Femoral (

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Femoral (groin) injecting

• David Griffin
• John Maliphant
• Jenny Scott
• Chair Jon Derricott

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Purpose and format of session

• Aim to stimulate discussion around the provision
  of safer injecting advice on groin injecting
• Bristol Drugs Project study (JS JM)
• Grass roots experience and key points for
  debate (DG)

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Groin injecting

• Into femoral vein in close proximity to femoral
  artery and femoral nerve

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Bristol Drugs Project study

• Ref Harm Reduction Journal (2005), 26
• www.harmreductionjournal.com/content/2/1/6
• Background observed a perceived increase in
  number of people using needle exchange who were
  IV in groin site. Wanted to explore this further
  to establish statistics on frequency and gather
  more information on reasons why and problems
  experienced

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Bristol Drugs Project study (2)

• Method snap shot short interview with all
  willing users of the BDP needle exchange over a
  one-week period (convenience sample)
• Results 98 interviews, 47 injecting into groin
  (48). Of these
• 66 (n31) male, 34 (16) female
• Mean age 31 yrs (range 17-50yr, SD 7.7)
• Mean length of time since 1st injection 9.6yrs
  (0.5-30yr 7.0)
• Mean length of time since 1st use groin 2.6yrs
  (1mth -15yr 3.3)
• Most had used other sites first
• 98 (n46) inject heroin 40 (19) inject crack
  (16 inj both).
• Most commonly use detachable 1ml syringes with
  orange (0.5 x 25mm, 25G) needles (70, n33) 23
  (n11) use blue (0.6 x 30mm, 23G)
• 34 (n16) no access problems 66 (n31) had
  experienced access problems inc, hard scar
  tissue, swelling, pain, dvt (Dx?)

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Bristol Drugs Project study (3)

• Observations and talking points
• Convenience of groin site perceived
• Perceived thing to do
• Rotating sites is difficult dexterity issues
• Fear of losing hit
• Groin sinuses useful for continued access

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Points for discussion

• Should we give advice on groin injecting?
• What should that advice be?
• How far do we go?
• What research evidence is there to support our
  actions?
• What research needs to be done?
• What training should workers receive?
• How should consequence of worker advice be
  monitored?
• Insurance by employers?