title: The fine line between harm reduction and harm production--development of a clinical policy on femoral (groin) injecting.
abstract: OBJECTIVE
  The femoral region ('groin') appears to be increasingly commonly used by injecting drug users in the UK. With the advent of Britain's first supervised prescribed injectable opioid treatment clinic, unprecedented decisions and judgements were required about the safe supervision of this practice, or whether to permit this behaviour on site at all. This paper reports the reasons for, and outcome of, development of a clinical policy on injecting into the deep femoral vein (groin injecting).
  
  
  METHODS
  A small in-depth audit of the complications of femoral injecting was undertaken in a supervised injecting clinic.
  
  
  RESULTS
  All femoral injectors had had either local site-related medical complications or other health problems which could potentially be worsened by ongoing injection. This finding along with the personal and professional issues raised by staff for supervision of femoral injecting led to a revised policy focussing on achieving a shift towards lower-risk peripheral venous and intramuscular sites.
  
  
  CONCLUSIONS
  While the clinic staff's training may be more compatible with professional duties of care by encouraging cessation of femoral injecting, this does not tell us what advice harm reduction workers in the field should offer groin injectors. More research is needed into this high-risk, controversial injecting practice.
authors.affiliation: National Addiction Centre, Institute of Psychiatry, King's College London, London, UK. deborah.zador@justicehealth.nsw.gov.au
authors.forename: Deborah
authors.initials: D
authors.lastname: Zador
authors.forename: Nick
authors.initials: N
authors.lastname: Lintzeris
authors.forename: Rob
authors.initials: R
authors.lastname: van der Waal
authors.forename: Peter
authors.initials: P
authors.lastname: Miller
authors.forename: Nicola
authors.initials: N
authors.lastname: Metrebian
authors.forename: John
authors.initials: J
authors.lastname: Strang
mesh_terms: D000328:Adult; D005260:Female; D005268:Femoral Vein / Q000187:drug effects; D005269:Femur / Q000187:drug effects; D006119:Groin; D040261:Harm Reduction / Q000941:ethics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015819:Substance Abuse, Intravenous / Q000150:complications* / Q000517:prevention & control