1. Harm Reduction and safer injecting Aim To understand the complexity of substance use behaviour Gain insight into why it is hard for some people to stop To see the line between using substances and not using is not a broad line

2. Note None of the following constitutes a recommendation of SAFE practice. They may only help make a high risk activity slightly less risky, NOT wholly safe. Some will still carry considerable risks.

3. Why accept a harm Reduction Approach? The role of the harm reduction approach is to neither condone nor condemn drug use. It simply aims to improve the relationship between people and the drugs they use by reducing drug related harm. We teach harm reduction all the time Road safety, suggesting safer sex practice etc

4. What is the difference between Risk and Harm? Risk: The possibility of an event occurring Harm: Event has occurred Types of harm: Harm can be related to the substance i.e. Alcohol The technique of administration i.e. IVI, snorting, bags, direct spraying. Associated harms Drink driving, overdose, accidents, septicaemia, abscesses, theft, violence to name a few. Health, social and economic Individual, community, society

5. Why harm reduction? Think about why harm reduction over abstinence? Lets discuss???

6. Drug use is universal Nearly everyone uses psychoactive drugs We all like mood alteration How much different is using legal and illegal drugs People will use drugs if they want to Drug use is here to stay Attracting drug users to services Excessive behaviours occur along a continuum Changing behaviour is stepwise, abstinence is the final outcome Abstinence is not for everyone Reduces harm to the community Can be related to all psychoactive substances

8. Exercise In threes Choose what you need to inject a single dose of heroin Pick the equipment Wait for checking then start preparing ONCE EQUIPMENT IS CHOSEN YOU CAN’T GO BACK TO TABLE ON FIRST ROUND You will be stopped on occasions to explain your decision making It is deliberate not to give you any help at this stage When at point of readiness to inject STOP. This is not the same as heroin and so does not react in the same way, it is just to show the process.

10. 5 Golden Rules of injecting Use your own works Don’t lend or borrow used works Use your own spoon, water, filter Use the smallest needle appropriate Use your own works once only