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Glossary of Key Terms1

Backloading/frontloading: “Backloading” and “frontloading” refer to a practice whereby one syringe is used to prepare the drug solution, which is then divided into one or more syringes for injection.  The drug solution is shifted from one syringe into another with the needle (frontloading) or plunger (backloading) removed.  HIV, hepatitis, and other infectious agents can be transmitted if the preparation syringe has been contaminated. 

Buprenorphine: A medication used in opioid substitution therapy programs.  It is included in the World Health Organization (WHO) Model List of Essential Medicines.

Harm reduction: Refers to a set of interventions designed to diminish the individual and societal harms associated with drug use, including the risk of HIV infection, without requiring the cessation of drug use. In practice, harm reduction programs include syringe exchange, drug substitution or replacement therapy using substances such as methadone, health and drug education, HIV and sexually transmitted disease screening, psychological counseling, and medical care.

Injection equipment: Items such as syringes, cottons, cookers, and water used in the process of preparing and injecting drugs. Each of these can be contaminated and transmit HIV or hepatitis.  The broader term “drug paraphernalia” comprises injection equipment as well as items associated with noninjection drug use, such as crack pipes.

Methadone: A medication used in opioid substitution therapy programs.  It is included in the WHO Model List of Essential Medicines.  

Needle or syringe exchange points: Programs that provide sterile syringes in exchange for used ones.  In addition to exchanging syringes, needle exchange points often provide HIV prevention information and screening, primary health care, and referrals to drug treatment and other health and social services.

Shirka: The popular name for one of the most commonly injected opiate derivates used in Ukraine, a homemade preparation of acetylated or extracted opium.  In the Odessa region, shirka refers to a homemade amphetamine derivate known elsewhere in the country as vint or perventin. 

Substitution or replacement therapy: Substitution therapy is the administration of a psychoactive substance pharmacologically related to the one creating substance dependence to substitute for that substance.  Substitution therapy seeks to assist drug users in switching from illicit drugs of unknown potency, quality, and purity to legal drugs obtained from health service providers or other legal channels, thus reducing the risk of overdose and HIV risk behaviors, as well as the need to commit crimes to obtain drugs.

Syringes or needles: The main components of a syringe are a needle, a tubular syringe barrel, and a plastic plunger. Graduated markings on the barrel of a syringe are used to measure the water or saline solution used to dissolve a solid substance into liquid form. Syringes and needles vary in size and do not always come as one piece; a syringe with the needle attached is often referred to as an “insulin syringe.”  While disinfection of syringes is possible, public health authorities recommend a new sterile syringe for every injection.

Ties or tourniquets: Items used to enlarge or “plump up” veins to facilitate injection.  Blood on a tie can also be a source of infection. Common ties include a piece of rope, a belt, a rubber hose, and a piece of bicycle inner tube.

Vint or Perventin:  The popular names for an injected homemade amphetamine derivate. 

Withdrawal: Clinical symptoms associated with ceasing or reducing use of a chemical agent that affects the mind or mental processes (i.e., a “psychoactive” substance). Withdrawal usually occurs when a psychoactive substance has been taken repeatedly and/or in high doses.



[1] Information in this glossary is drawn from a number of sources, including United Nations Office of Drugs and Crime, “Glossary of Terms,” [online] http://www.unodc.org/pdf/report_2000-11-30_1.pdf (retrieved December 8, 2005); World Health Organization, United Nations Office of Drugs and Crime, Joint United Nations Programme on AIDS, “Position Paper: Substitution Maintenance Therapy in the Management of Opioid Dependence and HIV/AIDS Prevention” (Geneva: WHO, UNODC, UNAIDS, 2004); and E-mail communication from Konstantin Lezhentsev, M.D., program officer, International Harm Reduction Development Program, January 20, 2006.


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