It can also cause the tissue to break down, resulting in sores and abscesses, which may become infected and spread. Use different coloured needles so you know who is using which needle. Slamming packs provide these. Once they are blunt they can damage your arms. Use soapy water to wipe down the surface where you'll prepare your hit or lay down the paper bag your equipment came in. Make sure you have everything you need within reach: new sterile fits, new sterile water or cooled boiled water in a clean glass , new swabs, a clean filter, clean spoon, and a clean tourniquet.
Wash your hands and your injecting site with warm soapy water. Hand washing is very important to remove viruses, bacteria, and plain old dirt from your injecting environment.
If you can't wash your hands use swabs, wiping in one direction to clean them. Rubbing swabs backward and forward spreads the dirt and bacteria around. Put the drugs in the spoon. No matter how well it has been cleaned, never let your used equipment or anyone else's come into contact with a group mix.
Unless new sterile equipment is used to mix and divide up, each person must have all their own equipment. Add water to the spoon and mix. You can use the blunt end of your syringe for mixing. Add the filter to the spoon. The best filters are a bit of a new swab, tampon or cotton bud. Injecting pills is bad for your health you can damage your heart, your veins and cause other serious health issues. If you are injecting pills, use pill filters if you can get them; if you can't get them, filter at least three times.
Draw the solution up through the filter to remove impurities. Remove air bubbles by pointing the needle skywards and flicking it on the side. Push the plunger up slowly until the air bubbles escape through the eye of the needle. Injecting air bubbles can cause serious problems with your brain stroke , heart and lungs that can be fatal. Place the tourniquet around your upper arm or above the injection site.
Don't leave it on too long. If you have trouble finding a vein, release the tourniquet and try again. Running warm water over the injection site will help raise a vein. So will opening and closing your hand in a pumping action. Try not to touch anything that hasn't been cleaned until you have finished injecting. Put the needle into your arm at a degree angle, with the hole facing up. Blood will sometimes appear in the barrel when the needle is inserted in the vein.
Pull back jack back slightly the plunger and blood should appear. If there is still no visible blood in the fit, remove the tourniquet and then the needle from your arm, apply pressure using a cotton ball, tissue or toilet paper to stop any bleeding, take a deep breath and start again. When you are sure the needle is in the vein, loosen the tourniquet and slowly depress the plunger.
If you feel any resistance or pain, you may have missed the vein and will need to start again. After injecting, remove the needle, keep your arm straight, and apply pressure to the injection site for a couple of minutes using a cotton ball, tissue or toilet paper. Don't use a swab to stop the bleeding, it may in fact stop the blood clotting.
Injecting over a long period of time can result in: Blocked blood vessels caused by things mixed or cut with the drugs Inflamed blood vessels and abscesses Damage to vital organs such as the liver, heart or lungs Periods of psychosis Injecting may also increase the risk of becoming dependent on the drug and thereby expose you to serious mental health problems CLEANING UP AND DISPOSAL Even if you are disposing of your fit, rinse it with clean cold tap water, straight after your hit.
This will remove most of the blood, prevent if from blocking and help reduce the likelihood of dirty hits if you have to use the fit again. Dispose of the rinsing water immediately, so no one else can use it and contaminate their equipment with your blood. Dispose of your fit in a disposal container or a puncture proof, childproof container and return the container to your NSP. Don't recap other people's fits. Wipe down the area where you have mixed up your fix with soapy detergent water.
Where there is a possibility of skin contact, the area should be wiped with household bleach. Don't re-use swabs, filters, or open water ampules - they can become contaminated once opened. When you have cleaned up, wash your hands and arms with warm soapy water.
If this is impossible, use single wipes with new swabs instead. Store all your equipment in a clean, safe place. Injecting is the greatest risk factor for contracting Hep C.
There is no way of completely eliminating the risk of viral transmission from used syringes. If you choose to inject: Use new injecting equipment every time you inject including new needles, sterile water, new swabs, a clean spoon, tourniquet, filter, a clean injecting space and clean hands. If you can't get a new equipment: Choose to wait until you can get new equipment Try using your drugs another way like smoking, snorting, swallowing or Booty Bumping up ya bum Clean equipment that only you have used before As the very last resort - clean equipment that someone else has used.
Even if you are already Hep C positive, cleaning is important, as you can be re-infected with a different or even the same strain of Hep C. Follow these directions for cleaning used equipment including your own Equipment: You will need three separate containers: 1. One filled with clean, cold tap water for rinsing blood out of your own fit. Soapy detergent water is best. Use water from the cold tap. If the water is too hot or too cold it can cause any blood in the fit to congeal and stick inside the needle where it can shed microscopic particles into your mix 2.
One filled with full strength bleach at least 5. You will also need a clean work space and a safe area to get rid of fluids - like a sink, bin or drain or whatever Cleaning process There are three steps to the cleaning process: rinsing, bleaching and flushing 1.
Count "1 , 2 " The symptoms of a dirty hit include; severe headaches, the shakes, fever, pain, vomiting and sweating. Paracetamol can help with the fever and anti-nausea tablets can help with the vomiting. If you or someone with you has these symptoms the person should rest, drink plenty of fluid and seek medical advice if the symptoms cannot be relieved or worsen.
You then have power over of the situation. You can include safer injecting practices like being hygiene aware, and can stop if you feel something is wrong. Remember - never use alone Stock up on equipment so you don't run out.
Always get more than you think you need Always mix up on a clean space wipe with a clean cloth and soapy water or use new swabs Clean your spoon before mixing up wipe once with a new swab Wash your hands with warm soapy water before and after injecting If you can't wash your hands, use single wipes with new swabs. Remember - rubbing swabs backwards and forwards spreads the dirt and bacteria around Stop the flow of blood after injecting with clean cotton wool, tissues or clean toilet paper Never let a used fit come into contact with a group mix - no matter how well it has been cleaned - Everyone must have their own fit, water, spoon and filter Have your own tourniquet and don't share it.
Wash it regularly to remove blood Rinse your fit with clean, cold tap water straight after your hit to help remove traces of blood If you keep your own fit, mark it and keep it somewhere safe Always dispose of injecting equipment in a disposal container or a puncture-proof container with a child-proof lid. If possible return the container to your local Needle and Syringe Program Don't re-use swabs, filters or open water ampoules: they can become contaminated once opened.
People who inject, or who are injected by someone else with drugs, are especially at risk if sharing or re-using injecting equipment. Hep C is the most common of the possible infections among people who inject drugs, with an extremely high percentage of people who inject likely to be exposed to a new infection and at risk of chronic long term infection. Be blood aware and take care. Safer using means understanding the risks associated with injecting drugs and making sure you protect yourself and others from these risks in any way you can.
Vein care Stimulants such as tobacco, cocaine, chocolate, coffee and black tea send your body into action mode. They make your heart work harder by causing your veins to tighten and shrink, squeezing more blood towards the heart.
When veins shrink, they are harder to find to inject. This could lead to misses, vein damage, and abscesses. Smaller veins also restrict blood flow and increase blood pressure. Many stimulants are toxic chemicals that can burn and eat away at delicate vein tissue.
With frequent injecting, vein tissue becomes inflamed and breaks down. This can cause scarring, abscesses and collapsed veins. Some chemicals can also make abscesses worse if you skin pop or miss. Tips for healthier veins Give your veins extended breaks from toxic chemicals and frequent puncture damage.
Your veins will be sure to last longer that way. The best way to protect your veins is to stop injecting drugs - particularly crystal, or if that's not a real option then try cutting back on injecting, or use in different ways. Water is your best friend when it comes to veins! Drink at least 8 glasses a day.
Drink less coffee, caffeinated soda and alcohol - these make your body lose more fluid than it takes in. Cut down on cigarettes, especially hours before having a shot. Nicotine also shrinks veins. Before you inject Try to make your veins expand as much as possible. When veins expand, or dilate, they are more visible. Veins you can see are easier and safer to hit.
Dilated veins also allow more blood to flow. If you're already speeding, your veins will be smaller than when you first shot up. So getting a good vein is going to be more difficult than when you had your first shot. Take a hot shower.
But you can make injecting safer by following a few simple rules. Lowering disease transmission saves tax payer money on disease treatment and decreasing the amount of syringes with HIV and hepatitis in the community promotes public safety.
Tips for injectors: A clean surface is important to prevent spread of bacteria. You can put down a fresh newspaper to make a clean surface. Always use clean water: Use sterile water. When injecting in a bathroom do not take water from the toilet bowl; water from the toilet tank is cleaner. Water can be sterilized by boiling it in the cap without the dope.
Reduce overdose risk: It is best not to shoot alone and not to lock doors in case of overdose. Always carry an overdose reversal kit Narcan if you can get one. Injection Kit Disposal: Be considerate when you dispose of your rig or syringe or leave blood in the bathroom.
Keep a biohazard kit on you to dispose of all materials; that way there is no evidence you were ever there. Coffee cans and plastic soda bottles made great biohazard containers too. Think: When choosing a place to inject, evaluate how much seclusion you are willing to risk. If you are more secluded the risk of someone finding you in case of an O. If you are out of syringes and you need them: You can buy syringes at pharmacies in North Carolina. We recommend that you use a new syringe for each shot to avoid abcesses, HIV and hepatitis.
Make sure to bleach your works to avoid disease. This will cut the risk of injection related diseases Hep, HIV, etc. To clean a set if re-using a syringe : draw up clean water all the way and shake. This will break down any excess blood that is in the set.
Do this three times. Then use full strength bleach 3 times and shake for 30 seconds each time, this will kill the remaining bacteria including HIV. Never share water, ties, cookers, spoons, sets or points. All of these can pass injection related diseases. Alcohol prep-pad: before injecting clean the skin.
This will help you avoid infections If you miss your shot: a squeeze the shot into a clean cooker; b clean the point or use a clean set and draw the shot back up; c never reheat blood it can clot the blood and send parasites directly into the blood stream; d move the shot up above the previous site and try again.
Where to shoot: below the collar bone and above the wrists. If you have to you can shoot in the hip area. Where not to shoot: a the back of the hands and wrists the walls of the veins are thin and damage easily; they are also loaded with nerve endings ; b legs the walls of the veins are thin and the circulation is slower ; c neck and groin real chance for damage , d eyes, forehead, tongue and genitals.
The blood will be dark and frothy. It will rush into the set and push the plunger. Pull out and raise arm above heart. Look for a blood vessel without a pulse. Rotate your veins: going into the same spot may callous the vein and cause it to collapse. It can also create abscesses. Always move the shots towards the heart. If you shoot below the previous injection site you may break free an existing scab or blood clot n the vein, which may travel to the lungs or the heart causing complications or death.
Rolling veins: A vein may roll if a tie is too thin. To stop a vein from rolling, you can put your arm against a flat surface and apply pressure. Angle of injection: you want to inject at a 45 degree angle with the hole in the needle the bevel pointing up.
This causes less tearing to the vein and lowers the chances of going through the vein. It also makes it easier for the point to enter the injection site. Tying off: will raise the vein and slow the flow of blood. Loosen the tie after getting register and before injecting. Slamming increases chances of an O. Primary Sidebar.
Signs Someone is Shooting Up Drugs
Unfortunately, there is very little published evidence or literature available to inform care. However, not all ulcers in PWID are venous in origin; some may be multifactorial due to arterial disease or co-morbidity.
Injecting process The most common illicit drug injected in the UK is heroin. It is usually brown in colour and originates from Afghanistan. Heroin is prepared from the opium poppy micrometry ppt is often manufactured in unhygienic conditions, often on the ground Zerell et al, The heroin produced may be contaminated with micro-organisms introduced during this manufacturing process, including spore-forming bacteria such as Clostridia Brett et al, Heroin is mixed cut with a range of substances from gravy powder to drugs such as paracetamol.
This cutting process reduces the strength of the heroin and increases the profits for the dealers. Injecting drugs users will not be aware of the content or strength of the drug they are using Coomber, Prior to injection the heroin is usually mixed with a liquid — usually water — and heated with an acidifier such as citric acid to dissolve it.
The solution is then drawn up into a syringe, usually through a filter,and injected into a vein Scott et al, Although heroin is primarily the injecting drug of choice in the UK, it may be mixed with other drugs during the cutting process, or users may choose to mix it with other substances such as cocaine. Heroin that contains cocaine will numb the injection area, which means that, if the vein is missed, the normal warning sign of pain will be masked Coull, Injection technique Poor injection technique increases the risk of damage to the veins.
This increases turbulence within the vein and can damage vein valves Preston and Derricott, ; Missing a vein or the needle going through the vein and puncturing the other side of the vein wall — bleeding can occur, and a granuloma may form around the site.
Missing the vein also increases the risk of infection Hope et al, Injecting drug users are encouraged to vary their injecting sites to preserve veins and limit tissue damage. Some sites, such as the feet or the groin, are riskier than others due to a heavy bacterial load on the skin.
Healing the wounds from injecting drugs
Injecting in the feet is also risky because the veins are peripheral and very small — it is easier to miss or puncture both sides of the vein and thereby inject into the surrounding tissue Hope et al, Risk factors associated with injecting drug use Injecting in the legs or groin femoral vein are known risk factors for development of leg ulceration. Injecting in the groin is strongly associated with the development of deep vein thrombosis DVTwhich often occurs in the thigh Coull, Clots may form because of the narrowing of the femoral vein from repeated injecting and the sluggish flow of blood in the thigh, possibly combined with long periods of inactivity.
DVT is also a risk factor for leg ulceration. Injecting in the femoral vein is becoming increasingly common among people who have been injecting drugs for a long time, as well as those who are new to injecting.
This may be because: The femoral vein is large and can tolerate repeated puncture; The injection site is hidden from view and easily accessed without a tourniquet so those who inject in public places — such as people who are homeless — find it easy to access and quick to inject into Preston and Derricott, Over time, a sinus may develop over the femoral site, making access more visible. The vein can scar and thicken, and injectors report finding the vein harder to puncture, resulting in their need to use longer and larger-bore needles to inject successfully.
Larger needles are associated with an increased risk of damage to the vein. Feet may become discoloured and purple due to venous congestion. Further disease of the venous system may develop and other signs become visible on the lower legs such as skin staining Fig 1ankle flare and an inverted champagne bottle-shaped leg Eklof et al, Fig 1. Long-standing ulceration of the right gaiter area with skin staining in a year-old former femoral injector In PWID, venous disease and associated ulceration may occur 20 years earlier than in the non-injecting population Pieper, and may appear long after injecting has ceased.
Ulceration can occur following simple trauma and patients do not necessarily associate their ulcer with injecting drug use, particularly when the ulcer appears at a site where no injecting has occurred — such as overlying the bony tibial crest.
Ultimately, venous disease that has arisen as a result of injecting in the femoral vein creates a vulnerable limb with poor healing capability.
Injecting in the femoral vein carries risk as it lies in close proximity to the femoral artery and the artery may be traumatised by injecting close to it. If a needle misses the vein and hits the artery, injectors usually experience sudden and acute pain and the limb may become red or white.
If the needle penetrates the artery, the injecting equipment may be forcibly ejected due to the high pressure within the artery. If the injector has injected into the artery, the limb is at risk as the drug is dispersed to the peripheries rather than into the central venous system. This can cause blockage of the arterioles and capillaries, leading to cell death and necrosis.
You may experience some pain and swelling after such intense activity. The safest way to do this is with powdered citric or ascorbic acid—ask your local syring service program or health food store where to find it.
Avoid lemon juice or vinegar, as these can lead to serious infections. To dissolve crack: put crack and citric or ascorbic acid about a pinch to a slab in the cooker; add plenty of water; mash and mix well.
Try to only use as much acid as you need, since extra will dissolve your drugs, and acid can be very hard on your veins. Skin-popping speed can be very painful, may cause an abscess, and will take a long time for the body to absorb. If you get the shakes after doing a few shots, it may be helpful to have a friend inject you if you are not using alone.
Safer Injection Drug Use
Because the quality of speed varies so dramatically, a tester shot is a good idea. ARMS: Arms, first upper then lower, are the safest sites for injecting.
HANDS: Hands are somewhat less safe than arms because the veins are significantly smaller and more delicate and therefore more likely to bruise or become damaged. Circulation is also slower in the hands, causing healing to take longer. Be vigilant about rotating the sites, and keep in mind that it is difficult to conceal injection marks and bruises on the hands.
Veins in the legs are more likely than those in the arms to develop clots that can obstruct circulation and eventually break off and lodge in the lungs or heart. Also, damaging the valves in the leg veins is more serious than damaging those in the arms since they play a greater role in getting blood back to the heart. FEET: As with the hands, the veins in the feet are generally smaller than in other parts of the body, and close to nerves, cartilage, and tendons which you want to avoid hitting when you inject.
Safer Injecting Practices
Because they are farther from the heart than the veins in the hands, arms, and legs, blood circulates more slowly in the foot veins and they therefore require more time for healing and repair. In addition, foot sweat and dirty socks act to prevent wounds from healing and increase the chance of infection from bacteria. GROIN: The femoral vein in the groin area is a large and fairly easy vein to access, but its location near the femoral nerve and the femoral artery make it quite a risky place to inject.
Among the three, the femoral vein is located closest to the groin, with the artery and then the nerve located as you move outward. Then move a short distance toward the inside of your leg to find the femoral vein. Because it lies fairly deep, you will probably not be able to see it but will have to inject into it without seeing where the vein is.
NECK : The jugular vein in the neck is the riskiest place to inject because it lies very close to the carotid artery, a major blood vessel that brings blood directly to the brain. Accidentally hitting the carotid artery could be fatal, and damaging the jugular vein in any way can interfere with blood circulation to the brain. You should avoid using veins that are tender, hardened, or inflamed until and if they heal.
Warm compresses and the use of appropriate creams can help speed the healing process. The larger and more visible the vein, the easier and safer it usually is to hit. Some wounds can last for months and even years. Certain spots on the body are more prone to problems, like the legs and the neck.
Infectious Disease doctor Laura Bamford. But Bamford, Dhand, and others at this clinic see lots of patients in the throes of addiction. So she often goes over safer ways to inject, to help reduce the infection risks. Studies out of Vancouver suggest that offering patients tools and teaching safe injection practices decrease complications, says Bamford, but no solid randomized controlled studies exist to further prove this. The biggest thing that has been shown to reduce infections is cleaning the skin first, with an alcohol wipe, to get rid of the bacteria.
Beyond that, she advises people to use boiled or sterile water when preparing drugs. She advises patients to rotate injection spots, to give gloomhaven movement a chance to recover, and to point the needle toward the heart at an angle between 15 to 45 degrees.
Still, even if a person takes all these precautions, the drug itself might be contaminated, so if and when bacteria does get in the body, the body fights back. It often forms an abscess, or a pocket filled with puss, to trap the bacteria. The skin may become swollen and painful. If the infection is beyond the skin, a patient may develop a fever. Bamford often prescribes antibiotics. The importance of trust Sheila Dhand, the nurse, says tending to any of this first requires trust. They can smell really bad and look pretty gruesome.
He says hospital staff have talked down to him. These competing drug cravings and the stigma of drug use make for a really tough situation, for patients and for doctors, when it comes to wounds.