NPS use in Lothian. Linda J Smith BBV Prevention Worker (RN/RMHN) Harm Reduction Team
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1 NPS use in Lothian Linda J Smith BBV Prevention Worker (RN/RMHN) Harm Reduction Team
2 The Lothian Issue Increased number of clients injecting NPS: over 10% of all IEP transactions but could be higher Lack of awareness of NPS amongst service users, professionals and challenge to services Increased number of publicly discarded works and public injecting. Increased media attention Drug related deaths Infections and related illnesses
3 Burst Most commonly reported injected NPS in Lothian Reported to contain pure Ethylphenidate Clients report this substance as being empathogenic and psychedelic in effect Clients report of an initial rush Severe comedown
4
5 Reasons for using NPS Self medicate Trauma-previous or present Curiosity Circumstances Friends using them Take away opiate withdrawal
6 other 6 0 Drug use Drugs used Current number Prior to NPS use using Legal High / NPS stimulant 49 n/a Legal High / NPS Non-stimulant 8 n/a Heroin Speed 7 34 Cocaine 6 38 Crack 9 36 Weed Benzodiazepines Alcohol Methadone Methamphetamine / Crystal meth 1 11 GBL 0 9 Ketamine 1 15 Prescription Drugs Someone-else s prescription drugs 5 17
7 What service users say I m here for a good time not a long time If its legal it can t hurt me Taking more risks than ever with heroin Best drug ever taken Initial rush so intense felt like I was going to drop down dead or faint Side effects horrific. Friend doing 10 years after stabbing someone
8 Temporary Class Drug Order 10th April 2015 ethylphenidate was placed under a Temporary Class Drug Order making it illegal to sell or distribute.
9 Test for Change Data collection to identify nature and extent of the challenge of NPS injecting. Face to face questionnaire Service user presentations. Treatment and recovery options. 12 week period
10 IMPACT Can be life changing Homeless Physical health issues (short and long term impact) Mental health issues Increased risky behaviours Society
11 Total Transactions May-July 2014 May-July 2015 Jan-March 2016 Leith Walk Newington NEON Musselburgh Exchange Lady Lawson Street
12 Heroin and NPS Transactions Leith Walk Newington NEON Musselburgh Exchange Lady Lawson Street 0 May-July 2014 Heroin May-July 2014 NPS May-July 2015 Heroin May-July 2015 NPS Jan-March 2016 Heroin Jan-March 2016 NPS
13 Syringes and Barrels Supplied May-July 2014 May-July 2015 Jan-March 2016 Leith Walk Newington NEON Musselburgh Exchange Lady Lawson Street
14 Physical effects Physical effects weight loss (27) wounds (19) cardiac symptoms (16) septicaemia (9) abcess (9) infection (18) DVT (6)
15 INFECTIONS/INJURIES Streptococcus Pyogenes infection Cellulitis Abcesses Joint infection Ischaemic limb Amputation Sepsis Staphylococcal infections Cellulitis Abcesses Sepsis Endocarditis DVT HDU/ITU admission Death
16 Psychological effects Psychological effects paranoia (58) hallucinations (28) insomnia (29) anxiety (12) psychosis (9) delusions (9) depression (6) aggression (3) suicidal thoughts (2)
17 Injecting Issues Highly irritant and corrosive damaging to veins and surrounding tissues 2-3 injections per site Extremely easy to miss the vein Large wounds at injecting sites Cooking up may solidify the substance Bingeing Snowballing
18 BEHAVIOURS Injecting frequency Injecting locations Injecting sites Sharing Hygiene BBV
19 Where are service users at now? Reverted back to Heroin Drug related deaths increase Increase in HCV Long term physical health issues Unsure of long term mental health issues
20 Where are services at now? Training Advice and information sessions Testing Collaborative working Pan Lothian NPS workplan National guidelines
21 Harm Reduction Smallest needle possible Clean equipment-follow good hygiene Liaise with friends Be cautious with dose avoid bingeing Always filter Avoid cooking Dilute small amounts with more water Do not use citric/vit C if not necessary Safe sex Avoid snowballing
22
23 resources Shooting Up New Psychoactive Substances One new drug a week Lothian Viral Hepatitis Managed Care Network Annual Report 2014/15 Drug-related Deaths 2014 Edinburgh and Lothians
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