There is no safe way to inject Subutex (also known as buprenorphine or 'bupe'), as it has been designed to be taken orally. This guide is intended to reduce the risks for people who insist on injecting Subutex.
Why injecting Subutex is dangerous
If you intend to inject your Subutex tablets you need to be aware of the potentially serious risks involved. You also need to be aware that this medication is only designed to be dissolved under your tongue - if you do intend to inject a Subutex tablet you have to have the skills to transform a solid substance into an injectable solution. This is more difficult than most people think and takes time and the correct use of specific equipment.
When you inject buprenorphine or 'bupe', it doesn’t last as long in your body as when you dissolve it under your tongue as prescribed, you may start “hanging out” and go into withdrawal quite a while before you can get your next dose. If you get caught diverting your dose there may be a lot of penalties coming your way from the clinic; as in no more take away doses, an enforced change of pharmacy, dose changes etc.
Injecting can lead to vein problems, hepatitis C and HIV/AIDS. Safer shooting techniques can reduce these risks. If you still choose to inject, here is a guide to reduce some of the risks involved.
Equipment needed to inject bupe
Use new, clean equipment with each shot. Never share your equipment.
Sterile water
Mixing bowl or teaspoon
Syringes
Two 3ml syringes
'Drawing up' needle
Ideally a 19 guage needle, able to draw up your mix into the barrel
Cotton wool or cotton filters
A wheel filter
Click here to find out more about wheel filters and how to use them. You
can also use a butterfly if you have multiple barrels.
Swabs
Use these to clean your equipment and injection sites. Wipe them in one
direction, once only. Wait for the area to dry - it is the drying action
that kills germs.
Soap
Clean your preparation areas, and hands before and after using to reduce
the risks of blood borne diseases like hepatitis C and HIV/AIDS.
Tourniquet
Make sure you clean this with soap before and after use and never share.
Click here to read up more on tourniquet use.
Safe disposal bottle
This should come with your gear from the NSP. It is illegal not to use one
with used injecting equipment!
Step one
Before you begin it is extremely important that you know where the Subutex came from. Only use tablets that you have removed from the packet. If the Subutex has been “diverted” from anyone’s mouth; including your own, do not inject it. Even small traces of saliva can permanently harm your health and destroy veins.
Wash or swab your hands and preparation area. Swab out the spoon or bowl you are going to crush the Subutex tablets into. Crush the tablets as fine as you can, then begin to gradually mix sterile water into the crushed tablets. Mix the water and the crushed tablets thoroughly.
Diluting your mix is VERY important; dilution means adding sterilised water when you are crushing up your tablet. When you dilute your drugs by adding water, it does not mean you will dilute the effects of the drug. It simply makes it easier to filter any undesirable substances out of your mix, which will also help to keep your veins healthier.
The more sterile water you add, the better the filtering. The sterile water you use for dilution must be room temperature only, never use warm or hot water. Subutex tablets are not a chalk-based tablet like the majority of pills you may have tried to inject. Subutex utilises maize starch to form a tablet. Therefore it may be necessary to utilise different techniques to break Subutex down into an injectable solution.
Step two
Do not heat the mix! Subutex has a maize starch base, rather than being a chalk-based tablet which is more common. If you heat the mix you will make something akin to gravy!
Draw up the mix through cotton filters into a syringe with a 19 gauge tip. Repeat this process as many times as it takes until you have a milky looking fluid. Set the mix aside on a sterile surface.
Step three
Prepare (aka ‘prime’) the wheel filter for use: (slowly inject 1ml of sterile water from a 3 ml syringe through the wheel filter prior to injecting the drug mix through it). Then, attach the ’primed’ wheel filter to the 3 ml syringe containing the mix, followed by a new 19 g needle tip. Push the mix through the wheel filter into another syringe or into a swabbed clean bowl.
Step four
Wash your hands, swab your injection site, attach a 26g needle tip and inject the mix slowly into the vein.
Step five
Wash your hands immediately after injecting. Place all the used equipment into a sharps container and dispose of responsibly.
Important: If there is any pain, inflammation or redness around your injection site seek medical assistance.
When you take the needle out of your arm, put pressure on the injection site for a couple of minutes to stop the bleeding. Using a swab will only make it bleed and bruise.
Wash your hands and place all used equipment in to the safe disposal bottle and seal. Dispose of the bottle responsibly.
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