Harm Reduction

Injecting Equipment Provision (IEP)

High quality and high coverage IEP is at the forefront of reducing blood borne viruses, skin and soft tissue infections and painful injections in the UK

Injecting Equipment Provision (IEP)

High quality and high coverage IEP is at the forefront of reducing blood borne viruses, skin and soft tissue infections and painful injections in the UK. Therefore part of our core harm reduction service delivery is the provision of the best possible injecting equipment we can. We supply this to individuals such as people who inject drugs (PWID) and to community pharmacies who supply this equipment onward to PWID on our behalf.

Training

Anyone in Cranstoun who supplies injecting equipment or community pharmacies doing so on our behalf receives in-depth training on this equipment and its optimal use. This vital aspect means that the risks associated with injecting are driven down, as those using the equipment know how to use it in ways that minimise risk. We are realistic however; injecting often occurs in far from ideal and sanitary environments, amidst unpleasant withdrawal symptoms and the fear of being discovered. Therefore our training takes this into account, enabling real world choices to be identified.

Equipment

As standard we provide foil for smoking heroin, 1ml fixed-needle syringes and 2ml syringes with detachable needles in a range of lengths and gauges. Additionally we offer acidifiers, ‘cookers, water for injection, filters and more.

We have recently added to the range of injecting equipment we make available to PWID. These are a greater range of needle choices to suit injecting into different veins and veins which are deteriorating. We always encourage the finest and shortest possible needle for the intended injection, and using a new needle for each time the skin is punctured. These micro-behaviours, repeated over time, have a long term beneficial impact on the health of the people we serve.

Sharing

Sharing of previously used injecting equipment including syringes is rising in the UK according to the most recent Shooting Up report (figure 7). Direct sharing of needles and syringes has increased among PWID from 20% in 2019 to 24% in 2020, and of sharing any injecting equipment from 37% in 2019 to 43% in 2020.

The impact of Covid-19 on IEP may well have been a driver for this worrying increase in sharing. Irrespective of causation it tells us that we must do better to provide enough injecting equipment for everyone who injects drugs for every single time they puncture skin with a needle.

Dead space

Dead space is the volume of liquid residue left after a syringe has been used for injecting. For venous injecting there will always be an amount of blood left in that dead space. If the syringe or needle is reused by another there is a significant risk of blood borne virus (BBV) transmission, depending on many factors such as whether the original user flushed blood back and forth into the syringe after injecting, where the syringe was stored and how long ago it was last used.

However the risk of BBV transmission is also determined by the type of syringe and needle used. The amount of dead space in 1ml syringes is naturally low, however standard 2ml syringes and their accompanying needles have much higher dead space. New syringes and needles with reduced or low dead space are now available. Cranstoun are pleased to provide the best combinations of 2ml syringes and needles, with the lowest dead space possible.

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