Transcript Break The Cycle (Preventing initiation into injecting

Break The Cycle
(Preventing initiation into injecting)
brief interventions
Simon Pringle
Drugs Action
Aberdeen
e-mail [email protected]
into practice.
Integrating
Introduction to Drugs Action (DA) services
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Drugs Action is the leading Independent
Specialist Drugs Service in the North East of
Scotland.
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Services include Needle Exchange in the
City Centre of Aberdeen and the following
locations throughout the City; Seaton,
Northfield, Woodside, Mastrick, Middlefield,
Harbour outreach, Quay Services Drop-in.
Drugs Action (DA) services (cont)
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Telephone Helpline
Counselling Service
Needle Exchange
Family Services
Pregnancy / Post Natal Service
Quay Services – Women involved in prostitution
Incite Stimulant Users Project
City Outreach Service
HIV/Hepatitis Service
Training Consultancy
Drugs Action (DA) Needle Exchange (statistics)
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The period from April ’07 – Feb ‘08 there
were an average of 461 individuals using
Drugs Action Needle Exchange services
each month.
DA Needle Exchange statistics (cont)
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There were a total of 7971 visits.
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There were 547 new clients over this period
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270,967 needles were given out.
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205,559 needles were returned. (76% return
rate)
Background to Break The Cycle project
Report by Neil Hunt, Gary Sidwell et-al
“Evaluation of a brief intervention to prevent
initiation into injecting” (1998) identified that
when initiation was raised with participants
the following was reported;
Background (cont)
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Disapproval of initiating non-injectors
significantly increased.
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Numbers of participants injecting in front of
non-injectors fell.
Background (cont)
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Numbers of participants talking about
injecting in front of non-injectors fell.
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The numbers of those initiated also fell.
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It was also apparent from the paper’s results
that the topic wasn’t routinely raised with
injecting drug users.*
Funding of Project
Funding has been secured from NHS
Grampian’s Hepatitis C Action Plan Budget to
pay for a half –time dedicated Drugs Worker
over 2 years to help implement Break The
Cycle as an intervention.
Methodology
Using the evidence from the paper by Hunt
et-al it was decided to design an intervention
that could be used in everyday practice with
IDU’s.
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The initial target group was every new IDU
that attends one of Drugs Action’s services
(Nov/Dec).
Methodology (cont)
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This has been now been rolled out to include
all conversations with current Needle
Exchange users, 1:1 IDU clients, Quay
Services (Jan – present).
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Groups included Prison Pre-release, Criminal
Justice Social Work, Service User Groups
Aims and Objectives of intervention
It was decided to use short questionnaires with
injecting drug users in order to;
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Raise awareness of issues around initiation with
injecting users, to
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Discuss how best to manage initiation requests
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Increase competence
Aims & Objectives (cont)
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Raise awareness of risks to initiated and
initiator.
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Reinforce the idea that talking about and
injecting in front of non-injectors can
‘condition’.
How is this achieved?
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Use of existing materials (Break The Cycle cards,
tear off strips).
Use of questionnaires as a harm reduction tool.
Practical interventions (dedicated worker available
to discuss alternatives to injecting. Including foil pipe
making – from Exchange Supplies website, UYB,
chasing techniques, risks of injecting, risks of
initiating others.
Target Groups
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Break The Cycle is raised with all new
Needle Exchange service users during the
assessment screening process.
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Break The Cycle is now raised with all
injecting drug users.
Target Groups (cont)
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Break The Cycle is primarily aimed at the
following groups:
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Transition prevention
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Reverse transition
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Positive transition
Number of Males and Females completing questionnaires
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Males – 88
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Females - 27
Respondents who reported they had given someone else
their first hit
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6 people reported giving one person, 3 reported
giving two people, 1 reported giving three
different people their first hits and 2 reported
giving four different people their first hit.
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(12 people in total)
Respondents that reported that they hadn’t given a first hit
or didn’t know
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55 people responded that they had never
given anyone their first hit.
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48 people responded that they didn’t know if
they had or not.
Injected in front of
a non-injector
Seen someone
inject before 1st hit
No
Yes
Heard someone
speak about
injecting before 1st
hit
0
10
20
30
40
50
60
70
Identified risks to the new injector
Total Number
Other
Stigma
Other infections
Dependency
Total Number
Injecting injuries
BBV's
Overdose
0
10
20
30
40
50
60
Identified risks to initiator
Total numbers
Other
Stigma
Risk of assault
Guilt
Total numbers
Prosecution
Criticism from family and friends
Criticism from peers
Overdose
0
10
20
30
40
50
60
Main reasons for having 1st hit
1.
2.
Economic.
Relationships with others already using
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3.
4.
Family
Friends
Wanted to experience ‘rush’/ heard it was a
good experience.
Curiosity.
Break the Cycle The Questionnaire
Future?
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Target ‘Hard to reach’ groups (non injectors,
recreational users, under 16’s etc)
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More interventions on managing initiation requests
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To make the interventions part of everyday practice
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Follow up questionnaires to enable evaluations and
influence future BTC interventions
Any Questions?