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Reduction of groin injection within the supervised injecting clinic
Clare Morgans, Senior Registrar in Addictions and Anne Hurwood, Substance Misuse Nurse, RIOTT Clinic, Tees Esk & Wear Valleys NHS Foundation Trust

Abstract
As part of the Randomised Injectable Opioid Treatment Trial (RIOTT) for heroin dependence in Darlington (one of 3 pilot sites for the trial in the UK), groin injecting had initially been allowed within the supervised injecting clinic along with peripheral intravenous injecting. As part of the trial and teams’ commitment to safer injecting practices and harm minimisation strategies, it was proposed that we would stop this practice in the clinic.

After discussion with our service users and amongst health professionals within the team it was decided to introduce and implement a policy to reduce and cease this practice, over a 2-3 month period. The service users were encouraged to use the alternative methods of injecting intramuscularly or in a peripheral vein. Out of our 29 service users who are injecting on the trial, 13 were using their groin to inject in the clinic environment. One service user left the trial due to the introduction of this strategy. Four of our service users continue to groin inject outside of the clinic environment when using illicitly.

This paper/presentation describes the implementation process of our policy in the clinic; challenges of implementation that we came up against and the health and treatment outcomes.
Femoral Vein (groin) injecting is a concern in all health and treatment aspects of substance misuse. The implementation of a method of reducing this practice including the difficulties would be of interest to all those working in the area especially in harm minimisation due to the high health risks taken by those who continue to groin inject and is not solely confined to the supervised injecting clinic environment.

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Biographies
Dr Clare Morgans is a General Adult Psychiatry Higher Trainee (ST6) and has just started working with the County Durham Substance Misuse Service, which includes Durham Prison. She has a special interest in Substance misuse and has been involved in the RIOTT trial (Randomised Injectable Opioid Treatment) in the Darlington pilot site for the past year.

Anne Hurwood is a Nurse working in the supervised injecting clinic as part of the RIOTT trial; she has been involved in this project since its onset 3 years ago. She has a long history of working with people with addictions and has been instrumental in the reduction of groin injecting within the clinic environment.