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News From Needle Exchanges What the staff say John Campbell March 2009 ScottishdrugsForum Overview • SDF’s relationship with needle exchange • Data sources • Findings • Conclusions ScottishdrugsForum SDF’s Relationship with Needle Exchange • Needle Exchange Workers’ Forum • Needle Exchange Guidelines • Glasgow Steroid Working Group • BBV Prevention Groups • SUI Survey • Training ScottishdrugsForum Data Sources • Needle Exchange Workers’ Forum (horse’s mouth) • Hard Data • SDF - Needle Exchange Workers’ Survey ScottishdrugsForum SDF – Survey • Staff views sought • Geographical coverage • Asked about injecting trends ScottishdrugsForum New Clients • 52% noticed an increase in new clients • All (except 1) had new clients injecting heroin • Most had new clients injecting steroids • Half had clients injecting cocaine/crack • First reports of injectable tan! ScottishdrugsForum Melanotan 2 • Melanotan is a hormone that stimulates melanin production • Other reported benefits: weight loss increased libido healthy spot free skin ScottishdrugsForum Hard Data GDCC - Steroids Steroid Comparison - 4 Years 04/05 05/06 06/07 07/08 65% 60% 55% 50% Percentage 45% 40% 35% 30% 25% 20% 15% 10% 5% 0% New Steroid User Steroid Needles Issued Total Steroid User Visits Details ScottishdrugsForum ScottishdrugsForum Existing Clients • All have clients injecting heroin • More than half have clients injecting: Steroids Cocaine or crack Amphetamines ScottishdrugsForum Poly- Drug Use • Most reported increase in combined use of: Heroin Alcohol (described as huge and massive) Cocaine and crack Benzodiazepines Methadone ScottishdrugsForum Changes in Preparation of Drugs • “Speed-balling” – but not new in every area • Crack needs to be cold prepared do clients know this? • Proper use of citric? Changes in Injecting Behaviour • “More people groin and neck” • “increase in femoral injecting” • “many more groin injectors than at any time over last 9 years” • “cyclizine injecting” • “methamphetamine becoming more popular especially when a dry up of heroin” ScottishdrugsForum Changes in the Choice of Injecting Sites • femoral injecting-choice or necessity? • Some reported neck injecting • Feet and legs also used ScottishdrugsForum Femoral injecting numbers? • 15,000 injectors • 1/3rd using the femoral vein = 5,000 • Injects 3 times per day =15,000 • Per week =105,000 • Per year =5,460,0000 ScottishdrugsForum Changes in Injecting Injuries • Nearly half reported increases in…….. ScottishdrugsForum Sharing Needles • Only 1 respondent noticed an increase in sharing - PRISON ScottishdrugsForum Sharing Paraphernalia • Only one respondent reported increase in sharing of spoons, filters and citric. • The paraphernalia given out from this area does not include the above! ScottishdrugsForum Paraphernalia Given and Asked for • Increase in long blue Needles • Increase in green needles and (2ml) barrels • Regional paraphernalia variations (2 respondents sell citric to clients) • Clients asking for a full range of paraphernalia ScottishdrugsForum Summary • Increase in steroid and other performance enhancing drugs • Increase in cocaine/crack injecting • Increase in poly drug use (especially alcohol) • Increase in high risk injecting sites • Increase in injecting injuries • Decrease in sharing ScottishdrugsForum Average NXC client? • If we have no such thing as an average needle exchange client. • We should ensure we have no such thing as an average needle exchange service. ScottishdrugsForum