Harm reduction is a set of practical strategies and ideas aimed at reducing the harms from using drugs. Harms include but are not limited to:
transmission of blood borne viruses
damage to veins and circulation
Harm reduction strategies include promotion of safer drug use such as alternatives to injecting and provision of clean equipment.
Harm Reduction Services
Harm reduction services recognise that management and reduction of drug-related harm is a more feasible option than efforts to eliminate drug use entirely. In Tayside we have a range of harm reduction services available including a specialist nursing team, access to opiate substitution therapy (OST) through Substance Misuse Services and Injecting Equipment Provision (IEP) also known as needle exchange.
Tayside Harm Reduction/BBV Nursing Service provides specialist nursing input and support to people who inject drugs
(PWID) across Tayside.
The team are based in The Cairn Centre, Dundee but deliver clinics across Dundee, Angus and Perth and Kinross.
The service plays an integral role in reducing the harms associated with injecting drug use for people. The aims of the specialist service are to:
Reduce and prevent blood borne virus (Hepatitis C, Hepatitis B and HIV) transmission
Reduce injecting site infections and treat injecting wounds
Reduce hospital admissions related to ulcerated wounds
Support individuals into BBV and drug treatment
Reduce drug related deaths and near fatal overdose
The specialist nurses undertake assessments of individuals’ risk, advise on safer injecting techniques, discuss alternatives to injecting, provide overdose awareness training to staff and clients and provide naloxone. They also provide screening for sexually transmitted infection and pregnancy testing, emergency hormonal contraception, hepatitis B vaccination, antibiotic prescribing and assessment for hepatitis C treatment.
Injecting Equipment Provision (IEP) provides people who inject drugs with; clean needles, syringes and other injection paraphernalia such as water and citric acid. These services were previously known as Needle Exchanges.
There are a number of health risks associated with injecting drug use:
collapsed veins (injecting with a blunt needle, over use of injecting sites)
increased risk of getting a blood-borne virus (BBV), particularly Hepatitis C.
For many injectors, engagement with an IEP service is a first step towards recovery.
IEP services can be found across Tayside. Look for the symbol below in the window.
If you or the person has naloxone, you can give them this to buy time until the Emergency Services arrive.
What is Naloxone?
Naloxone is an opioid antagonist; a drug which can temporarily reverse the effects of a potentially fatal overdose involving opioid drugs such as heroin, morphine or methadone.
Why is it important?
Intramuscular injection of naloxone is a first aid emergency response to overdose and provides more time for emergency services to attend and medical care to be given. Supplies of ‘take home’ naloxone (THN) kits are made, along with training on overdose awareness, to people at risk of opioid overdose in order to reduce the risk of death.
In an emergency ANYONE can legally administer Naloxone to save a life.
However, to supply the naloxone (supplying in advance when there is no emergency but this person is at risk of an opiate overdose) you must attend Naloxone T4T (training for trainers) training programme and also be an approved supplier. Approved suppliers can include nurses, pharmacists and staff working in third sector (Gowrie Care and Addaction).
Please note that ANY staff member can train someone on the signs of overdose and how to use naloxone after they have attended the Naloxone T4T training, however, currently in Tayside only certain staff can supply naloxone.
Naloxone counteracts opiates for around 20-30 minutes
It does not rid the body of opiates
It has no effect on alcohol
It does not reverse the effect of non opiate drugs, although they can contribute to overdose in combination with an opiate
It will buy time until an ambulance arrives
Contact Information For further information please contact
Pauline Cunningham Administrator – Harm Reduction/BBV Team (For paperwork, Naloxone kits, to book training)
“Legal Highs” as they used to be called, are now covered by The Psychoactive Substances Act. It was introduced in the UK on the 26th May 2016 and it makes it an offence to manufacture, export/import.
Under the new regulations, possession with intent to supply is an offence. Possession is not an offence, except in a ‘custodial institution’.
Injecting carries the risk of Blood Borne Viruses such as HIV and Hepatitis C, risk of vein damage and overdose. Snorting of these drugs is likely to be less risky but still may expose to BBVs and corrosive damage.
HARM REDUCTION ADVICE
Use clean needles for every new injection and never share!!!
Dispose of needles and other equipment safely following use
Make smaller joints/lines/bongs
The purity and strength of legal highs can vary from what you are used to, start with a smaller dose
Avoid mixing drugs as this can greatly increase the chances of cardiac arrest and overdose.
Extensive information on “lived experiences” of substance use.
IPEDs are substances that are taken by people with the intention of improving their physical appearance and/or to enhance their sporting performance. For the most part body image, physical strength and size is the main motivation to use IPEDs. IPEDs can be taken by injection or orally (swallowed).
Risks are particularly high for young people. If IPEDs are taken while a person is still growing they can cause a number of serious problems included stunted growth.
If a person is injecting they also carry the risk of transmission of HIV and other blood borne viruses (BBVs) such as Hepatitis B and C. Injecting can also cause muscle damage, scarring and infections at the site of injection.
Anabolic steroids and other similar IPEDs are now considered Class C in the Misuse of Drugs Act 1971.
Before taking steroids, people should consider the alternatives such as:
a better, healthy diet
protein and vitamin supplements
If you are planning to inject, please visit the harm reduction team to ensure you have enough clean equipment for your cycle.
Edinburgh based, training and support organisation
Chemsex refers to the use of any combination of drugs that includes crystal methamphetamine, mephedrone and/or GHB/GBL by men who have sex with men (MSM) before or during sex.
Although drugs and alcohol have often been used in sexual contexts throughout history, crystal methamphetamine, mephedrone and GHB/GBL provide a particular sexually-disinhibiting “high”, which represents a different public health concern than that associated with other drugs more commonly used in the past.
Their use has been accompanied by higher-risk sexual activity than has ever been observed or associated with any other kind of drug use. Users of these drugs can feel invulnerable to harm, supremely confident, dismissive of consequences, sexually adventurous, experience a heightened sense of pleasure, and can possess a stamina and endurance that may keep them awake for many days. When used in sexual contexts, this can translate into a reduced concern for safer sex practices and contact with a higher number of partners during a short, concentrated period of time. Unwanted side effects while under the influence can include aggression, paranoia, hallucinations/perceptions of persecution, overdose and more.
Chems use is relatively low in Scotland however the risks and harms from using chems can be significant particularly if crystal methamphetamine and mephedrone are injected (known as “slamming”). If you are injecting, please visit one of our IEP sites to collect clean equipment.
If you are involved in chemsex, it is important that you know how to keep you and your partners as safe as possible. Come along to MOT or sexual health clinic for more information.
Understanding Chemsex by THT gives practical advice about safer drug taking, and how to lower the chance of sexual health risks when mixing drugs and sex.
More information on drugs and sex can be found on THTs Friday/Monday website.