Educations for safer injection in the Mobile Drug Consumption Room in Lisbon

Educational sessions (ES), held in the context of the Mobile Drug Consumption Room (MDCR) in Lisbon, are interventions aimed at reducing drug related harms and promoting safer injection practices during supervised consumption episodes. The present study intends to understand the main educational needs of MDCR clients, their motivations to adopt safer injection practices and changes observed over time.

Data on ES were collected through a standardized checklist covering pre-injection (hand hygiene, substances effects and doses, overdose risk), injection preparation (needle gauge, filtration, choosing and disinfection of injection site, vein finding) and post injection topics (homeostasis, discarding used material). Data on motivation to adopt safer injection practices were collected through structured interviews. Information on injection practices was gathered from consumption episodes data. Between January and December 2021, 1075 ES and 1370 injection episodes by 73 clients were analysed. Additionally, 10 clients participated in structured interviews.

The most frequent topics addressed in ES were in the preparation phase, in particular the choosing and disinfection of the injection site and finding veins, and to some post-injection practices like compression of the injection site to stop the bleeding and filter reuse. Through the interviews, participants perceived the consumption in the MDCR as having a low risk compared to the consumption elsewhere. Most participants felt able to adopt safer practices and passing on the knowledge to their peers.

The study results suggest the importance of providing tailored education on safer injection practices in the context of drug consumption rooms and particularly during the injection episodes. This would also allow us to deepen our understanding of injection practices in order to develop interventions that are more effective.