Roy Jones Presentation - European ChemSex Forum 2016 Training Day

1.  At Code Clinic I complete an injecting triage form with
those seeking support.
 This covers substances being used, current injection
sites, problems such as lumps, bumps, infections,
BBV’s, access to needle exchange and who is doing
the injecting.
 If they are injecting themselves I get them to run
through the procedure with me. If others are injecting
them I show them the correct way it should be done.
Chemsex and Injecting

2.  Initially started smoking Methamphetamine but someone
offered to inject them and with their inhibitions reduced
they said yes. They move on to injecting themselves.
 Some patients use Methamphetamine and Mephedrone
together but generally they use one or the other.
 Mephedrone injectors may use more than twenty times in
a session resulting in rapid vein loss.
 Sessions may last for three days with poor intake of food
and fluids. Psychotic symptoms such as visual and auditory
hallucinations start to appear with severe paranoia.
Typical Presentation

3.  Age range is across the board from 17 to 60 with no
previous injecting history.
 They do not view it as problematic use initially and
therefore do not seek out mainstream drug services.
 They don’t have the years of education that heroin
and crack users have had around good injecting
practices resulting in poor technique and high risk of
BBV transmission and vein damage.

4. Needle Exchange Packs

5. Current Packs

6. 1ml syringes in glorious technicolor

7. Spoon with filter and magnetic mat

8. Pre Injection Swabs

9. 2ml syringes for measuring G

10. Bins for safe disposal of sharps

11.  Packs will vary from area to area in terms of content
and places of access.
 Main places for pick up are usually pharmacy based
needle exchanges and drug and alcohol services with
some areas having mobile vans or outreach workers.
 Do you know your local services so you can signpost
people to them?
Needle Exchange

12.  Wash hands and area to be injected with soap and water. Pre injections swabs if
this is not possible.
 Never share injecting equipment, spoons, water or filters.
 Always inject towards the heart at a 45 degree angle.
 Don’t touch the filter with your fingers so bacteria or blood get on it.
 If someone else is injecting you make sure you see the equipment come out of a
sealed packet.
 Never draw up from the same water or drug mix as other people.
 Do not boil Mephedrone.
 Have your own clean area away from others.
 Always use sterile or boiled water. Bottled water can contain bacteria.
Safer Injecting Tips

13.  Mephedrone and Methamphetamine irritate the lining of your veins so always
rotate injection sites.
 Always use a filter. The drugs may contain cutting agents and other impurities.
 Using needles more than once damages veins and makes them more likely to
collapse.
 Do not flush the syringe it can damage veins.
 Alcohol pre-injection swabs should only be used before injecting and never after.
 Do not backload syringes always use a filter.
 Never recap needles put them straight into the sharps bin especially if you are
injecting other people.
 Don’t share tourniquets or over tighten them.
Safer Injecting Tips

14. One use only

15.  Autoimmune vasculitis, where the immune system attacks your own
body. This would seem to account for some of the odd and infre-
quent side effects, such as bruising or turning blue at the joints.
Current reports suggest that this isn’t an issue of a dodgy supply for
some people compared with the rest, but rather a small percentage
of the population are at risk, probably because of some genetic dif-
ferences
 Cellulitis
 Phlebitis
 Ulcers
 Abscess
 DVT
 Endocarditis
Problems you may see

16.  Flucloxacillin
Adult: 500 mg, four times daily, for five to seven days.
 Ibuprofen tablets for general pain in the arms.
 Arnica Gel for bruising.
 Hirudoid Cream for phlebitis.
Useful Treatments

17. Hirudoid

18.  Slamming : Intravenous injecting
 Crystal dick : erectile dysfunction due to
Methamphetamine
 PNP: Party and Play
 HNH : High and Horny
 Booty Bump : taking a drug via the rectum
 Feel of the Steel : enjoying the process of injecting
Some terms to be aware of:

20. Roy Jones
Medical Team Leader
South Westminster Drug and Alcohol Service
Turning Point | 31 Wardour Street| London | W1D 6PT
T: 0207 851 2955 | M: 07974199005 | F: 020 7799 3553
Email: roy.jones@turning-point.co.uk
Contact Details