Safer injection guide: Difference between revisions

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{{#ev:youtube|https://www.youtube.com/watch?v=MppHWdZ-S_I|340x240|right|[[#Single-use spoons|Single-use spoons]] for preparation of drugs for injection complement [[#Syringes|syringes]] and [[#Hypodermic needles|hypodermic needles]] in preventing transmission of blood-borne diseases, which often goes unnoticed through communal spoons: ''Boiling, burning, or using common cleaning fluids, alcohol, or peroxide can reduce the amount of the hepatitis C virus (HCV), but this may not prevent you from getting infected.''<ref>https://www.cdc.gov/hepatitis/hcv/pdfs/factsheet-pwid.pdf</ref> The [[Sharing_injection_materials#Hepatitis_C|hepatitis C]] virus can survive outside the body for <span style="color:red">'''6 weeks'''</span>.<ref name="pmid24273176" /> The international prevalence of {{nowrap|hepatitis C}} is between <span style="color:red">'''60% and 80%'''</span> among people who use injection drugs.<ref name=Lancet2011>{{cite journal | vauthors = Nelson PK, Mathers BM, Cowie B, Hagan H, Des Jarlais D, Horyniak D, Degenhardt L | title = Global epidemiology of hepatitis B and hepatitis C in people who inject drugs: results of systematic reviews | journal = Lancet | volume = 378 | issue = 9791 | pages = 571–83 | date = August 2011 | pmid = 21802134 | pmc = 3285467 | doi = 10.1016/S0140-6736(11)61097-0 }}</ref><ref name=China2008>{{cite journal | vauthors = Xia X, Luo J, Bai J, Yu R | title = Epidemiology of hepatitis C virus infection among injection drug users in China: systematic review and meta-analysis | journal = Public Health | volume = 122 | issue = 10 | pages = 990–1003 | date = October 2008 | pmid = 18486955 | doi = 10.1016/j.puhe.2008.01.014 }}</ref>|frame}}

'''Injection''' is the act of delivering a [[psychoactive substance]] into the body using a hypodermic needle. Injected substances are mixed with a liquid (such as water for injection) to form a solution, which is usually either injected directly into the bloodstream via the veins (i.e. intravenous or [[#IV_injection|IV injection]]) or into the muscle tissue (i.e. intramuscular or [[#IM_injection|IM injection]]).

'''Injection''' is the act of delivering a [[psychoactive substance]] into the body using a hypodermic needle. Injected substances are mixed with a liquid (such as [[#Sterilie water for injection|sterilie water for injection]]) to form a solution, which is usually either injected directly into the bloodstream via the veins (i.e. intravenous or [[#IV_injection|IV injection]]) or into the muscle tissue (i.e. intramuscular or [[#IM_injection|IM injection]]).

Injecting substances removes any bodily filtering mechanism and IV injection results in 100% bioavailability of a substance.<ref>{{Citation | vauthors=Editor | year=2011 | title=Bioavailability of Drugs | url=http://howmed.net/pharmacology/bioavailability-of-drugs/}}</ref> Any impurities present in the product will pose a significantly greater health threat. Even medical grade substances specifically manufactured for injection carry a risk of infection and death. As a result, this guide has been deliberately named the "safe(r) injection guide" to emphasize the fact that there is no such thing as truly safe injection.

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"It is common to have muscle pain when injecting larger doses of liquid Ketamine into muscle tissue. The pain can continue for several days if it is not administered properly. The muscle soreness can be somewhat controlled by using a very fine (small gauge) needle and by injecting very slowly. It should take 15-30 or more seconds to inject a dose into a muscle. If you feel it begin to sting, slow down the injection rate."<ref>{{cite web |title=Erowid Ketamine Vault : Dosage |url=http://www.erowid.org/chemicals/ketamine/ketamine_dose.shtml#im |website=www.erowid.org}}</ref>

===~~Water~~ for injection===

===Sterile water for injection===

[[File:Sterilewater.jpg|245px|thumb|right|The USP standards for water for injection includes a "target limit response" of 500 µg of Carbon/L, and 10 [https://en.wikipedia.org/wiki/Colony-forming_unit {{abbr|CFU|colony forming units}}]/100mL.<ref>https://www.usp.org/frequently-asked-questions/water-pharmaceutical-and-analytical-purposes</ref>]]

[[File:Sterilewater.jpg|245px|thumb|right|The USP standards for water for injection includes a "target limit response" of 500 µg of Carbon/L, and 10 [https://en.wikipedia.org/wiki/Colony-forming_unit {{abbr|CFU|colony forming units}}]/100mL.<ref>https://www.usp.org/frequently-asked-questions/water-pharmaceutical-and-analytical-purposes</ref>]]https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/018632s051lbl.pdf

'''[https://en.wikipedia.org/wiki/Water_for_injection ~~Water~~ for injection]''' is ~~water of extra high quality without significant contamination~~.

'''Sterile [https://en.wikipedia.org/wiki/Water_for_injection water for injection]''' is used to create solutions that will be administered by injection. Water for injection is generally made by distillation or reverse osmosis.<ref name=Gh2004>{{cite book|last1=Ghosh|first1=Tapash K.|last2=Jasti|first2=Bhaskara R.|title=Theory and Practice of Contemporary Pharmaceutics|date=2004|publisher=CRC Press|isbn=9780203644478|page=396|url=https://books.google.com/books?id=whiC7aSFLY8C&pg=PA396|language=en|url-status=live|archiveurl=https://web.archive.org/web/20170116162803/https://books.google.ca/books?id=whiC7aSFLY8C&pg=PA396|archivedate=2017-01-16}}</ref>

Water for injection is generally made by distillation or reverse osmosis.<ref name=Gh2004>{{cite book|last1=Ghosh|first1=Tapash K.|last2=Jasti|first2=Bhaskara R.|title=Theory and Practice of Contemporary Pharmaceutics|date=2004|publisher=CRC Press|isbn=9780203644478|page=396|url=https://books.google.com/books?id=whiC7aSFLY8C&pg=PA396|language=en|url-status=live|archiveurl=https://web.archive.org/web/20170116162803/https://books.google.ca/books?id=whiC7aSFLY8C&pg=PA396|archivedate=2017-01-16}}</ref>

Syringe designed saline drops (e.g. Wallace Cameron Ultra Saline Minipod) are distributed in modern needle-exchange programmes as they can be used efficiently either by injection or ophthalmic (if the drug is potent in small doses) route of administer which is compared to intravenous use; by demonstration, the elimination of latanoprost acid from plasma is rapid (half-life 17 minutes) after either ophthalmic or intravenous administration.<ref>{{cite web|url=https://www.drugs.com/mmx/latanoprost.html|title=Latanoprost Drug Information, Professional|publisher=Drugs.com|access-date=18 September 2014}}</ref>

* [https://en.wikipedia.org/wiki/Eye_drop Eye drops] '''with medications can be deadly when injected'''. However, preservative-free eye drops made of [https://en.wikipedia.org/wiki/Saline_(medicine) saline] from sterilized water (as isotonic solution) are sometimes used for injection.

* Distilled water should be avoided in large amounts directly into a vein, as it can cause your blood cells to become hypotonic, possibly leading to death.Water for injection is generally made by distillation or reverse osmosis.<ref name=Gh2004>{{cite book|last1=Ghosh|first1=Tapash K.|last2=Jasti|first2=Bhaskara R.|title=Theory and Practice of Contemporary Pharmaceutics|date=2004|publisher=CRC Press|isbn=9780203644478|page=396|url=https://books.google.com/books?id=whiC7aSFLY8C&pg=PA396|language=en|url-status=live|archiveurl=https://web.archive.org/web/20170116162803/https://books.google.ca/books?id=whiC7aSFLY8C&pg=PA396|archivedate=2017-01-16}}</ref>

* Distilled water should be avoided in large amounts directly into a vein, as it can cause your blood cells to become hypotonic, possibly leading to death.

* Hot tap water should always be avoided because it contains heavy metals.

* Boiled tap water: It is also important to change the water at a regular interval to prevent bacteria growth within the water. Be mindful that using multiple needles in the same water supply can easily spread illness and disease. No other liquid substance should be added to the injection, even if it is supposed to increase the solubility of the drug in the water solution. Heat can be used to aid dissolution, but fruit juice or vinegar can lead to infections.

@@ Line 2: / Line 2: @@
 {{#ev:youtube|https://www.youtube.com/watch?v=MppHWdZ-S_I|340x240|right|[[#Single-use spoons|Single-use spoons]] for preparation of drugs for injection complement [[#Syringes|syringes]] and [[#Hypodermic needles|hypodermic needles]] in preventing transmission of blood-borne diseases, which often goes unnoticed through communal spoons: ''Boiling, burning, or using common cleaning fluids, alcohol, or peroxide can reduce the amount of the hepatitis C virus (HCV), but this may not prevent you from getting infected.''<ref>https://www.cdc.gov/hepatitis/hcv/pdfs/factsheet-pwid.pdf</ref> The [[Sharing_injection_materials#Hepatitis_C|hepatitis C]] virus can survive outside the body for <span style="color:red">'''6 weeks'''</span>.<ref name="pmid24273176" /> The international prevalence of {{nowrap|hepatitis C}} is between <span style="color:red">'''60% and 80%'''</span> among people who use injection drugs.<ref name=Lancet2011>{{cite journal | vauthors = Nelson PK, Mathers BM, Cowie B, Hagan H, Des Jarlais D, Horyniak D, Degenhardt L | title = Global epidemiology of hepatitis B and hepatitis C in people who inject drugs: results of systematic reviews | journal = Lancet | volume = 378 | issue = 9791 | pages = 571–83 | date = August 2011 | pmid = 21802134 | pmc = 3285467 | doi = 10.1016/S0140-6736(11)61097-0 }}</ref><ref name=China2008>{{cite journal | vauthors = Xia X, Luo J, Bai J, Yu R | title = Epidemiology of hepatitis C virus infection among injection drug users in China: systematic review and meta-analysis | journal = Public Health | volume = 122 | issue = 10 | pages = 990–1003 | date = October 2008 | pmid = 18486955 | doi = 10.1016/j.puhe.2008.01.014 }}</ref>|frame}}
-'''Injection''' is the act of delivering a [[psychoactive substance]] into the body using a hypodermic needle. Injected substances are mixed with a liquid (such as water for injection) to form a solution, which is usually either injected directly into the bloodstream via the veins (i.e. intravenous or [[#IV_injection|IV injection]]) or into the muscle tissue (i.e. intramuscular or [[#IM_injection|IM injection]]).
+'''Injection''' is the act of delivering a [[psychoactive substance]] into the body using a hypodermic needle. Injected substances are mixed with a liquid (such as [[#Sterilie water for injection|sterilie water for injection]]) to form a solution, which is usually either injected directly into the bloodstream via the veins (i.e. intravenous or [[#IV_injection|IV injection]]) or into the muscle tissue (i.e. intramuscular or [[#IM_injection|IM injection]]).
 Injecting substances removes any bodily filtering mechanism and IV injection results in 100% bioavailability of a substance.<ref>{{Citation | vauthors=Editor | year=2011 | title=Bioavailability of Drugs | url=http://howmed.net/pharmacology/bioavailability-of-drugs/}}</ref> Any impurities present in the product will pose a significantly greater health threat. Even medical grade substances specifically manufactured for injection carry a risk of infection and death. As a result, this guide has been deliberately named the "safe(r) injection guide" to emphasize the fact that there is no such thing as truly safe injection.
@@ Line 101: / Line 101: @@
 "It is common to have muscle pain when injecting larger doses of liquid Ketamine into muscle tissue. The pain can continue for several days if it is not administered properly. The muscle soreness can be somewhat controlled by using a very fine (small gauge) needle and by injecting very slowly. It should take 15-30 or more seconds to inject a dose into a muscle. If you feel it begin to sting, slow down the injection rate."<ref>{{cite web |title=Erowid Ketamine Vault : Dosage |url=http://www.erowid.org/chemicals/ketamine/ketamine_dose.shtml#im |website=www.erowid.org}}</ref>
-===Water for injection===
+===Sterile water for injection===
-[[File:Sterilewater.jpg|245px|thumb|right|The USP standards for water for injection includes a "target limit response" of 500 µg of Carbon/L, and 10 [https://en.wikipedia.org/wiki/Colony-forming_unit {{abbr|CFU|colony forming units}}]/100mL.<ref>https://www.usp.org/frequently-asked-questions/water-pharmaceutical-and-analytical-purposes</ref>]]
+[[File:Sterilewater.jpg|245px|thumb|right|The USP standards for water for injection includes a "target limit response" of 500 µg of Carbon/L, and 10 [https://en.wikipedia.org/wiki/Colony-forming_unit {{abbr|CFU|colony forming units}}]/100mL.<ref>https://www.usp.org/frequently-asked-questions/water-pharmaceutical-and-analytical-purposes</ref>]]https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/018632s051lbl.pdf
-'''[https://en.wikipedia.org/wiki/Water_for_injection Water for injection]''' is water of extra high quality without significant contamination.
+'''Sterile [https://en.wikipedia.org/wiki/Water_for_injection water for injection]''' is used to create solutions that will be administered by injection. Water for injection is generally made by distillation or reverse osmosis.<ref name=Gh2004>{{cite book|last1=Ghosh|first1=Tapash K.|last2=Jasti|first2=Bhaskara R.|title=Theory and Practice of Contemporary Pharmaceutics|date=2004|publisher=CRC Press|isbn=9780203644478|page=396|url=https://books.google.com/books?id=whiC7aSFLY8C&pg=PA396|language=en|url-status=live|archiveurl=https://web.archive.org/web/20170116162803/https://books.google.ca/books?id=whiC7aSFLY8C&pg=PA396|archivedate=2017-01-16}}</ref>
-Water for injection is generally made by distillation or reverse osmosis.<ref name=Gh2004>{{cite book|last1=Ghosh|first1=Tapash K.|last2=Jasti|first2=Bhaskara R.|title=Theory and Practice of Contemporary Pharmaceutics|date=2004|publisher=CRC Press|isbn=9780203644478|page=396|url=https://books.google.com/books?id=whiC7aSFLY8C&pg=PA396|language=en|url-status=live|archiveurl=https://web.archive.org/web/20170116162803/https://books.google.ca/books?id=whiC7aSFLY8C&pg=PA396|archivedate=2017-01-16}}</ref>
 Syringe designed saline drops (e.g. Wallace Cameron Ultra Saline Minipod) are distributed in modern needle-exchange programmes as they can be used efficiently either by injection or ophthalmic (if the drug is potent in small doses) route of administer which is compared to intravenous use; by demonstration, the elimination of latanoprost acid from plasma is rapid (half-life 17 minutes) after either ophthalmic or intravenous administration.<ref>{{cite web|url=https://www.drugs.com/mmx/latanoprost.html|title=Latanoprost Drug Information, Professional|publisher=Drugs.com|access-date=18 September 2014}}</ref>
 * [https://en.wikipedia.org/wiki/Eye_drop Eye drops] '''with medications can be deadly when injected'''. However, preservative-free eye drops made of [https://en.wikipedia.org/wiki/Saline_(medicine) saline] from sterilized water (as isotonic solution) are sometimes used for injection.
-* Distilled water should be avoided in large amounts directly into a vein, as it can cause your blood cells to become hypotonic, possibly leading to death.Water for injection is generally made by distillation or reverse osmosis.<ref name=Gh2004>{{cite book|last1=Ghosh|first1=Tapash K.|last2=Jasti|first2=Bhaskara R.|title=Theory and Practice of Contemporary Pharmaceutics|date=2004|publisher=CRC Press|isbn=9780203644478|page=396|url=https://books.google.com/books?id=whiC7aSFLY8C&pg=PA396|language=en|url-status=live|archiveurl=https://web.archive.org/web/20170116162803/https://books.google.ca/books?id=whiC7aSFLY8C&pg=PA396|archivedate=2017-01-16}}</ref>
+* Distilled water should be avoided in large amounts directly into a vein, as it can cause your blood cells to become hypotonic, possibly leading to death.
 * Hot tap water should always be avoided because it contains heavy metals.
 * Boiled tap water: It is also important to change the water at a regular interval to prevent bacteria growth within the water. Be mindful that using multiple needles in the same water supply can easily spread illness and disease. No other liquid substance should be added to the injection, even if it is supposed to increase the solubility of the drug in the water solution. Heat can be used to aid dissolution, but fruit juice or vinegar can lead to infections.