Foil for changeOne of the many roles of a needle programme is supporting people to move away from injecting to a safer route of administration, this is of course where foil is most likely to be used as a tool for most of us. But getting someone who injects to just move over to smoking is a pretty hard sell so bear these points in mind:
- Timing is everything. An ideal time to move over to smoking is when someone is already considering a change in their use, it might be because they are having problems getting a vein, or that they want to reduce the risk of overdose following a personal or witnessed OD. Be aware of these opportunities to positively change behaviours.
- You don't have to change all at once. Moving to smoking is a big step for some people. If someone is having problems with their veins then smoking, even just once a day, rather than injecting can help give those veins a bit of much needed rest.
- If you're reducing, it's easier to dose when smoking. Although injecting is perceived as cheaper we have to remember that no matter what the strength of the deal thats injected you are getting it all, with smoking if the drug is stronger you can adapt your use easier. This is especially useful when reducing the amount used as it's likely people only want to get rid of withdrawals rather than getting high.
Of course, if someone has been injecting for a while then they may be out of practice with smoking, and the worries they have about smoking being more expensive might prevent them from even trying it. The perception has always been that injecting is more cost effective, but bear in mind that if someone is using an acidifier (Citric or VitC) to prep their injection they are probably using too much and destroying some of their drug. That said though, it's important to make sure we make smoking as cost effective as possible to help encourage the change. The two videos below show useful ways of making the foil 'pipe' to maximise the amount of drug you can 'recycle' from reside. I'd recommend all drugs workers to be familiar with making these, personally when talking to people in the past about moving to smoking I've always made paper versions of these pipes to show people how to do it (it's also part of the training I deliver LINK).