Research Output
Below the Belt Supporting staff and clients to recognise the early signs of vein damage associated to groin injecting
Approximately one third of regular injectors in Edinburgh are likely to be injecting into the groin. This is a concern due to the associated risks which can lead to severe skin infections, vascular problems and traumatic social and medical consequences. This project aims to address a gap in knowledge and literature, plus up-skill staff in checking the skin and legs for early signs, not just examining the injecting site.
We developed resources showing signs of venous damage in the legs for use with current injectors and those in recovery.
We also developed training to:
• Increase understandings of physical health complications and risks associated with groin injecting.
• Improve knowledge of early signs and symptoms.
• Improve confidence to approach and support these issues.

• Since 2017- 49 people have been trained in Lothian.
• At follow up 100% of respondents said their knowledge and awareness of groin injecting and venous damage had increased.
• Prior to training over 50% said they DID NOT ask PWID to show them their legs. Post training- 99% DO.
• The Drug Liaison Nurse uses the resources with PWID during acute hospital admissions and as part of staff training.

• The training and resources have attracted interest on a national level and feedback is they are “opening up a whole new conversation”.

Input also provided to:
o Tissue viability community link nurses
o IEP pharmacy providers
o Scottish needle exchange workers forum
Further work is planned to reach the homeless population in Edinburgh and people in recovery using peer engagement events.
• Continue to follow up with staff and clients to identify if there is any effect on injecting behaviour.
• There is a need to extend the reach of this resource and up-skill more staff outwith addictions services to identify these issues.

  • Type:


  • Date:

    01 November 2018

  • Publication Status:



Coull, A., Glen, C., Shanley, J., & Smith, L. (2018, November). Below the Belt Supporting staff and clients to recognise the early signs of vein damage associated to groin injecting. Poster presented at Faculty of Public Health in Scotland Annual Conference


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