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Title: Evidence based harm reduction
Author: Ponton, Rhys
ISNI:       0000 0001 3494 4059
Awarding Body: University of Bath
Current Institution: University of Bath
Date of Award: 2006
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Review of the literature demonstrated that knowledge surrounding the process of illicit drug injection preparation is limited. A better understanding of the details of injection preparation methods could inform study of the risks and complications, as well as the development of harm reduction advice. This project had two main objectives: To characterise the injection preparation process in detail, then to attempt to quantify the risks posed by these injections through laboratory investigations. The project had specific focus on the use of the acids by injectors to increase the solubility of insoluble illicit drugs. To study injection preparation, a novel interview was designed to record the methods that a cohort of injectors used to prepare their injections of heroin and 'crack' cocaine. The interview incorporated two separate sections: firstly a semi-structured questionnaire, then observation of participants preparing an inert 'fake drug' for injection using their usual preparation procedure for real drug. The injector interviews documented the use of acids by injectors in detail. The injection preparation demonstration enabled a complete characterisation of the preparation procedures for heroin, crack and speedball injections and enabled the development of a standardised method by which injections using real drug samples could be reproduced in the laboratory. Prepared injections were subjected to a number of assays to evaluate their properties. These assays allowed a comparison with pharmaceutically prepared injections (pharmacopoeia standards) to provide some quantification of risk. Investigations were conducted into the drug content, the microflora, the particulate content and the physical characteristics of the injections. Electrospray mass spectrometry was used to identify the components within illicit heroin samples. This methodology has never before been used to examine illicit drug samples. The project developed microbiological investigation techniques that enabled the isolation and identification of micro-organisms within drug injection solutions. Particulate content of injection solutions was found to be high, and the use of rudimentary illicit filters was shown to add to this. The use of filters made specifically for illicit drug users could significantly reduce this content. Overall, no significant risks were identified and this supports current harm reduction advice which was not based on any published research.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available