Vein Search (or a search in vain?)

David RobertsonClinical Nurse Specialist in Harm Reduction

Camden and Islington Substance Misuse Services

What is a vein search?

Looking for somewhere to

injectBut….

What is a vein search?

What else can we do with it? What purpose does it serve? How can we make the most of it?

What should it be?

Reduce injecting damage

• Assessment of recent and current injecting• Advise on what to look for (“good veins”),

where (“suitable sites”) and How (technique and works)

• Educate on good practice/safer drug use/BBV

• Encourage reflection • Teach the client how to do it themselves

Education

• Why do I need to change my injecting?• What am I doing wrong?• Why do veins collapse?• Why is injecting damaging?• How can I reduce the damage?

• Increased ability = Increased self esteem

Prevention

• Most clients present when their veins have run out and new access is limited if there is any at all

• Harm Prevention • Be proactive - use the intervention to

reduce current damage and prolong vein life

Engagement

Injecting Risk Assessment, Education and Behaviour Modification Intervention

Engagement

• Client centred - about change not abstinence

• Non-judgmental• Harm reduction• Practical - It works! • Improved faith in service/ Drugs worker

=improved engagement

Motivation

• Change injecting and drug using behaviour

• Attendance and Engagement• Think about future

Good Practice

• All injecting carries risk - not injecting is best

• Competence and Responsibility• Evidence based• Accepted practice• Limits to advice• Dilemmas• Relative risks - Client responsibility

Ethical Considerations

• IS teaching someone to inject the same as encouraging them?

• Are we prolonging someone’s injecting career and so increasing the amount of damage?

• Shouldn’t we be encouraging people to stop?

Contact:

david.robertson@candi.nhs.uk