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
injecting wounds
bacterial infections
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 understand that the reduction of drug-related harm is a more achievable option than trying 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 Injection 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 at South Ward Road, 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.Ā The aims of the specialist service are to:
Reduce and prevent blood borne virus (Hepatitis C, Hepatitis B and HIV) transmission
Reduce injection site infections and treat injection 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 individualsā risk, advise on safer injecting techniques, discuss alternatives to injecting, provide overdose awareness training to staff and clients and provide naloxone.Ā 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.
The team can be contacted on 01382 632001 (voicemail checked regularly)
Please have a look at ourĀ Service Finder list for more info.
Dundee Recovery Road Map is a social platform that brings the Dundee community together. It provides signposting to useful local services for mental health support, food provision, addiction and recovery support, harm reduction, health and wellbeing, rehabilitation, peer support, as well as family and carer support.
The app makes every service accessible for every person. Download for free to access all features including service listings (with directions, opening times, and contact details), as well as upcoming events in the local area. Click here toĀ download the app to an Apple device or here for android.Ā
Injecting Equipment Provision (IEP)
Injection Equipment Provision (IEP) provides people who inject drugs with; clean needles, syringes and other injection paraphernalia such as water and acidifier (citric/vit C or ascorbic acid). These services were previously known as Needle Exchanges.
There are a number of health risks associated with injecting drug use:
abscesses
cellulitis
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 take drugs by injecting them, you are more vulnerable to injuries, infections and blood borne viruses. Itās also easier to overdose from an injection.
Using a needle can cause abscesses, ulcers and damage to your veins. Using a contaminated needle can also pass on viruses like hepatitis and HIV.
If you notice an injection site that is bleeding, changing colour, weeping, or is swollen or painful for more than a few days, please speak to a doctor or medical professional as soon as you can.
Safer Injecting Advice for Opiates
Wash hands & injection site
Always use clean/new equipment
Never share any equipment including spoons, filters and water
Work from a clean surface to prepare your hit
Ensure you are using the right needle in the right place
Rotate your injection sites
ALWAYS INJECT TOWARDS YOUR HEART (up the way)
Do NOT inject if you can feel a pulse
Dispose of equipment in sharps bins and return to your IEP service
There are a number of useful short films produced by Harm Reduction Works that can be found on their You Tube channel
There are a number of alternatives to injecting that the harm reduction team can discuss. These include:
Smoking heroin
Snorting
Up yer bum!
You can access our Safer Injecting leaflet here, to find out about safer injecting sites and needle sizes.
Signs of Overdose
Pinpoint pupils
Pallor (pale skin colour)
Cyanosis (blue tinge to lips, finger nails)
Breathing problems e.g. slow/shallow breaths, not breathing
Snoring deeply – this is often and understandably mistaken for sleeping
Unconsciousness
Overdose can be described as a process and therefore it is important to be aware that the effects can kick-in hours after the initial hit.
What to do
Useful life-saving action you could take if you think someone has overdosed:
If casualty is breathing normally:
Put in recovery position – see images below
Dial 999
Stay with them and monitor their condition until help arrives
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.Ā
There are two options for Take Home Naloxone in Tayside
Prenoxad āĀ an intramuscular preparation (syringe contains five doses)
Nyxoid āĀ a nasal spray (pack contains two single use nasal sprays)
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 ātake homeā 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.Ā
Legal bits
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.
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.
Ā Key Points
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
April Anderson Administrator ā Harm Reduction/BBV Team (For paperwork, Naloxone kits, to book training)
On completion of the eLearning a certificate will be emailed to you. Ā A copy of this certificate must be retained by the service as evidence of training.Ā A copy must also be emailed to the Tayside Naloxone Programme
Local training is also a requirement.Ā Watch the Tayside Naloxone Programme training video below to provide local context and recording requirements.
If you need any further information please contact us
“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 ācustodial institutionā.
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.Ā For the most part body image, physical strength and size is the main motivation to use IPEDs.Ā IPEDs can be taken by injection or orally (swallowed).
Risks are particularly high for young people.Ā 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.Ā 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.Ā
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 āhighā, 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 āslammingā). 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.
Postal IEP Service for Tayside Residents
The service is only available for people who live in Tayside and are over 18. Unfortunately we can only provide packs to the following postcodes:
DD1 ā DD11
PH1 ā PH18
KY4 ā KY6
KY13
Call us onĀ 01382 200 532, 10am-4pm, Monday to Friday, to discuss your needs and we will send equipment to your home. Alternatively you can use the order form below.
Orders can be sent as a one-off order, or you can set up a standing order to arrange a regular delivery pattern ā weekly, fortnightly or monthly.
The following packs are available to order:
10 pack: 10 1ml fixed, 10 citric, 10 water, 10 spoons, 10 wipes, 1 x 0.2 bin, 20 sheets of foil, small 5 pack of foil, Harm Reduction Leaflet, Recovery contacts leaflet, How to use Naloxone leaflet.
20 blue pack: 10 long blue, 10 short blue, 20 1ml syringes, 20 citric, 20 water, 20 spoons, 20 wipes, 1 x 0.2 bin, 40 sheets of foil, small 5 pack of foil, Harm Reduction Leaflet, Recovery contacts leaflet, How to use Naloxone leaflet.
20 orange pack:10 long orange, 10 short orange, 20 1ml syringes, 20 citric, 20 water, 20 spoons, 20 wipes, 1 x 0.2 bin, 40 sheets of foil, small 5 pack of foil, Harm Reduction Leaflet, Recovery contacts leaflet, How to use Naloxone leaflet.
50 pack:Ā 10 long blue, 10 short blue, 10 long orange, 10 short orange, 10 1ml fixed, 40 1ml syringes, 50 water, 50 spoons, 50 wipes, 50 citric, 2 x 0.6 bins, 60 sheets foil, 2 x small 5 pack of foil. Harm Reduction Leaflet, Recovery contacts leaflet, How to use Naloxone leaflet.
IPED pack ā 30 short blue, 30 long blue, 30 2ml barrels, 30 swabs, 1 x 0.6 Bin, Steroids Leaflet
50 kits is the maximum amount we can process in one order, however there is no limit on the number of orders you can place.
Please note, needle heads can be customised, e.g. a 50 pack can contain 50 long blue, 50 1ml syringes and 50 paraphernalia, just let us know in the ‘Extra Information’ box below.
Please note this is a confidential service but we do record your name and address on our system to allow us to post your order. All information is held securely. Please see the GDPR statement below for more information.
There will be no information on the packages that will identify the contents. Sender details (required by Royal Mail), will state: 4 South Ward Road, Dundee DD1 1PN.
Naloxone
Please note we are unable to offer supplies of Naloxone for online ordering, if you need a supply of Naloxone, you must call us on 01382 200 532.
If you are interested in finding out more information on preventing overdose and how to give naloxone,Ā Scottish Drugs ForumĀ has created a short e-learning courses on opiate overdose prevention, intervention and naloxone.Ā We recommend to anybody who would like a naloxone kit, to complete this online training before using naloxone.
GDPR Statement: Your data is held for use by the Postal IEP Service only.Ā We will not contact you for any other reason but we may from time to time include some health promotion material in your order or invite you to provide anonymous feedback on the service. Your email address will be stored to save you from having to provide your full details for every order.Ā We may confirm receipt and advise when orders are on route via email.Ā Your email address will not be used for the communication of personal data and we will never share any data. You can ask to have your details removed from this service at any time by email to tay.bbvmcn@nhs.scotĀ Please note we can only register one user per email address.
More Information
For more information, resources and advice see our Harm Reduction Resources Pages here
