1. News From Needle Exchanges What the staff say John Campbell March 2009 ScottishdrugsForum

2. Overview SDF’s relationship with needle exchange SDF’s relationship with needle exchange Data sources Data sources Findings Findings Conclusions Conclusions ScottishdrugsForum

3. SDF’s Relationship with Needle Exchange Needle Exchange Workers’ Forum Needle Exchange Workers’ Forum Needle Exchange Guidelines Needle Exchange Guidelines Glasgow Steroid Working Group Glasgow Steroid Working Group BBV Prevention Groups BBV Prevention Groups SUI Survey SUI Survey Training Training ScottishdrugsForum

4. Data Sources Needle Exchange Workers’ Forum (horse’s mouth) Needle Exchange Workers’ Forum (horse’s mouth) Hard Data Hard Data SDF - Needle Exchange Workers’ Survey SDF - Needle Exchange Workers’ Survey ScottishdrugsForum

5. SDF – Survey Staff views sought Staff views sought Geographical coverage Geographical coverage Asked about injecting trends Asked about injecting trends ScottishdrugsForum

6. New Clients 52% noticed an increase in new clients 52% noticed an increase in new clients All (except 1) had new clients injecting heroin All (except 1) had new clients injecting heroin Most had new clients injecting steroids Most had new clients injecting steroids Half had clients injecting cocaine/crack Half had clients injecting cocaine/crack First reports of injectable tan! First reports of injectable tan! ScottishdrugsForum

7. Melanotan 2 Melanotan is a hormone that stimulates melanin production Melanotan is a hormone that stimulates melanin production Other reported benefits: Other reported benefits: weight loss weight loss increased libido increased libido healthy spot free skin healthy spot free skin ScottishdrugsForum

8. Hard Data GDCC - Steroids ScottishdrugsForum

10. Existing Clients All have clients injecting heroin All have clients injecting heroin More than half have clients injecting: More than half have clients injecting: Steroids Steroids Cocaine or crack Cocaine or crack Amphetamines Amphetamines ScottishdrugsForum

11. Poly- Drug Use Most reported increase in combined use of: Most reported increase in combined use of: Heroin Heroin Alcohol (described as huge and massive) Alcohol (described as huge and massive) Cocaine and crack Cocaine and crack Benzodiazepines Benzodiazepines Methadone Methadone ScottishdrugsForum

12. Changes in Preparation of Drugs “Speed-balling” – but not new in every area “Speed-balling” – but not new in every area Crack needs to be Crack needs to be cold prepared cold prepared do clients know this? do clients know this? Proper use of citric? Proper use of citric?

13. Changes in Injecting Behaviour “More people groin and neck” “More people groin and neck” “increase in femoral injecting” “increase in femoral injecting” “many more groin injectors than at any time over last 9 years” “many more groin injectors than at any time over last 9 years” “cyclizine injecting” “cyclizine injecting” “methamphetamine becoming more popular especially when a dry up of heroin” “methamphetamine becoming more popular especially when a dry up of heroin” ScottishdrugsForum

14. Changes in the Choice of Injecting Sites femoral injecting- choice or necessity? femoral injecting- choice or necessity? Some reported neck injecting Some reported neck injecting Feet and legs also used Feet and legs also used ScottishdrugsForum

15. Femoral injecting numbers? 15,000 injectors 15,000 injectors 1/3 rd using the femoral vein = 5,000 1/3 rd using the femoral vein = 5,000 Injects 3 times per day =15,000 Injects 3 times per day =15,000 Per week =105,000 Per week =105,000 Per year =5,460,0000 Per year =5,460,0000 ScottishdrugsForum

16. Changes in Injecting Injuries Nearly half reported increases in…….. Nearly half reported increases in…….. ScottishdrugsForum

17. Sharing Needles Only 1 respondent noticed an increase in sharing - PRISON Only 1 respondent noticed an increase in sharing - PRISON ScottishdrugsForum

18. Sharing Paraphernalia Only one respondent reported increase in sharing of spoons, filters and citric. Only one respondent reported increase in sharing of spoons, filters and citric. The paraphernalia given out from this area does not include the above! The paraphernalia given out from this area does not include the above! ScottishdrugsForum

19. Paraphernalia Given and Asked for Increase in long blue Needles Increase in long blue Needles Increase in green needles and (2ml) barrels Increase in green needles and (2ml) barrels Regional paraphernalia variations (2 respondents sell citric to clients) Regional paraphernalia variations (2 respondents sell citric to clients) Clients asking for a full range of paraphernalia Clients asking for a full range of paraphernalia ScottishdrugsForum

20. Summary Increase in steroid and other performance enhancing drugs Increase in steroid and other performance enhancing drugs Increase in cocaine/crack injecting Increase in cocaine/crack injecting Increase in poly drug use (especially alcohol) Increase in poly drug use (especially alcohol) Increase in high risk injecting sites Increase in high risk injecting sites Increase in injecting injuries Increase in injecting injuries Decrease in sharing Decrease in sharing ScottishdrugsForum

21. Average NXC client? If we have no such thing as an average needle exchange 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. We should ensure we have no such thing as an average needle exchange service. ScottishdrugsForum