For most of us when we think of a needle exchange we picture either a pharmacy exchange where someone is given pins and very little else (including information in a lot of cases) or a static site exchange where someone is given a fuller intervention in a nice warm building.

But for services that run street outreach there are other options. This article is about an exchange we did with a heroin injector and the advantages it had both to the user and to the service.

I’m quite a liberal Needle Exchange worker at heart; I’m happy to work with clients to get to where they want. That of course doesn’t mean I don’t do my best to get people thinking about reducing or stopping, but if they are going to inject I’ll work with them to do it as safely as possible.

But today was one of those very rare times that I say to someone, “Look mate, just stop injecting”. It’s only the second time I’ve been in a situation where I’m so at a loss with someone that the only way out is to say “stop” (and I’ve been doing this work for a fair few years now). The following article explains why I needed to say it and how we planned to make it happen.

The title says it all really. A young woman came into the exchange saying she was having a lot of problems with finding a vein, but during the conversation she mentioned that normally her partner injects her.

So what are the health issues around letting someone else inject you, and more importantly what are the legal implications both for the injector and for the needle exchange worker.

What do you do when someone comes into an exchange asking to collect pins for someone else? My thoughts on this have changed over the years. It used to be that I'd allow it only once or twice and then insist that the  person needing the pins comes in for themselves so I could make sure they got the advice I was so precious about giving.

But now I've changed my approach to things, your really missing a trick if you don't take advantage of having a significant other come into the exchange, but you should be aware of the legal implications of what's given out.

I do wonder, when I get a new user in the exchange, how much the person in front of me has actually found out about their drug of choice before they put it in their body. Especially when they are getting equipment to inject a drug for the first time like todays newest steroid client.

This guy was a 19 year old who has recently started using cocaine (both snorted and injected) and is intending to start his first course of steroids. While the guys knowledge of cocaine appeared to be quite basic, his knowledge of steroids was, as you'll see, very poor.