What do you do when someone come into an NSP who isn’t injecting drugs, this week I’d like to talk a bit about someone I recently saw who has a different reason for injecting.

This person was slightly different, the woman coming into the NSP was someone who had stopped using heroin a while ago, and she wanted the needles and citric acid but not to inject drugs with.

Why?

We had a quite long chat it seems that she used injecting itself as a coping strategy for stress. She’d have a build up of feelings and emotions that would previously have lead to heroin use, but now she just injected water and citric acid, very much in the way someone with a history of self injury uses small cuts to relive stress.

We discussed what aspects of this made it help, she told me that it wasn’t really the ‘feeling’ of the injection as I would have expected but more the way it looked. Her partner (who was now also no longer using
drugs) kept encouraging her to attend a Narcotics Anonymous meeting but she didn’t like the way these worked and found they just increased her stress levels.

Other strategies

We looked at different ways this she could cope using more appropriate methods, it seems that she used to be very good at art but said that she now has no patience to draw full pictures. I talked to her about the fact that even just a few lines on a page with some colour might help (there is an old technique for working with self injury where people draw the intended wounds rather than make them).

I did talk to her about the extra risk she was adding by using an unneeded acidifier and tried to encourage her to just inject water if she felt a continued need. We also discussed using boiled water from a cold tap and allowing it to cool (our project doesn’t currently have access to water in amp form).

Self injury

She appeared to be very stable as far as her mental health is concerned, and I felt at the time that their use of injecting as a coping strategy did have some risks, both because of the injection itself and because it kept them ‘skilled’ at injecting which makes a possible relapse easier. But I do feel that this may be the most appropriate coping skill they currently had to deal with stresses and that by doing this they probably avoided doing themselves more harm either by relapsing or worse.