Assessment of New Zealand needle exchange provision of equipment and advice to people who inject performance and image enhancing drugs

Needle exchange services are organisations/facilities which provide sterile injecting equipment and advice to people who inject illicit drugs. Historically, needle exchanges have focused on providing care for those who inject classical drugs of misuse, notably opioids and amphetamines. The use of Performance and Image Enhancing Drugs (PIEDs) is a worldwide concern and New Zealand is no exception. Whilst the focus of needle exchanges has been on ‘traditionally’ injected drugs, they also provide equipment and care for people who use PIEDs. People who use PIEDs are at similar risk of blood-borne virus infection to those who inject drugs such as heroin and methamphetamine, such infections including HIV and hepatitis B and C. Furthermore, injecting practises mean they are vulnerable to bacterial and fungal infections. The provision of clean injecting equipment is vital in protecting people who inject drugs from such harms, and the importance of the needle exchange programme for these people is clear.

Needle exchanges (NEXs) largely focus on providing care for those who inject typical drugs of misuse (largely opioids and amphetamines). They also, however, provide equipment and care for people who use PIEDs. This service user group has some very specific needs: PIEDs are very different to other drugs of misuse and they are administered through a variety of routes and NEX staff may lack the knowledge and skills to provide advice.

This project proposes to explore the current understanding of staff and generate valuable feasibility information to inform a further study of PIED injection. Through conducting qualitative interviews with NEX staff valuable feasibility information will be obtained and the research will provide a detailed insight into the knowledge of NEX staff. This will allow the NZ NEX programme to implement training that may be found necessary by this work, to improve the care and approach to this service user group. The study will also provide important data which may be used in future studies which might explore the implementation of harm reduction interventions for PIED users.

This study continues Rhys’s research interest in the fields of illicit drug injection and harm reduction.