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.
The first thing of course was to talk her though the injecting process to help increase her confidence in injecting herself, this included talking about the importance of good tourniquet technique, slow injecting and using the right amount of acidifier.
I talked to her about the increased health risks she faced from allowing her partner to inject her:
- Increased risk of missing (and abscess) from him not being able to feel when the injection is hurting.
- Risks from when she is injected, e.g. is she injected after him or before him, and what state is he in when he's injecting her.
- Risks from BBVs if his hands are not washed between shots
I also talked with her at length about the legal issues. If you inject someone and that person dies as a result of the drug then you can be prosecuted for manslaughter, even if all you do is site the needle for them and they take their own shot. It's of course important when you have this conversation with people to make it clear to them that while it may be the partners choice to take this legal risk, it is also their responsibility for asking them in the first place.
Although I didn't discuss it at the time it's also good to consider the social aspects of being injected by another, and the possible control issues from her relying on the partner for her shots (most female injectors are initiated by a partner).
For further reading on being injected by others I'd recommend the following article from the SMMGP "Working with Drug Users Who are Injected by Others " and the presentation given to the 2005 NCIDU "The experiences of women receiving injections from others" both of which are by Charlotte Tomkins and Nat Wright.
Nigel Brunsdon is the owner of Injecting Advice.com. He's been working in harm reduction since the 1990's, although he's previously a frontline needle programme worker he now spends most of his time developing online resources for drugs workers and users.