safer injecting

hints for safer injecting
cleaning fits
steroid users
recreational users
users with Hep C

In providing the following harm minimisation information, neither the authors nor Fitzroy Legal Service Inc. intends to condone or promote the unlawful consumption of drugs. People who do inject illegal drugs, however, are at risk of contracting or transmitting blood borne viruses and experiencing other harms. This information has been developed to assist injecting drug users to take steps that can help minimise risks to themselves and others.

hints for safer injecting

preparation
mixing up
injecting
cleaning up

These hints cover 'best practice' principles, i.e. the most effective ways to reduce the risks of blood borne virus transmission and bacterial infections, taking into account the situations in which illicit drugs are injected.

'Best practice' assumes that everyone injecting will have sterile syringes that can be disposed of immediately after use. It is strongly recommended that users plan their injecting in such a way that they can incorporate best practice procedures when they use, wherever possible. For example, taking more sterile syringes than you think you need so you always have some spare is a good plan for avoiding risky injecting situations. The following tips relate to injecting illicit powder drugs, such as white heroin, speed or cocaine, etc. Contact VIVAIDS or your NSP for risk-reduction tips for injecting other kinds of drugs.

preparation

Gather the equipment you need: new syringes (fits) in unopened packets, spoon, sterile water, swabs, cotton wool or other filter, tourniquet (if needed) and a sharps-safe or puncture-proof container.
Wipe down the surface where you intend to prepare your hit with warm soapy water. If you can't find a clean space, put some newspaper down or split the paper bag that the syringes came in. Get rid of any clutter in the area (e.g. ashtrays etc).
Wash with warm soapy water:
- your hands;
- the injecting site (e.g. your arm); and
- the spoon.
It's important to use warm soapy water to wash as this helps to remove traces of blood and dirt, and helps prevent blood borne viruses and bacteria entering your body. If you don't have access to warm soapy water, use swabs to clean your hands, spoon and injecting site. It's a good idea to ask for extra swabs when you pick up your injecting equipment just in case you get caught short.

mixing up

Swab your spoon. Always swab in one direction, otherwise you will just be spreading the bacteria back and forth rather than removing it. If you have to remove a lot of dirt you can scrub with a few swabs, but always finish with a fresh swab, wiped in one direction. It is important to wait until the alcohol from the swab dries - it does not take long and it is only truly effective once it has evaporated.
Place the drugs in the spoon.
Take the syringe out of the wrapper and remove the orange cap. Once you have opened your fit it is a good idea never to let it leave your hands until you place it in a sharps-safe. That way you can be one hundred per cent sure that it is your fit and that it has not come into contact with anyone else's blood.
Draw water into the syringe and then squirt it into the spoon. It is best to use sterile water from an ampoule that you have just opened, but if you cannot do that the next best option is to use boiled water that has been allowed to cool. Whichever water you use, be careful not to stab and blunt the needle point as you draw up water. Never put a used fit into water that others might use.
Gently stir the solution in the spoon. Use the end of the plunger to mix your drugs with water. If it doesn't readily mix then apply some heat, but be careful not to boil the solution. (Don't apply heat to a plastic spoon!)
Tear a small piece of clean cotton wool (or swab, tampon, etc), roll into a ball and add to the solution in spoon. Ensure your hands are clean before touching the filter, otherwise as you roll it into a ball the surface dirt on your fingers will contaminate both it and the solution you drop the filter into. (Other forms of sterile filters may be available through your NSP)
Place needle point, flat edge down, onto the cotton wool/filter in the spoon and draw the solution up through the filter and into syringe. Be careful not to blunt the needle tip by stabbing the spoon.
Hold the syringe upright, gently tap out any air bubbles and push the plunger to remove any air.

injecting

Locate the vein and use a tourniquet if needed. Tourniquets often get blood on them, so its best to have your own (something stretchy works best). Remember not to have it on too tight, or for too long.
Swab the injecting site. Always swab in one direction rather than back and forth, as this action tends to move bacteria back and forth instead of removing it. Always wait for your injection site to dry before injecting (it doesn't take long).
Insert needle into the vein at a 45-degree angle. Slide the needle in smoothly. One clean stab increases the chance of hitting a vein cleanly. Don't 'fish around', as repeated stabbing will cause bruising and scarring.
Slowly pull back the plunger. Check that you are in the vein - a small amount of dark blood should trickle into the syringe. If the blood is frothy and light in colour, this means that you have hit an artery and you need to loosen the tourniquet, slowly withdraw the syringe and immediately apply pressure to the site.
If using a tourniquet, now's the time to loosen it. Be gentle so that you don't move the fit or the vein. You shouldn't inject while the tourniquet is still on because there will be too much pressure on the vein (which can mean that some of the drug solution could leak out, which could in turn cause bruising or local infection).
Gently push plunger and slowly inject the solution.
Withdraw the needle slowly and smoothly. Withdrawing too quickly can cause damage to your veins. Being careful means that you will be able to use veins longer with fewer problems.
Apply pressure to the injecting site. You can use the remainder of your cotton wool or a tissue; swabs actually encourage bleeding, which in turn encourages bruising. Keeping your arm straight will also lessen the chance of bruising.

cleaning up

Put your used syringe straight into a sharps container (or puncture-proof container). Re-capping fits is unnecessary and a bad habit. It is also a sure way to get a needle stick injury. Only ever re-cap if it is not possible to dispose of the fit straight away in a puncture-proof container, and only if it is a fit that only you have used.
Wash your hands with warm soapy water. Blood on your hands can transfer onto anything that you touch, so as soon as you're able to, wash your hands.
Don't leave any injecting waste lying around. Leaving waste 'red-lights' an area and makes things harder for users everywhere.

Sloppy or unsafe injecting puts you at risk, not only of contracting and transmitting Hep C, Hep B and HIV, but also of dirty hits, bruising, blood poisoning and abscesses. These things are an unnecessary part of injecting drugs. If you choose to inject drugs, it is important to do it as safely and carefully as you can. This means using sterile injecting equipment, washing your hands before and after injecting, and disposing of equipment safely. If you have to use a used fit, read about cleaning fits below.