service users.