Chapter five - National Treatment Agency for Substance Misuse
Contents
1. v Getting tested for hepatitis B amp C is the first step even if you think you have it How do you prevent getting it A vaccine is available to protect you from hepatitis B Sex Safer sex use condoms Pi Injecting Specialist treatment Sharing crack pipes for hepatitis C is available which can cure 40 80 of cases e It takes 6 12 months e It causes low mood e p Don t share drugs Body piercing and e Don t let alcohol tattoos or drugs make you forget yourself Pregnancy childbirth and breastfeeding Hepatitis A or B vaccination e Blood transfusion Sharing toothbrushes and razors o Client name Keyworker Date How useful was this map and discussion 1 2 3 4 5 6 7 8 9 10 Comments Map 05 Harm reduction HIV e Many people have no symptoms Human Immunodeficiency Virus for years attacks the immune system Some get a flu like illness within 2 months fever headache fatigue swollen glands in the neck and groin e With reduced protection the person develops severe illnesses they are then said to have AIDS Acquired e Even if there are no symptoms the person can pass HIV onto another person DW Immune Deficiency Syndrome e There is no cure or vaccination for HIV or AIDS How can you tell if you have been infected How do you get it Sex The only way to How do you know if2. Map 08 Crack and other drugs S USWIWWOD 0 6 8 9 S 7 Z L uUolssn3sIp pue dew siy sem jnjesn MOH shun 1noA sabewep V Buiseq i1J u uA An eJodeA PIUOWWE e yee IL Jo JSL BOW Suugueddns UlWe A aen 5uisn dasojaq 383 yee IL Jo JSL BOW sisddod eruui ul11 d u dinjzesadwa uBiu AJA JO JSI SIOW wu 1S1U 13332 UMOP Ase s 3 S906 3ajja 553 Ang 0 JL 9 1NZI9S S J 10 GO 181u pi22e Jo MSL SOW 3e1 d 3 qe 0JWI0 e Ul 3SN noA odoad uuuM aen Beuep Jal pue y2e77e LISS Jo MSL BOW 399 135 au JJO Anq 0 you AAL u e303 420 19 YIM S6NAp 13470 aye NOA USYM NO YD EM WII eeng 1 YJIOM Y uleu 1u 12 Acknowledgements This manual was prepared by Ed Day in conjunction with Nick Shough Birmingham amp Solihull Mental Health NHS Foundation Trust Contributions were made by Kieran Lynch and Emma Pawson National Treatment Agency and considerable feedback and suggestions came trom members of the Eastern Region Integrated Drug Treatment Services In particular staff from HMP Peterborough Chelmsford System Change Pilot HMP Chelmsford and Chelmsford DIP team HMP Littlehey and HMP Edmunds Hill We would like to thank Professor Don Dansereau and Norma Bartholomew for their generous sharing of materials that they have developed around node link mapping and Professor Dwayne Simpson for his leadership and support in bringing these mate
3. and blood pressure e Heart attack e Stroke e Worse with alcohol J a Harms caused J v e Follow safer injecting guidance e Don t share snorting equipment o Client name e Paranoia Anxiety e Depression and suicidal thoughts Delirium confusion e Psychosis o Mental health x Powder cocaine yourself e Stagger use of alcohol e Nasal washing e Practice safe sex use condoms and lube e Do not use alone Keyworker How useful was this map and discussion 1 2 3 4 5 6 7 8 9 10 Comments Harm reduction Map 02 Powder cocaine See Injecting Map Corrosion of nasal septum High risk behaviour Poor diet weight loss e Poor immune system e Problems In pregnancy e Liver damage o A Preventing harm Use as little as possible The effect goes down after the first hit try to buy less each time to reduce wastage oO Date Map 03 Harm reduction Injecting e Wash the site e Change needles e Avoid tap or bottled water e Use new filters e Don t lick the needle O Arteries veins and capillaries gt J Only inject in veins Arteries have a pulse e How veins collapse O Some drugs damage veins more than others e Temazepam e Crack cocaine e Pills capsules Too much acid DW Client name Bacteria To clean a needle draw up clean cold water thr
4. INHS National Treatment Agency for Substance Misuse Routes to Recovery via criminal justice Mapping user manual Map 01 Harm reduction Crack cocaine e Fluid build up or bleeding into lungs Foreign bodies may Paranoia e Constricts blood vessels get trapped Anxiety and blood e Smoking damages pressure lungs cleaning ele mechanism and suicidal crack lung thoughts e Ammonia or Delirium confusion e Liver Psychosis damage N 14 t A Harms caused p Crack cocaine e Poor diet and weight loss e Poor immune system e Depression e Heart attack e Stroke e Worse with aluminium alcohol O poisoning O e Problems in pregnancy Preventing harm Use as little as possible Look after yourself e Avoid smoking from plastic or tin pipes fumes can cause lung damage Don t share pipes this will increase the risk of contracting Hepatitis C through mouth sores or burns O Client name e Smoke can damage your lungs hold it in for as little time as possible e Use Vaseline or lip salve to keep your lips moist Drink plenty of water e Eat before using Keyworker How useful was this map and discussion 1 2 3 4 5 6 7 8 9 10 Comments e Take breaks between each smoke The effect goes down after the first hit try to buy less each time to reduce wastage B Date e Constricts blood vessels
5. ough it into the syringe barrel flush it out again and repeat Repeat the cleaning process with household bleach Repeat the process with cold water again o If you see someone overdose e Call an ambulance dial 999 e Check if they are breathing e Do not leave them alone e Stop them rolling onto their back e Tell the ambulance staff what they have taken l Keyworker How useful was this map and discussion 1 2 3 4 5 6 7 8 9 10 Comments A A cay v X Overdose Overdose k Don t share your needle syringe water spoon or filter e Use a needle exchange service Dangerous injecting sites Neck Penis e Breasts e Groin O Reduce the risk by e Not injecting snort swallow smoke or chase e Take a test dose of drugs Only inject half a barrel at a time Don t mix drugs Inject with other people O Date Harm reduction Map 04 Hepatitis e An infection of the A transmitted by contaminated food or liver that causes it water infection lasts less than 6 months to become inflamed and can cause permanent damage B 90 get only short infection Three main types A B andC C 80 90 get chronic hepatitis gradually J progressing to cirrhosis liver failure and possibly death Flu like illness tiredness slight fever aches in muscles nausea vomiting weight loss jaundice
6. reduction Map 06 Overdose Stimulants crack cocaine speed e Pressure tightness or pain in the chest e Shaking or fits Choking sounds Foaming at the mouth e Unconsciousness coma Ifyou see someone overdose e Callan ambulance dial 999 e Check if they are breathing e Put them in the recovery position e Tell the ambulance staff what they have taken Date Duo 00 10 ul youus out DIOU A uo s did ued ul JO 313Se d sn u0g oF o 3a DU A G OD 53 del 0 1 U0 d JOW noA saaib s youls u M1 q sye q bulyel uoi e p u p do1s 0 J3 2M yup pue suljasea UMA sdn u ls oW o o h S S ZK Q H a s d d OD d eys 1 uop x Ew j sa G T s eS BUIYOUIS wa J ao gy ow UU lt aed s u uluio2 aen 1 1Je sliisou no useM s ii sou EZE jeseu DIOAN uye y no SUE 0S Jajes Ayliessazau usi BUlRIOUS 4 dap jo JS sanpsy SMP 1 S seys u0g Bullous Jay JOMASY OL 6 8 9 G 7 Z L uolssn3zsip pue dew siy Sem nj sn MOH dod ulys 1 uod gt 2 yo ays uo1p fu y 3 o squinu auies04 a 5 uip fu 10 X221 UMOP yeaig 0 31 1319 aen Bul eqpeeds u uA sn ul0 u Jno ywq 4 d H jo ysl sanpsy yu uidinb Aue eus J A N 6u 3 ul uleu 1u 2 Treatment options
7. rials to Drug treatment services in England A wide range of node link mapping materials are available for free at www ibr tcu edu www ibr tcu edu NHS National Treatment Agency for Substance Misuse National Treatment Agency 6th Floor Skipton House 80 London Road London SE1 6LH Tel 020 7972 1999 Fax 020 7972 1997 Email nta enquiries nta nhs org uk Printed on recycled paper This manual is a development of material first produced by Texas Institute of Behavioral Research at TCU Fort Worth www ibr tcu edu together with new material developed at the University of Birmingham TCU has granted the University of Birmingham permission to adapt their material for the purpose of producing and publishing this manual Copyright The National treatment Agency for Substance Misuse 2010 All rights reserved Except as otherwise permitted under the Copyright Designs and Patents Act 1988 no part of the work may be reproduced stored in a retrieval system or transmitted in any form or by any means electronic mechanical photocopying recording or otherwise without the prior permission of the University of Birmingham Enquiries concerning reproduction outside these terms should be sent to The University of Birmingham Department of Psychiatry The Barberry 25 Vincent Drive Edgbaston Birmingham B15 2FG This manual should be cited as Day E 2010 Routes to Recovery via Criminal Justice Mapping User Manual The National Treatmen
8. t Agency for Substance Misuse London
9. you have HIV prevent is to get tested getting it Antiretroviral treatment aims to keep the amount of HIV in the body ata low level Injecting Sharing crack pipes Body piercing and tattoos e Pregnancy childbirth and breastfeeding e Safer sex use condoms It is not a cure but it can stop people from becoming ill for many years Don t share drugs e Blood transfusion e Don t let alcohol or drugs make you forget yourself Sharing toothbrushes and razors O e Tablets need to o be taken every day for life a Client name Keyworker Date How useful was this map and discussion 1 2 3 4 5 6 7 8 9 10 Comments e Taking so much of any drug that your body cannot handle it e May cause death by heart liver or respiratory failure DW e Injecting heroin e Combining drugs High alcohol consumption High levels of use e Low tolerance following detox or prison O Client name Depressants heroin methadone benzos Unable to talk Body limp e Face pale Slow heartbeat Slow and shallow breathing e Choking or gurgling sounds Unconsciousness coma o How do you avoid it e Go easy after a break Don t mix your drugs e Taste the hit e Make a pact Keyworker How useful was this map and discussion 1 2 3 4 5 6 7 8 9 10 Comments How can you tell if someone has overdosed A gt ease Harm
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