This month we’ll focus on the misuse of opioids. The series will highlight different interventions aimed at addressing the “opioid epidemic.”
Our first topic will introduce risk reduction and its application in the use of intravenous (IV) opioids.
“Harm reduction, or harm minimization, is a range of public health policies designed to lessen the negative social and/or physical consequences associated with various human behaviors, both legal and illegal. Harm reduction policies are used to manage behaviors such as recreational drug use and sexual activity in numerous settings that range from services through to geographical regions.” (1)
The CDC offers guidance on risk reduction regarding the transmission of HIV while injecting IV drugs. In addition, the Harm Reduction Coalition publishes a booklet on risk reduction in IV drug use (IVDU). A few of their recommendations are listed below which you can pass on to your patients. (2,3)
- Consider using in the presence of another, trusted person.
- Privacy and cleanliness can be paramount in reducing risk of injecting.
- Use a clean needle and a clean syringe every time, do not share injection or preparation supplies (like cookers, cottons and spoons) with others.
- Clean used needles with bleach, with contact time of at least 2 minutes. This may reduce the risk of HIV and Hep C, but not eliminate it.
- Using sterile water to fix drugs.
- Normal saline (even sterile) may cause drugs to precipitate.
- Water from a toilet is high risk for infection, although it is typically advisable to use water from the tank over the bowl.
- Do not use spit to clean your supplies, it contains bacteria from your mouth which can cause a serious infection.
- Cleaning your skin with a new alcohol swab before you inject.
- Wash your hands before preparing or injecting drugs.
- Take care not to come in contact with the bodily fluids of other users, especially blood on the skin or equipment.
- Disposing of needles safely after one use. Use a sharps container, or keep used needles away from other people.
- Hard sided containers such as recycled coffee canister can reduce risk of unintentional stick.
- Seek medical attention if your injection site swells, becomes red and warm or shows other signs of infection.
- CDC recommends testing for HIV at least once a year.
While risk reduction can be a difficult topic to tackle with patients, consider trying out the following questions and find a few that work for you!
- Do you reuse needles or other injection supplies?
- How do you clean your injection site?
- Do you inject alone?
- Where do you dispose of used needles?
- Harm reduction. (2018, July 11). Retrieved July 22, 2018, from https://en.wikipedia.org/wiki/Harm_reduction
- HIV/AIDS. (2018, May 07). Retrieved July 22, 2018, from https://www.cdc.gov/hiv/risk/idu.html
- Harm Reduction Coalition. (n.d.). Getting Off Right: An safety manual for IV drug users. Retrieved July 22, 2018, from http://harmreduction.org/wp-content/uploads/2011/12/getting-off-right.pdf