Let’s face it. Injecting substances can be a complex (and sometimes dangerous) activity. Reaching your desired high, while also preventing potential harms, can be a challenging balance to achieve. Potential risks associated with injecting drugs include:
Death and overdose complications
HIV or Hepatitis C infection
Abscesses (a walled-off collection of pus within and underneath the skin)
Collapsed veins
Heightened risk of addiction
While these risks are significant, if you inject drugs, there are some steps you can take to keep yourself safer and healthier in the process. We provide an overview below.
Plan Ahead
1. Ensure you know how to prepare and inject your drugs safely, especially if you’re new to injecting drugs.
2. Ensure your drugs are safe. While not 100% accurate, drug checking can help you determine if there are unknown or potentially dangerous ingredients in your drugs. Drug testing kits can be ordered from Dancesafe.org.
3. Ensure you have the supplies you need. These might include:
Needles and syringes
Alcohol swabs
Cookers
Sterile water
Cottons or filters
Tourniquets or ties
Vitamin C or Citric Acid
Naloxone kits
Use new equipment every time you inject, especially needles. Do not share drug equipment with others. Sharing drug equipment with others can lead to transmission of infections, including HIV and Hepatitis C. You can access free injection equipment from the EMHC’ s Peer N Peer team by contacting connect@peernpeer.ca or calling or texting 587-599-7290. You can also access these supplies from our partner Streetworks (link to: streetworks.ca). If you cannot access free supplies from an organization near you, many of these supplies can be accessed from a pharmacy.
4. Find a safe place to inject. Perhaps the safest place to inject is in the presence of a trained healthcare professional, at a supervised consumption site. Currently, Edmonton has two supervised consumption sites: The George Spady Centre and Boyle McCauley Health Centre. You can find them on the map below.
Not everyone is comfortable accessing, or is able to access, a supervised consumption site. So, in the absence of that, find a space which is clean, dry, and well-lit; with clean, running water; and where you won’t be disrupted by unwanted observers or police. If possible, ensure someone is with you that you trust.
Prepping Your Drug
Powdered drugs must be dissolved into liquid form before they can be injected. This process is known as “cooking.” Different drugs dissolve differently. Some drugs are already in liquid form and don’t need to be dissolved at all. Some drugs dissolve best when heated. Some drugs dissolve in water without being heated, and can actually clot if heated. Some drugs, like brown heroin or crack dissolve more easily with acid. Heating the drug along with powdered vitamin C will help it dissolve more easily (vinegar and lemon juice are not recommended).
Injecting pills is only recommended as a last resort. If injecting pills, they should be crushed as finely as possible. Some pills, or their coating, will not dissolve properly in water. Injecting undissolved pill particles can cause a range of health problems, including abscesses.
Use sterile water to dissolve your drugs (don’t use saline water as your drugs might not dissolve in it). If sterile water is not available, use cooled water that has been boiled beforehand. If that is not available use the next cleanest source of water available (such as fresh, clean water from a tap).
Use a clean cotton/filter when drawing the liquid up into the syringe. This will help filter out unwanted particles, preventing them from entering the bloodstream.
Remove tiny air bubbles from the syringe by pointing it upwards, flicking it gently on the side, and pushing the plunger up slowly until you can see a small drop of liquid at the tip of the needle.
Injecting
Choose an injection site. For intravenous injection (injecting into your vein), the safest areas for injection include your arms (upper then lower), following by the backs of your hands (avoid your wrists). Do not inject into your groin or neck, as major arteries are present. Injecting into arteries can be dangerous and even fatal. If you inject often, consider rotating sites so that your veins have time to repair before being used again.
Wash your hands. Ensure the site around you is as clean as possible.
Clean the injection site using an alcohol swab or soap and water. Wipe in one direction to ensure you are removing the dirt instead of just moving it around the injection site.
Find a vein to inject into. To help, you can use a tourniquet/tie, pump your fist, or swing your arm in a circle.
With the needle bevel up, slowly insert the needle into your vein. The needle should be inserted at an angle (about 35-degrees), in the direction of the heart (the direction of blood flow) to reduce damage to the veins. To ensure the needle is in the vein, you can pull back slowly on the plunger. If a little blood flows into the syringe, you are likely in a vein.
However, if the blood is frothy or brighter than usual, or if there is significant pressure from the blood, you may have hit an artery, which can result in significant blood loss. Remove the needle slowly and place pressure on the site of injection. If bleeding, swelling, or pain continues for more than ten minutes, ensure you get medical attention.
Once you are sure the needle is in the vein, release your tourniquet or tie and slowly inject the substance. Remember, it’s much easier to put more substance in than it is to take substance out. So, if you haven’t used in a while or are unsure about the safety of the drug you’re using, consider using a smaller dose at first.
Slowly remove the needle at the same angle it was inserted. Place clean and dry gauze, tissue, or a cotton ball on the site of injection and apply pressure until bleeding has stopped.
Cleaning Up
Dispose of all drug use equipment or other materials (i.e. newspapers) used.
Ensure needles are placed in a sharps container if one is available. If not, consider placing it in an empty bottle with a tight-fitting lid.
Clean any surfaces used with soap and water, as infections such as hepatitis C can live on surfaces for days.
Clean your hands with soap and water.
Access Supports
If you’d like support to change your substance use or use substances more safely, contact a Peer N Peer team member at connect@peernpeer.ca or by text/call at 587-599-7290. We offer free access to one-on-one counselling, education and support; screening and referral services; and access to clean substance use supplies.
References
“Drug Checking.” DanceSafe, dancesafe.org/drug-checking/.
“Getting Off Right Safety Manual.” Harm Reduction Coalition, harmreduction.org/drugs-and-drug-users/drug-tools/getting-off-right/.
“Routes of Administration.” Toronto Vibe, torontovibe.com/routes-of-administration.
“Safer Injecting.” TouchBase, touchbase.org.au/toolkit/safer-injecting.
“Safer Injection.” CATIE, 2011, www.catie.ca/en/practical-guides/hepc-in-depth/prevention-harm-reduction/safer-injection.