Injecting drugs can be dangerous. For the sake of your health and to lower the risk of addiction, switch to a non-injectable form of the drug if you can. But if you are going to inject here’s what you need to know.
Know the basics
- Learn the difference between a vein and artery as injecting into an artery can kill. Arteries are deeper and harder to find than veins, but they sit very close together. If you hit an artery the blood will be brighter and will spurt rather than ooze. It will be harder and more painful to inject your drugs and the plunger will probably be forced back and may contain frothy blood. It you think you’ve hit an artery, pull out straight away and apply firm pressure to the injection site. If the bleeding continues for more than five minutes seek medical help by going to an Accident and Emergency Department, NHS Walk-in Centre or a GP surgery.
- Use a new needle if you fail to find a vein straight away. To reduce the risk of collapsed veins avoid injecting into the same part of the body.
- Avoid injecting into veins in your hand as they’re too small to handle the volume and could collapse. Injecting below the waist can cause serious circulation problems if a vein is damaged. Never inject into a site that’s sore or swollen as this area may be infected or the vein may be blocked.
- Get to a doctor if an injection site is swollen for more than a few days, if it is red, hot or tender or if there’s any serious bleeding, the skin changes colour, is sore or weeps.
- Know where to get clean injecting equipment and take back used equipment (both can be done at needle exchange programmes, drug agencies and many chemists). Think about registering with a needle exchange.
- Use the smallest needles you can (ones colour coded orange are smallest). Work out how many needles you’ll need – and make sure you have at least that many before getting the drugs so that you won’t need to share.
- Use surgical swabs to clean the part of the body you inject into (and swab after injecting too) to keep the area clean. Or at least make sure you have soap and warm water to wash the area.
- The temptation to share is often strongest when coming down from the drug, not before taking it. Sharing with people you feel close to may feel safer but this is often an illusion - infections can easily spread between friends and lovers.
- Drawing up drugs from a shared pot risks the drug left in the pot getting contaminated with infections like hepatitis C. Everyone sticking to their own container is best.
- Don’t let one swab be used by different people – minute traces of blood on it could spread hepatitis C. If someone is injecting several others they may not realise that latex gloves can carry tiny amounts of infected blood between people, so fresh gloves should be put on as each new person is injected.
Preparing to inject
- Choose a quiet, safe and clean place to inject - at home is best.
- Use warm soapy water to wash your hands and wipe down the surface you’ll use to prepare your mix.
- Make sure you have all your clean injecting equipment within reach - a syringe and needle, swabs, spoon or foil, water, filter, and tourniquet.
- Have an approved sharps disposal bin or a bottle with a lid to put the needle, etc in afterwards.
- With a clean swab, wipe the spoon firmly in one direction, don’t rub the swab up and down in two directions as this spreads any germs on the spoon.
- Put your drugs in the spoon. If sharing a mix with others, you must all have new sterile needles and syringes. It’s important no used equipment comes near a group mix.
- Use a clean needle and syringe to draw the water up, sterile water is best.
- Add the water to the spoon and mix. If you’re using the blunt end of the barrel to mix your drugs, make sure it’s been cleaned.
- Put a filter in the spoon – the best filter is a hand-rolling filter, cotton wool or a tampon.
- Draw the solution up through the filter to remove impurities. If you’re injecting pills, use pill filters. If you can’t get pill filters, filter your mix at least three times.
- Remove air bubbles by pointing the needle skywards and flicking the side with your fingernail. Push the plunger up slowly until the air bubbles escape through the eye of the needle.
- Try not to touch anything that hasn’t been cleaned until you’ve finished injecting.
- Warm your arm and let it hang down to build up blood pressure.
- Use a tourniquet and place it around your upper arm just above the site where you plan to inject. If you tie the tourniquet too tight you could cut off your blood supply and have difficulties finding a vein - you should still be able to feel your pulse. Don’t share your tourniquet.
- With a clean swab, firmly wipe the injection site once.
- Put the needle into your arm at a 45-degree angle with the hole facing up.
- Pull back the plunger and blood should appear. If it doesn’t then you’re not in the vein. So you’ll need to pull the needle out, take the tourniquet off and apply pressure with a cotton ball to stop any bleeding.
- When you’re sure the needle is in the vein, loosen the tourniquet before you slowly inject your drugs. If you feel pain or resistance, you may not be in the vein, in which case you’ll need to start again.
- Keeping the arm straight, remove the needle and apply pressure to the injecting site for a couple of minutes (use cotton wool or tissue). Don’t use a swab as this won’t stop the bleeding.
- Be responsible and clean up all equipment. Recap your needle and syringe and put it in a safe disposal container and take it back to your local needle exchange. Never recap other people’s needles and syringes.
- Clean the area that you’ve used for injecting with household bleach. If you have no bleach, use warm soapy water.
- Throw everything out that has been used and opened.
- When you’ve cleaned up, wash your hands and arms thoroughly with warm soapy water. If you can’t, use swabs.
- Store all equipment in a clean and safe space.
There’s more info on safer injecting here.
How to clean equipment
One day you might have no option but to share, so it pays to know how injecting equipment can be cleaned. Click here for how.
This article was last reviewed on: 28/10/11
Date due for next review: 28/10/14