Drug Misuse - Harm Reduction

Question 1

What are the risks of injecting of heroin?

Answer 1

• Physical dependence leading to crime
• Overdose
• HIV infection
• Hepatitis Infection
• Bacterial Infection
• Damaged Veins

Question 2

What do we need to accept about drug misusers and how do we give it to drug misusers?

Answer 2

ACCEPT that a proportion of people will continue to inject drugs + help them do so as safely as possible.

Should be:

• In language that can be understood by the drug misusers
• Achievable for drug misusers

Should NOT be:

• biased
• designed to ‘scare’

Question 3

What 3 areas should be covered when giving advice to drug misusers?

Answer 3

1. Preparation of drugs for injection
   - Do wash your hands, use sterile equipment etc.
   - Don’t use more than 1 drug, or crush tablets etc.
2. Advice on injecting sites
   - Avoid femoral vein or veins in neck, penis, or breast.
3. Advice on injecting technique
   - Don’t share equipment
   - Use smallest needle, use tourniquet, inject towards heart

Question 4

How can we reduce the harm associated with injecting?

Answer 4

1. Provide education on safe injecting
2. Provide + supply sterile injecting equipment
3. Provide clean/sterile paraphernalia
4. Accept the return of used injecting equipment for safe disposal

Question 5

What is the 4-tiered system for treatment issues by the dept. of health?

Answer 5

Tier 1: General Services
- General health, housing etc.
Tier 2: Open Access Services
- Advice + Info
- Harm reduction
Tier 3: Community Services
- Community Prescribing
Tier 4: Specialist Services
- Inpatient and residential rehabilitation

Question 6

What agencies are available to support drug users?

Answer 6

Sterile injecting equipment service

• Can provide to drug misusers + some paraphernalia like cookers, citric acid etc
• ENHANCED level community pharmacy contract

Manchester City Council
- Health and Wellbeing Board:
Alcohol, Drug and substance abuse (NHS services, community pharmacy needle exchange, CGL, Manchester Integrated drug and alcohol service)