If you are injecting drugs, there are steps you can take to reduce the risks of overdose, vein damage and infection. Visit your local QuIHN Needle and Syringe Program for safer injecting education and free sterile equipment.

Preparation

The place where you prepare and inject your drugs should be as safe, clean and well-lit as possible. It is also helpful to have access to running water.

When injecting drugs there is a risk of bacteria, viruses and other infection-causing microbes entering your bloodstream.

It is important to thoroughly clean your skin at your chosen injection site.

You can use spray and wipe or soapy detergent and water to clean the surfaces where you prepare your hit. This removes viruses, bacteria and dirt from your injecting environment.

Alcohol pads and swabs also work well. Only wipe in one direction once – not in a circular motion – to remove the dirt and germs from your skin, it is best to wait 30 seconds before injecting so the skin is dry.

Cleaning the skin before injecting is one of the most important things to do to reduce your risk of endocarditis (heart infection), blood poisoning and other infections.

And always remember: use a new fit for every hit. Always inject yourself if possible.

Mixing

Use a clean swab to wipe your spoon firmly in one direction. Avoid rubbing the swab up and down; because if germs avoid the alcohol or aren’t killed, they could still be there.

Put your drugs in the spoon. If you’re unsure about the quality, start with only a small amount (test dose).

If you’re sharing a mix as a group, everyone should have new sterile needles and syringes every time. Never let used equipment come anywhere near a group mix. You can mark your own equipment or use different coloured needles so you don’t confuse them with someone else’s.

QuIHN provides sterile injecting equipment at no cost.

Contact us about postage if you can’t access a Needle and Syringe Program directly.

Use a clean needle and syringe to draw the water up. Sterile water for injection or water that has boiled for 10 minutes and cooled – is best. Bottled water is not always sterile, and can have impurities.

Add the water to the spoon and mix. If you use the blunt end of the barrel to mix your drugs, make sure it’s clean.

Draw your mix up through a filter to remove particles and impurities. Wheel filters are best.

You don’t need to remove all air bubbles but if you want to reduce the amount of air, point the needle skywards and flick the side with your fingernail. Push the plunger slowly until the air bubbles release through the eye of the needle.

Injecting

Avoid touching anything you haven’t cleaned until you’ve finished injecting.

If you need a tourniquet to find veins, place the tourniquet around your upper arm or above the potential injection site. Elastic tourniquets are best, as using a shoelace or belt can twist veins.

With a clean swab, firmly wipe the injection site once.

Put the needle in your arm at a less than 45-degree angle to the skin surface with the hole facing up. It should be in line with the vein in a direction that comes back towards the heart. Sometimes blood appears in the syringe after the needle is inserted in the vein.

Pull back the plunger and blood should appear. If it doesn’t, then the needle is not in the vein.

When you’re certain the needle is in the vein, loosen the tourniquet and slowly inject the drugs.

If you feel pain or resistance, you may not be in the vein and you’ll need to start over. (If you hit an artery, it will be painful with bright red blood under more pressure. It will take longer to stop the bleeding and will do more damage if you inject into it.)

Remove the needle slowly, keep your arm straight and apply pressure to the injection site for a couple of minutes.

Cleaning up

Dispose of rinsing water immediately.

Put your needle and syringe in a disposal sharps container or childproof, puncture-proof container, not a glass jar.

Whenever possible, return your disposal container to your most convenient needle and syringe program. View QuIHN locations here or Queensland Needle and Syringe Programs at hospital or pharmacy locations.

Put swabs, filters and opened water ampoules in the disposal container or inside multiple plastic bags before placing them in the rubbish bin. Dispose of everything that has been used and opened.

Clean up any surface blood spills with spray and wipe or soapy water.

Wash your spoon and your tourniquets afterwards.

Wash your hands thoroughly with soap and warm water. If you can’t, use new swabs to clean them. Wipe with the swabs in one direction.

When to get help

The area around the injecting site is raised, red, hot and painful.

If you have accidentally been pricked by someone else’s used needle go to your doctor as soon as possible (or hospital if you can’t get in).

Go to your local Emergency department immediately if:

• You have painful, heavy, swollen and/or dead leg, which is a sign of Deep Venous Thrombosis DVT
• You have hit an artery and the bleeding last for longer than five minutes
• Your arm or leg is white, cold, or there is a loss of sensation