Needles and syringes to care and counselling: the need for innovative primary health care to meet the needs of street-based injecting drug users

This article addresses the potential role that the Australian Needle and Syringe Program (NSP) could play to assist the delivery of primary health care to street-based injecting drug users (i.e., those who spend the greater part of their lives on the street). Their personal circumstances mean that street-based drug users are particularly vulnerable to health problems. However, they also face obstacles that discourage their use of health care services. Consequently, relatively minor health problems may be allowed to deteriorate until emergency treatment is required. As one of few established services frequented by street-based drug users, NSPs may be in a unique position to intervene at an early stage of need. This article draws upon research undertaken with street-based drug users at the primary St Kilda NSP. Some 150 drug users were surveyed. A further 32 were interviewed at length. Users described the obstacles that discouraged their use of mainstream health care services. This article argues that these obstacles - primarily issues of accessibility and attitudinal barriers - might be addressed by linking primary health care services with existing NSP services. NSP staff could draw upon their relationships and skills to refer clients to linked health services.