A TO Z OF SAFER INJECTING

Alternatives to injecting

Getting drugs into you via needles has a lot of risks, including the chances of overdose, infections, dirty hits, HIV, hepatitis C, collapsed veins and more. Depending on your drug of choice, you may be able to snort it, swallow it, smoke it or shaft it (up your bum). It pays to give your veins a regular break by using these alternatives – have a go and see what you think. There is less rush but your high usually lasts longer.

Blood-borne viruses

These tiny buggers laugh at the best filters and can move from person to person through traces of blood left on tourniquets, fits, fingers and your drug preparation area. The most common serious ones include HIV, hepatitis C and hepatitis B. The best way to avoid them is never share any injecting gear with others, wash your hands with warm soapy water, have a clean preparation area and dispose of everything legally and safely!

Clean water

When you inject, you bypass all your body’s natural filters, so you gotta make sure the water for your mix is as sterile as possible. Your best bet is the sterile water from your local needle and syringe outlet, if any exist in your area. The next best option is tap water you have boiled for several minutes, but remember to let it cool to room temperature. Your last option is simply cold water from your tap.

Disposal of used injecting gear

Users have it tough enough with a judgmental society – please don’t make it worse by leaving used fits lying around! As all self-respecting users know, we need to clean up after ourselves. Safe disposal of used injecting gear not only protects others from needle stick injuries, it protects us from getting busted. Safe disposal is required by law in many countries– in fact in some cases you can carry used gear around for disposal if it’s in the necessary rigid-walled sealed container. Check with your local users group to find out the legal stuff in your region.

Enjoy with others

It doesn’t matter if it’s a legal drug like alcohol, or an illegal one like speed – most humans have a tendency to use drugs to party, feel happy, chill out, or experience the world in a different way. Most of us find that sharing the experience with mates makes it even better. This is also a lot safer – your mates can talk you down if you have a bad trip, keep you out of trouble if you freak out, or call the ambulance if you overdose. Always try to be with someone you trust when you use!

Filtering your mix

Swallowing ecstasy? Your stomach filters the mix. Smoking freebase? Your lungs do the filtering. Shafting heroin (up your arse)? The lining of your rectum filters the crap from your mix. But when you inject, your body has no defence against the fillers in your mix that can cause some very serious shit to your health! At the very least, use the special filters that come in every kit from your Needle & Syringe Program and swab your fingers before you handle the filters. Your next best bet is cigarette filters. But if you can get them, 0.2 wheel filters even filter out bacteria!

Germs

Those blood-borne viruses aren’t your only worry. There are millions of bacteria itching to get into your system via that fit. These blue dots are just one example – s.epidermis live on your skin and can infect the valves in your heart. It’s only one of over 200 types that live in or on your body!

Hepatitis C

Hepatitis C (HCV) is a major issue for all injecting drug users. In some countries, it is reaching epidemic levels. Australia’s harm reduction approach is only now starting to keep HCV in check, but HCV is very common in our prisons, where new needles and syringes aren’t distributed (well duh). Hepatitis C is a blood-borne virus, and it is transmitted very easily between users through poor infection control, particularly sharing fits and other injecting equipment. There is also a very small risk of getting HCV from unsterile tattoos and body piercings, or sharing razors and toothbrushes. Hepatitis C is an inflammation of the liver that can lead to serious health problems including cancer of the liver. As the symptoms don’t always show, it’s worth getting checked out by a doctor if you’ve ever injected drugs. The good news is there are treatments available.

Injecting

Injecting first started in 1853 when morphine was used to treat painful nerve disorders. In the 1860s, injection became very popular in Britian, Europe and the USA. Just over a century ago, morphine and syringes were given to the wealthy to treat themselves for all sorts of ailments.

Jacking back

Jacking back is when you draw back on the plunger to make sure you are in the vein. You should get a bit of dark red blood. If the blood is bright red, then gently pull out gently as you have hit an artery! Arteries are very dangerous to inject into, and usually painful as well because they are surrounded by nerves. Always jack back very slowly and gently to avoid vein damage. If you’ve missed the vein, pull out, take a few deep breaths and try again. Jack back while your tourniquet is still on, but remove before you inject.

Keep a balance

It’s tempting to use drugs to kill the pain or boredom when we aren’t feeling so good. The problem is drugs only help for a moment and can leave you feeling even worse in the long run. Most users find the key to getting the most of out of a drug is balancing use with other fun things in life – friends, family, exercise, work, hobbies. Like chocolate or wanking, too much of a good thing leads to a bum trip. Remember there are user groups in many countries that can help you work out a balance, or take a break, or stop using all together... whatever YOU decide is best for you.

Legal hassles

There are all sorts of legal hassles you can get caught up in, whether it’s possession, distribution, being classified as an unfit parent, or done for a crime to support your habit. The legal systems in some countries are gradually starting to see serious illicit drug dependency more as a health issue, not a criminal one. This is in line with a harm reduction approach. Unfortunately, countries such as Russia and the USA are still waging a 'war on drugs' so many users wind up in prison instead of treatment.

Methadone & Subutex

If you’ve got an opiate habit, there are quite a few ways to handle it if things are getting out of control. Methadone has been around for a long time, and some users find it the best way to stabilise their life when heroin or morphine use has got out of control. Subutex is a similar treatment which can also be used for rapid detox. There’s also suboxone which includes naloxone which blocks any other opiates that enter your system. Have a talk with staff at your Needle & Syringe Program about these options if you want to get off heroin, morphine or other opiates.

New fit each time

A new fit every time means less chances of viruses, bacteria and vein damage. And of course, don’t share that fit with anyone else. A great idea is to plan ahead so you never have to look longingly at that used syringe for your next hit. Most needle & syringe outlets should let you take a good number of fits at one time, so stock up. If you absolutely have to reuse a syringe, try the 2x2x2 method. Rinse twice with clean water. Rinse twice with bleach (shake for two minutes each time). Rinse twice with clean water again. Remember that this is a last resort though!

Overdose

Don’t be shy – your average ambo is non-judgmental, friendly and just wants to keep your mate alive. If someone drops, call the ambulance straight away. They never call the cops unless they believe they could be in personal danger. If the person is unconscious, roll them on their left side. It only takes a tiny bit of vomit to drown someone if they are on their back!

Prison

A lot of people find that using on the inside isn’t worth it. You can’t get new fits in the prisons of most countries, so the risk of vein damage, infections and viruses like hep C and HIV are really high. Getting caught can lengthen your stay, and all sorts of shit can happen if you can’t pay the dealer in prison for what you’ve used.

If you do go to prison, take your time to make friends and get to know who is who. Inevitably there are a lot of internal politics. Most inmates find the best way to do their time is to stay clean and to avoid the rush in joining any groups. Your sentence will go faster if you grab whatever work is going and get into some of the programs – people even come out the other end with diplomas and degrees!

Quitting

Some of us find it easy to keep our habit under control, while others only have trouble when the shit hits the fan in one way or another. Still other users find they just can’t keep their use in balance with other things in life, and it always spirals out of control.

At some point, most of us have had a full blown dependency and have needed to detox – whether it was to take a break, get off for good, or forced on us by being in prison. The good news is that there is detox support, whether you detox at home, in prison, with medication, or in a residential detox. There’s also a lot of support out there to either help you stay clean, or manage your habit more effectively if you get back on.

Rotate your inejction sites

We humans are creatures of habit, whether it is the way we put the toilet paper roll on the dispenser, or where we choos to inject our drugs. Everyone has their favourite spot, but you damage your vein lining every time you inject, even with new fits. Give your veins time to recover by having a few spots you can rotate each time you use. Also see if you can use your other arm as well to share the load.

Small taste first

If you buy cigarettes or a beer, you know just how much drug you will be getting into your system. A huge problem with illicit drugs is you usually have next to no idea how strong or weak your hit will be. Sometimes the urge to jump right in is overwhelming, especially if you are hanging out. But when injecting, it’s a good idea to inject a small bit first to see how strong the mix is. It won’t reduce your rush, and may just save your life if you’ve scored some really strong shit!

Tourniquets

Tourniquets help to get your veins pumped so they are easier to see and enter with that needle. Some Needle Syringe Programs sell cheap tourniquets, or you can make do with a long sock or tie. Leave the tourniquet on while you ‘jack back’ to make sure if you are in the vein, but ALWAYS release the tourniquet before injecting! Otherwise, you inject into a vein that’s under pressure, increasing your chances of a missed hit or vein damage. Have own tourniquet that you don’t share with anyone. Sharing your tourniquet increases your risk of contracting blood-borne viruses like hep C and HIV.

Use swabs

Swabs come with the fit pack you get from your Needle & Syringe Program. Use the swab to wipe ONCE, and in ONE direction only, across your injection site. Why? Wouldn’t a good scrubbing kill bacteria better? No! Germs are killed by the evaporation of the alcohol, so scrubbing or wiping a few times just moves the bacteria around. No swabs? Another option is to dip a tissue in methylated spirits and wipe once. The best option of all is warm soapy water for your hands and injection site, then use the swab on your site just to make sure.

Vein care

As we all know, injecting is the riskiest way to get the goods into you. It’s worth giving your veins a rest by taking breaks from injecting, and rotating your sites. Be on the lookout for any lumps, bumps, pains or strange skin colour around your injection sites. We strongly urge you to see a doctor at the first hint of trouble – these things can even lead to losing an arm or leg eventually.
Your Needle & Syringe Program staff will usually know of non-judgmental doctors in your area.

Wheel filters

Wheel filters are usually used in industrial settings but are such a good way to filter your mix that many Needle & Syringe Programs are starting to supply them. If you are going to inject pills, these wheel filters are a MUST to reduce the risk you face when injecting all the extra fillers (i.e. chalk) and crap that come in pills.

Wheel filters are not only the best filter for injecting any drug, but the smaller 0.2 micron size even filters out bacteria! You can’t reuse wheel fitlers because bacteria grow inside them, but they are very cheap - it’s a small price to pay for a very clean hit. See if your Needle & Syringe Program has them in stock, or you may even be able to order them from wholesalers in the chemical industry.

X marks the spot

As many long-term users know, your veins start to shut down, especially if you use old fits, don’t take regular breaks from injecting, and don’t rotate sites. Your lower arm is the best place to inject, but what do you do if you lose all your veins there? See if you can use your other hand to access the veins on the lower half of your other arm.

Otherwise, the next safest place is the upper arms. If they have closed down too, then next best place is the veins in your hands, although these are very fragile so use a fine needle if you can (we suggest 29 guage). After that, the risks just keep getting higher at other sites on your body. Have a talk with your Needle & Syringe Program staff if you have trouble finding good veins, and remember exercise improves your veins.

Your hygiene

Your skin has natural oils in it that bacteria use to glue themselves to you. Soap gets rid of this oil so the bacteria just wash right off, and they don’t get a chance to get into your body via your fit.
You can go for extreme hygiene and use bacterial soap, but careful hand washing with ordinary soap will usually do the trick. It’s also a good idea to use warm soapy water to clean your spoon and preparation area – bacteria like to hang out there as well!

Zzzzz

We thought it was tough finding a topic for X, but Z was a real brain stopper. Eventually we figured zzz could stand for nodding off. While nodding off is kinda neat, remember it is actually at the milder end of what is technically an overdose. Always shoot up with people you trust, who can keep an eye on you, and can call the ambulance if you do drop.

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The economics of dependency

Ever heard of the law of diminishing returns? In a technical sense, economists would say it is where diminishing marginal returns occur in a production system, when each additional unit of input yields less and less additional profit.

Sound boring? Hell yes. For most people economics is a great way to get to sleep, but this particular law has a lot of relevance for users.

The key? Don't overdo it!
To use an example, say Ford has worked out that producing around 12 493 Falcons a year gets them the most profits on each car. But if they made a million Falcons next year, they would obviously be getting bugger all profit on each car. Overdoing it just doesn’t yield the same results.

There’s a similar action at work with many drugs. If you only have one shot a week, you’ll probably have a good high each and every time. But the more often you hit up, the less effect you get. Then your body develops a tolerance to the drug, and at some point you’ll need to hit up just to feel normal, let alone high.

How much this process occurs varies from drug to drug. For example, tolerance to drugs like alcohol and cannabis will develop at a slower rate than drugs such as heroin, nicotine, speed and cocaine.

So the problem with many illicit drugs is that you can definitely have too much of a good thing, especially if you have it too often. If you really want to get the most positive effect out of your drug, you need to work out a level of use that keeps tolerance to a minimum.

The weekend user
Context has a lot to do with it. If you are doing speed or ecstasy just for a night out on weekends, chances are you won’t hang out, or at least not too badly. You might feel sleepy or crappy come Monday and Tuesday, but you balance the pros and cons and might decide it’s worth a good weekend bash.

But if you start doing drugs like smack, speed, benzos and cocaine a few times a week, you’ll soon need to keep taking more to get the same high, and you will get some nasty withdrawals when you cut back or stop using.

Constant cravings
So we’ve only looked at minimising our body’s physical dependence. There is something that really buggers some of us up even if we try to only use now and then. There’s also the psychological dependence, or the craving that our brain can develop for our favourite drug. Some users have a hell of a time trying to balance their use because their brain is craving another hit, even if their body isn’t.

For some users, this can mean they will find they simply can’t reduce their level of use. Anyone involved in Alcoholics Anonymous or Narcotics Anonymous would tend to agree, as they see addiction as a disease, and the only cure is staying well away.

If you aren’t happy with your level of use, there are plenty of counsellors, support groups, programs and detox facilities to help out, regardless of whether you just want to reduce or give it all away.

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