THE LOW-DOWN ON ‘DIRTY’ SYRINGES “I try not to reuse picks and I’d prefer to be more on the ball and not have to but honestly shit just happens,” – Dave (62) People who inject drugs in Australia can appear to be well provided for with regard to sterile needles and syringes. Across the country there are 3500 needle and syringe programs (NSPs) which distribute almost 50 million pieces of equipment a year. But the international bestpractice for injecting drugs of a fresh needle for every injection is far from reality. People who inject drugs reuse syringes, share equipment like spoons, water and tourniquets, and a small proportion continue to share injecting equipment with others. A 20-year survey by the Australian NSP Survey showed that the numbers of people who inject drugs who reuse and share have plateaued in recent years after steady declines since the 1990s. For instance one in three (31 per cent) injecting drug users reported that they reused syringes in 1997. Since 2011 the reuse had hovered around 2125 per cent. The percentage of people who inject drugs who reported they shared syringes with others was also steady at 1516 per cent from 2011-2015. And the sharing of equipment other than needles remained stable at 28-31 per cent. For more information on these statistics see: https://kirby. unsw.edu.au/report/australiannsp-survey-national-datareport-1995-2014 and https:// kirby.unsw.edu.au/report/ australian-nsp-survey-nationaldata-report-2011-2015
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The Bulletin spoke to three people who inject drugs about their reuse of injecting equipment. All agreed that they knew it was unwise to “recycle” syringes and share paraphernalia. But they also claimed it was unavoidable under certain circumstances. Chris* (57) a single gay man from Sydney said he used to share and reuse needles but was vehement he did not share or reuse now. “I only ever used clean needles for myself but Tom, Dick and Harry would all show up. They’ve got the drugs and I’ve got the clean needles. What else am I going to do?” Chris shared equipment out of social pressure and was very lucky not to have contracted any blood-borne viruses. But his arms are a vivid illustration of the damage that skin infections can wreak. Both forearms are a scarred and pitted moonscape as a consequence of bad injecting practices. Three months ago as he passed me a coffee a tiny rivulet of pus trickled across his arm and dripped onto the floor. Now the wounds are fully healed and Chris is justifiably proud of his achievement. He glows as he holds up his clean “summer” arms, as he calls them. Chris credits his drug counsellor with encouraging him to use more safely and enable his arms to heal. He is fortunate the abscesses and other bacterial infections that caused the scarring did not
develop into life-threatening conditions such as endocarditis, septicaemia or gangrene. Amputations are not unknown if infections get out of hand. “A part of me likes to think I’m going to just stop and that using blunt needles will encourage me to quit.” He visits his local pharmacy twice a week for medication. But will not use them to get needles for fear he will be stigmatised, so he collects clean needles from the community health centre. Dave* (62) lives in Melbourne and is in a long-term relationship. He uses regularly and says he was a “voracious” drug user. Currently though he does not use every day. “I did share needles when I was a young fella and I do have the hep C antibodies but I didn’t get it full strength. Two other mates from then got it properly and have just been on the new drugs to get clear. “No matter how hard I try, though, I just accept now that reusing picks is a way of life for me.” He says he is planning ahead more often and thinking more often about stocking up but his timescale runs into the decades. Dave first started injecting speed in 1973. “I know fresh picks don’t grow on trees – you need to be organised.”
