I’ve got a bit of a bee in my bonnet at the moment (for any of you that have met me, I’m sure that mental image is a great one). This happens a lot, I get very focused on one area of advice and hammer it home in everyone I see. This week it’s convincing people to take enough needles, and making sure they have spare.
Anyone who has worked in a good NSP (needle and syringe programme) knows the score, its Friday afternoon and people are coming in and only asking for 5 or 10 needles:
“Are you sure that’s enough? Tomorrows the weekend.”
“Ohh yeah… give us another twenty then.”
I’ve always been of the opinion that every NSP worker should take the time to work out with people how much kit they need, as most people who inject tend to underestimate their needs. This should include discussing how many times the person injects and how many times they miss or get a blocked pin. But working out minimum need alone isn’t enough.
Problems of reuse
Once a needle has been used for injecting it will have bacteria growing, and as I’m very fond of mentioning to people this kind of bacteria could double about every 20 minutes at room temperature (and how many people keep their used kit in the fridge).
So even injecting with your own used needle will greatly increase the chances of developing an abscess.
What we need is for people to ALWAYS have a sterile needle. That means allowing for:
- Giving needles to friends
- Bent needles
- Blocked needles
- Dropped needles (which shouldn’t be used)
- The NSP being unexpectedly shut
- Illness preventing you getting out to the NSP
One solution, and this is the one I’m currently pushing at work, is for people to take a number of ‘emergency kits’. These should contain everything someone needs for at least 2 days injecting. Spoons, needles, barrels, acids, filters, swabs and if you have it water.
I’m currently getting everyone to take spare kit and stow it away on a cupboard or somewhere else safe and out of the way. I think it’s important that this is kept away from their normal needle stores to prevent it being just used as standard, emphasis should be put on the emergency aspect of this ‘pack’. I’m even considering the idea of printing small bags or stickers with ‘To be used in emergency’.
There’s a great website for generating your own warning labels, and I’ve used it to make the label shown here which you are of course free to download and use on any pack you might put together.
I think this is an important aspect of work and that all NSP workers should do their best to encourage injectors to take spare kit, and for any injectors reading this ask yourself. “If I’m too ill to get to the NSP this week have I got enough kit to get me though?”