1. Vein Search (or a search in vain?) David Robertson Clinical Nurse Specialist in Harm Reduction Camden and Islington Substance Misuse Services

2. What is a vein search? Looking for somewhere to inject But….

3. What is a vein search?  What else can we do with it?  What purpose does it serve?  How can we make the most of it?  What should it be?

4. Reduce injecting damage Assessment of recent and current injecting Advise on what to look for (“good veins”), where (“suitable sites”) and How (technique and works) Educate on good practice/safer drug use/BBV Encourage reflection Teach the client how to do it themselves

5. Education Why do I need to change my injecting? What am I doing wrong? Why do veins collapse? Why is injecting damaging? How can I reduce the damage? Increased ability = Increased self esteem

6. Prevention Most clients present when their veins have run out and new access is limited if there is any at all Harm Prevention Be proactive - use the intervention to reduce current damage and prolong vein life

7. Engagement Injecting Risk Assessment, Education and Behaviour Modification Intervention

8. Engagement Client centred - about change not abstinence Non-judgmental Harm reduction Practical - It works! Improved faith in service/ Drugs worker =improved engagement

9. Motivation Change injecting and drug using behaviour Attendance and Engagement Think about future

10. Good Practice All injecting carries risk - not injecting is best Competence and Responsibility Evidence based Accepted practice Limits to advice Dilemmas Relative risks - Client responsibility

11. Ethical Considerations IS teaching someone to inject the same as encouraging them? Are we prolonging someone’s injecting career and so increasing the amount of damage? Shouldn’t we be encouraging people to stop?

12. Contact: david.robertson@candi.nhs.uk