What it’s like to run a needle exchange service
The people I see come from all walks of life. The key is getting to know them properly without judgement
By Cilicia Wyman, Harm Minimisation Worker at Addaction Lincoln
Sitting pride of place in my home is a slightly worse for wear old teddy. Most people assume it’s a relic from my childhood, something I can’t part with. In fact, a man who used the needle exchange service I run gave it to me a few years ago. I used to work with children who have ADHD and this man’s restlessness, trouble focusing on one thing, and tendency towards impulsive behaviour had some of the hallmarks. He was also using an amphetamine to help focus his mind. I got him into treatment with a key worker and told them about my concerns so they referred him to a specialist. The specialist agreed with me and gave him medication to put his mind at ease. All of sudden the drugs he was using didn’t have the same hold over him. One day he popped back in, bearing the teddy. After a tough day it’s a great reminder of why I do what I do.
A needle exchange service is a non-judgemental space where people can pick up fresh needles while disposing of used ones safely. This greatly reduces the chance of people sharing needles and thus the spread of bloodborne viruses like Hepatitis C and HIV. It also helps reduce drug paraphernalia from being discarded in public areas.
So what’s it like to work in a needle exchange? When I tell people what I do they can assume I’m just like a glorified human vending machine. But it’s so much more than that. I do a full risk assessment with everyone who walks through the door and give them advice about how best to reduce the harms of the drugs they are using. I teach them how to inject safely and encourage them to seek medical help where appropriate. This means getting to know people properly and without judgement. Last summer a woman wanted to go to a family event where she had to wear a dress. She was scared of showing the scars of injecting on her arms and legs so had taken to using her groin instead, which is far more dangerous. Instead, I taught her other safer ways to avoid scarring her limbs. It’s a small thing, helping someone attend a family event, but it did wonders for her self-esteem.
The people who use the needle exchange come from all walks of life. Some come in wearing the suit they wore to work, briefcase in hand. Others have nothing except the clothes they’re wearing. Often these two very different kinds of people are using the same substance. A lot of the time drug use is a reaction to trauma, a way of managing pain and trying to switch off. My father was abusive and had an alcohol problem so I can easily identify with how early pain can influence people’s behaviour as they get older.
A big part of my job is staying up to date with different trends. More and more people are injecting drugs as a way of improving the way they look. Often this is men who use steroids to improve their physique. They tend to think they’re invincible, but injecting steroids increases the risk of a heart attack so it’s vital that I explain the risks. I’ve also had to educate myself about the potential harms of injecting the tanning agent melanotan as more and more young women are turning to it as a way of achieving that bronzed look.
While I love my job I’d be lying if I said it doesn’t come with challenges. Drug related deaths are at an all time high in England and I feel this in our service. Recently, I attended the funeral of a client who died from a heroin overdose. He knew my husband as a child so it really affected me. It’s hard going back to work knowing I’ll never see him again, but it also strengthens my resolve to give the best possible service to my clients. Many of them will be grieving too so they need me at these points more than ever.
One thing that upsets me is when people say that needle exchanges are part of the problem because they normalise drug use. People were injecting way before needle exchanges were around and they’re a great first step in engaging people and helping them into treatment. Working in partnership with the recovery service means they get a holistic package of support, from help with housing to tips on healthier living. Shutting down these kind of services would not only damage the people who use them but communities as a whole.
Personally I think we should be doing even more to reduce harm. It always strikes me as odd that I give people detailed advice about how to use drugs safely but no one will be there at the critical moment to make sure they put it into practice. I’d love to see a drug consumption room piloted here. Nobody should die because they are looking for some relief in their life.
As told to Nye Jones
If you or someone you love needs help or support, reach out. You can chat to a trained advisor at addaction.org.uk.
