Introduction
A variety of important medical problems, both infective and non-infective in nature, are associated with injection drug use (IDU) including the blood-borne viruses such as HIV, hepatitis B (HBV) and hepatitis C (HCV), all of which may be transmitted via the sharing of injection equipment.
Consequently the medical care of patients using drugs requires a knowledge of both drug- and infection-associated conditions. The use of recreational drugs either occasionally or continually should not be a bar to or be used as a means of discriminating against access to health care in the UK as has been alleged recently. This right of access was explicitly addressed in the updated “ Guidelines on Clinical Management, Drug Misuse and Dependence” published by HMSO in 1999. This report stated that:• Drug misusers have the same entitlement as other patients to the services provided by the NHS.
• It is the responsibility of all doctors to provide care..., whether or not the patient is ready to withdraw from drugs.
• This should include the provision of evidence-based interventions, such as hepatitis B vaccinations, and providing harm minimisation advice.
Although combination therapy for HIV is not specifically mentioned in this document, because it is an evidenced based intervention the same principles apply.
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