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Needle Fixation and Impact on Social Work with Drug Addicts
HAJŠMANOVÁ, Alena
Injection drug use is rated by the users as their most intense experience. This way of drug application excite in the body way faster and stronger coming of chemical substance than the alternative ways of drug use. Needle become most prefered choice among the users. From the experts point of view injection application brings a highest number of risks as transmission infection diseases or devastation of venous system. Needle fixation is another possible risk of injection drug use. This phenomenon was defined as "Recurrent breaching of skin integrity with needle, with or without application psychoactive substance intravenous or intramuscular way, likewise without bind to expected effect of active substance". (McBride AJ, Pates RM, Arnold K, et al. Needle fixation, the drug users perspective: a qualitative study, 2001, 1050). Next symptoms of needle addiction are for example repetitive pretension, application of different substance or diving in smaller doses. Needle fixation develops from principle of the operant conditioning. Injection use brings secondary gains (e.g. sexual satisfying) to the drug users. Phallic shape of the needle could evoke in some people exciting feelings. Mutual "shot" between partners could be instrumental as sexual foreplay. For some individuals it could become partial or full replacement for sex. Pain caused by needle is rated by some users as pleasing part of the injection. Pain is sort of valve for unpleasant feelings or way how to punish himself. Very often the skill of proper drug injection application might provide post of the"shooter" and respect of rest members of the community. Needle fixation phenomenon could become sizeable complication for user decided to fight his addiction. For example, user quitting opiates has to fight both with physical drug addiction and psychical needle addiction. Practical part of this bachelor thesis was made in summer 2016 in Street work program of non profit-making organization Spolek Ulice Plzeň, where the author of this thesis worked since January 2016. Two objectives were specified. First objective was to describe the with of needle fixation phenomena. Possible impacts of this appearance for casework with the drug users was the second objective. Questions and hypothesis for research purposes were formed: Q1: Which demographic factors affect needle fixation? H1: Needle fixation phenomenon is more common for women than for men. H2: Needle fixation phenomenon is more common for younger drug users than for older drug users. Q2: Do the social workers have a sufficient awareness about needle fixation? Four casework workers (two men and two women) of Spolek Ulice Plzeň were involved to qualitative part of research. They absolved semi-structured interviews. One of the female workers was employed there for 5 years and second for 6 months. Male workers spent there 10 and 7 years. Additional interview was made with a doctor of the substitional department of Spolek Ulice Plzeň. Interviews were axially encoded and described in diagrams for data analysis. Author finds out that asked case-workers know about needle fixation phenomenon, they are familiar with professional literature and they are able to make out solution for the problem. Question is, if it would be optimal. For quantitative part of research the questionnaire was filled by 89 drug injection users - clients of Spolek Ulice Plzeň. Questionnaire was standartized on the subject of needle fixation for injection drug user in Czech Republic (original version: R. Pates, A. McBride, K. Arnold, 2005; translation and correction: M. Pešek, O. Sklenář, 2013). The questionnaire maps those areas: skill, pain, needle fastination, zonk out, sex substitution, sexual excitement and aspiration. Data was processed SPSS software. Research has shown, that needle fixation has statistically significant independency on the age. Another considerable finding is that females are more vulnerable for needle fixation.
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