Commissioners should use pharmacies to ensure access to needle exchange programmes for young people and those injecting image- and performance-enhancing drugs, Nice has recommended.

Nice named pharmacy as an integral part of its draft guidance update on needle and syringe programmes, launched for consultation yesterday (September 24), which calls for them to be extended to under-16s. The plans mark a departure from existing guidance, published in 2009, which focused on over-18s.

The update also addresses growing use of performance- and image-enhancing injectable drugs such as steroids, Botox and tanning agents. Although use of opiates and crack cocaine is thought to be in decline, the home office estimates 70,000 16- to 59-year-olds in England and Wales have used anabolic steroids over the past year.

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	Pharmacies with suitably trained staff could provide young people with needles, syringes and injecting equipment, Nice said. It recommended that pharmacy teams offering needle exchange should be able to offer advice on performance- and image-enhancing drugs, the side effects and healthy lifestyle alternatives.

In its updated recommendations, Nice also called for out-of-hours vending machines for injectable equipment, but stressed that these should be an add-on rather than a cheaper alternative to staffed services.

Nice reiterated its call in the existing guidance for local commissioners to ensure pharmacy was part of local service provision. Services should be available around the clock, and pharmacies with extended opening hours should be encouraged to offer needle and syringe provision, it said.

It also reiterated recommendations for pharmacy staff to receive training to treat people in a non-stigmatising way and provide advice on a full range of drugs.

Professor Mike Kelly, director of the Nice centre for public health excellence, urged pharmacies to respond to the consultation. It will close on November 5 and Nice's public health committee will meet to discuss the feedback on November 22. Nice aims to finalise the updated guidance next year.