Our Island Plan

Needle Exchange Service (NES)

Community pharmacies who offer NES are professionally trained to provide you with the highest standard of treatments and services, so every time you visit, you leave with a positive experience.

About the Needle Exchange Service

What the Needle Exchange Service is

Needle Exchange Service (NES) Logo

The Needle and Syringe Exchange Service is a free, confidential service for people who inject illicit drugs. You can get new, sterile injecting equipment through the service. This reduces your risk of catching viruses, like HIV and hepatitis B and C, which are spread by contact with infected blood.

The service also helps dispose of used equipment safely, which reduces the risk of other people coming into contact with these viruses via used needles or syringes.

Who can use this service

If you inject drugs of any sort, you can use a needle and syringe exchange service. This includes:

  • Opioids
  • Steroids
  • Stimulants
  • Tanning solutions

You do not have to commit to any treatment to use the service, although the staff will be happy to help you access other services at any time if you want.

Why the Needle Exchange Service is needed

Reckless drug injection can lead to a variety of detrimental side effects, such as:  

  • Bacterial and viral infections:
    This could potentially lead to a high fever, intense pain, and inflammation

  • Wounds:
    This may result in painful abscesses, ulcers, and damage to the veins 

  • Blood borne viruses:
    The transmission of either three BBV’s could include hepatitis B, hepatitis C and HIV

  • Injuries:
    Unfortunately, this could bring about critical conditions like sepsis, gangrene, amputation, and potentially fatal outcomes

What you can expect at an exchange

The service can offer advice, information and support to help you reduce your risk of harm. You will be treated in a respectful manner at all times by all staff and your exchange will be confidential. It is also expected that you will behave in a respectful way towards staff and other clients at all times.

You can get advice or written information on:

  • Safer injecting

  • Hepatitis B immunisation

  • Guidance on how to treat wounds from injecting medications 

  • Advice on how to avoid infections and reduce the spread of blood borne viruses 

  • Receive a sharps bin each time you visit and be encouraged to use it 

  • Overdose prevention, including Naloxone (a medication which can save lives by reversing the effects of opioid overdose) 

You can get sterile needles and syringes for injecting, and associated materials, such as condoms, citric acid and swabs, along with sharps containers (cinbins) for returning used equipment in. 

What equipment is available

The equipment provided with this service is free of charge, as its aim is to assist in eliminating the misuse of drug exchange and enhance safety.

When you access the Needle Exchange Service, an available pharmacist will be able to match the right equipment for you according to the medical information you provide, such as:

  • Needles (pins)
  • Syringes (barrels)
  • Spoons (cookers)
  • Citric
  • Bins

Water for injections

Currently sterile water is not available under Manx Care on the Isle of Man. See below information as to what water is safest to use:

No/low added risk of bacterial infection

  • Unopened ampoule of sterile water for injections:
    Manufactured for medical use, so therefore completely safe if used once and surplus is thrown away

  • Water Boiled in a kettle and then cooled:
    Good enough: will kill all organisms, is easy for most, and isn't too much trouble. If you haven't got a water amp, use water from a recently boiled kettle

  • Cold water freshly run from the kitchen tap:
    Likely to come from the rising main, and in the Isle of Man will be very clean. Better than water from the bathroom which may have come from a tank in the loft

Risk of bacteria

  • Hot water from a tap:
    Hot water tanks aren't usually hot enough to kill bacteria - avoid using hot water taps, cold is better

  • Bottled water:
    It may be pure, but it can have bacteria in it - especially if someone has drunk from it. Pour into the cap and draw up from there so you don't contaminate the bottle further

Medium to high risk of bacteria

  • Shared cup of water:
    Could have bacteria from the needle, or even blood. Throw it away and get water fresh

  • Part-used ampoule of water for injections:
    Could be contaminated by a needle, even a small risk of viral infection if there is blood in it. Tap water is safer: throw away part-used amps

High/very high risk of bacterial infection

  • Toilet water: Risk can be reduced by flushing the toilet and catching the water before it enters the bowl. Look out for empty bottles you can get filled from a tap

  • Puddle water or saliva: Too dangerous to be a last resort: try asking people for their almost empty bottles of water

  • Having your solution too acidic causes tissue damage, making it vulnerable to infection: You don't need a whole sachet for less than a gram of heroin

  • Too much acid increases the risk of infections

Needle exchange providers will work with you to make sure you have enough equipment for your needs. If you want more than one pack or extra needles because you live far away and find it hard to get to the pharmacy, or because you are getting packs for friends, then tell your pharmacist so they can give you extra packs.

If you don’t plan to use all the equipment in a pack, please tell your pharmacist so they can open it and you can take only what you need. This saves you having to dispose of what you don’t use, and also saves money because expensive equipment is not being thrown away.

It is really important that you return your needles so they can be disposed of safely. Before bringing them to the pharmacy, put them in your small black cinbin, and make sure it is properly sealed.

How a pharmacist can help

Pharmacists can assist in providing you with new and sterile equipment as well as being a location for you to dispose of NX sharps. Furthermore, as this service is FREE and does not require the need for an appointment, professional help and advice is instantly available. 

Where your nearest service is

There are pharmacy-based services currently operating at the following stores (pharmacies that provide this service will have the NES window sticker on display):

  • Boots Pharmacy – Strand Street, Douglas
  • Clear Pharmacy – 17 Parliament Street, Ramsey
  • Clear (Cowley) – 8-10 Atholl Place, Peel
  • Clear Pharmacy – The Parade, Castletown
  • Clear Pharmacy – Station Road, Port Erin
  • Clear Pharmacy - Cushag Road, Anagh Coar
  • Kinrades Pharmacy Ballaquayle Road, Douglas

View the gov.im Pharmacy webpage to find more information as to the pharmacies who provide this service. This will enable you to contact your local pharmacy for any queries or information regarding our Needle Exchange service and more.

Who else can help

Drug and Alcohol Team

This team works within a harm minimisation framework to provide a comprehensive, evidence-based assessment treatment and support service to people who are presenting with alcohol and/or drug dependency.

The multi-disciplinary team delivers an Island-wide specialist service including dedicated provision for young people under 18 years of age. The service works in partnership with allied statutory and non-statutory agencies/providers.

Drug and Alcohol Team

The Martyn Mackie Treatment Centre,
Reayrt Noa,
Noble's Hospital,
Douglas,
Isle of Man

Telephone: +44 1624 617889

Operational hours

Monday to Friday: 9am to 5pm (excluding bank and public holidays)

Out of hours services are available on Tuesday evenings from 5pm to 7pm. Please note that this is by prior arrangement only.

Motiv8

This service can help you change your relationship with Drugs, Alcohol and Gambling, view the Motiv8 website for more information. The right support can change everything, and their professional counsellors and support workers can help you get your life back.

Call Freephone 0808 1624 627 Monday to Thursday 9am to 4:30pm, Friday 9am to 4pm.

There is a confidential answer phone at all other times which will be responded to the next working day. Appointments are available Monday to Friday 9am to 5pm. Some evening appointments are available. 

Mobile: +44 7624 426400 or Telephone: +44 1624 627656

Email: contact@motiv8.im

If you are in Crisis please call the Crisis Team on +44 1624 642860 or in a medical or safety emergency please call 999 for an ambulance or the police.

Safer injecting advice

Below is the main advice regarding safer injecting:

  • Always use a new set of equipment for every injection
    Safely dispose of your equipment right away to avoid anyone reusing it or hurting themselves by accident

  • Always use the best water available to you
    Sterile water for injection is best, followed by water that's been boiled and allowed to cool. Never share water

  • Clean your hands and surfaces before and after each injection
    This helps to stop infections

  • Don't use too much citric
    This can help injecting sites heal better and can reduce the risk of burns to the skin and veins

  • Always use the smallest, thinnest needle possible for the injection site
    Larger needles damage your veins more than small ones.

  • Rotate sites in both arms as much as possible
    This gives each injection site time to heal and stops you moving on to riskier ones like your feet and groin

  • Never inject into the neck or the inside of your groin
    Both areas have important arteries and are extremely dangerous for injections

  • Don't inject alone
    Try to do it with other people around and know what to do in an emergency

  • Always carry naloxone
    Naloxone is a drug that can temporarily reverse the effects of an opioid overdose and save someone's life

Needle Exchange frequently asked questions

How can I stop my drug problem

We can signpost treatment options at alternative services to support users overcoming their addiction. For example, talking therapy such as CBT, accessing substitution medication and joining support groups etc. are good steps to achieve this goal. We can also assist with DBT, harm reduction, relapse prevention and acupuncture.

Where can family members and friends of users go for support

We recognise there are many parents, partners, children, carers and friends affected by their loved one who is using or working towards coming off illicit drugs. There are many support systems available to family and friends such as helplines and support groups.

Is the service confidential

This service and your privacy are confidential and respected. Our pharmacists and branches are a non-judgmental space for you to enter and receive support in reducing the risks of reckless drug injection and its detrimental side effects.

How to tell if someone is experiencing a drug overdose

Some visible signs someone may be overdosing are: small pupils of their eyes, the inability to speak, vomit, they are pale and clammy, lips and fingernails have a bluish or greyish tinge, slow, shallow, irregular or lack of breathing, they are making a loud noise when breathing or choking sounds. If you suspect someone is experiencing these symptoms immediately ring 999.

Where can family members and friends of users go for support

We recognise there are many parents, partners, children, carers and friends affected by their loved one who is using or working towards coming off illicit drugs. There are many support systems available to family and friends such as helplines and support groups like Motiv8, where you can learn more on their website.

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