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Safer injection guide: Difference between revisions
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'''Injecting''' is the process of dissolving a compound in a liquid and | '''Injecting''' is the process of dissolving a compound in a liquid and drawing the resulting solution into a needle-tipped syringe for the purpose of self-administration. Substances can either be directly injected into the veins of the person's bloodstream (a practice known as Intra-Venous or '''I.V. injection'''), into the muscle tissue (known as Intra-Muscular or '''I.M. injection'''), or more rarely, in the flesh right under one's outer layer of skin (known subcutaneous or '''S.C. injection'''), the last of which is known as "skin popping" in street drug circles.<ref>http://www.thefreedictionary.com/skin-popping|Skin-popping - definition of skin-popping by the Free Dictionary</ref>. | ||
== | ==Risks and Hazards== | ||
* ''' Risks of infection ''' - The simple act of penetrating one's skin with anything is a way to introduce bacterium, viruses, etc. directly into your body. Be as sterile as humanly possible! Use alcohol swabs to wipe the injection area before and after injection. There is also infection risk if one is injecting impure, adulterated, or unfiltered substances into their body. These drugs are not passing any membrane for filtration and '''any''' impurity in the drug will be directly introduced into the body. | * ''' Risks of infection ''' - The simple act of penetrating one's skin with anything is a way to introduce bacterium, viruses, etc. directly into your body. Be as sterile as humanly possible! Use alcohol swabs to wipe the injection area before and after injection. There is also infection risk if one is injecting impure, adulterated, or unfiltered substances into their body. These drugs are not passing any membrane for filtration and '''any''' impurity in the drug will be directly introduced into the body. | ||
* ''' Blood-borne diseases''' - Sharing needles with other users is the most obvious way to transmit a blood-borne disease or infection, but there are other less commonly thought of ways too. Using multiple needles in the same water supply can spread disease. Sharing the same spoons and other equipment used to prepare the injection solution is also a way to contract a blood borne disease. | * ''' Blood-borne diseases''' - Sharing needles with other users is the most obvious way to transmit a blood-borne disease or infection, but there are other less commonly thought of ways too. Using multiple needles in the same water supply can spread disease. Sharing the same spoons and other equipment used to prepare the injection solution is also a way to contract a blood-borne disease. | ||
* ''' Re-using needles ''' - Reusing needles is not advised for some medically relevant reasons. If upon injection you do not hit a vein, only retry with that same needle one more time IF NEEDED. It is always best to use fresh needles every time you inject. | * ''' Re-using needles ''' - Reusing needles is not advised for some medically relevant reasons. If upon injection you do not hit a vein, only retry with that same needle one more time IF NEEDED. It is always best to use fresh needles every time you inject. | ||
* ''' | * ''' Abscessed infections ''' - An abscessed infection is a collection of pus that has built up within the tissue of the body at or underneath an administration site that is usually caused by a bacterial infection. If one recognizes an abscess following an injection it is imperative that they go ''SEEK PROFESSIONAL MEDICAL HELP IMMEDIATELY'' as abscessed infections can lead to severe health complications and not uncommonly, death. | ||
*'''Injecting into the wrong tissue''' - Some substances need to be injected into certain types of tissue | *'''Injecting into the wrong tissue''' - Some substances need to be injected into certain types of tissue in order to be effective. This can inform which injection method should be used. For example, [[heroin]] has been shown to work "best" when IV'd and can be extremely harmful when injected into the subcutaneous tissue. This is why it is so important that one makes sure they are 'in a vein' before proceeding to inject themselves. | ||
*'''Increased withdrawal effects''' - This can be experienced with substances like [[opiates]], such as [[heroin]]. The higher bioavailability of the drug when injected | *'''Increased withdrawal effects''' - This can be experienced with substances like [[opiates]], such as [[heroin]]. The higher bioavailability and time to peak blood plasma levels (i.e. "rushiness") of the drug when it is injected -- along with increased [[Cognitive euphoria]] and [[Physical euphoria]] that accompanies it -- is thought to contribute substantially to compulsive use, addiction, [[withdrawal]], and persisting drug cravings long after cessation of use. | ||
==Materials== | ==Materials== | ||
*'''[[Dosage#Milligram scales|Milligram scale]]''' - | *'''[[Dosage#Milligram scales|Milligram scale]]''' - It is vitally important to weigh out the substance one is going to inject to help mitigate the risk of overdose. | ||
*'''Insulin syringe with | *'''Insulin syringe with I.V. needle''' - Used for I.V. injection, this type of syringe has a short needle meant to penetrate surface veins. | ||
*'''Syringe with | *'''Syringe with I.M. Needle''' - This type of syringe is used for the less common Intra-Muscular (IM) injection. These needles are longer than the traditional insulin needles seen for IV use because it is designed to penetrate deep into the muscular tissue and deposit the solution there, instead of in a vein. | ||
[[File:IM needle diagram.jpg|300px|thumb|right|An IM needle differs from an IV needle in length.]] | [[File:IM needle diagram.jpg|300px|thumb|right|An IM needle differs from an IV needle in length.]] | ||
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*''' Alcohol swabs" - For sterilization before and after injection. | *''' Alcohol swabs" - For sterilization before and after injection. | ||
* '''Sterile water''' - It is important to use deionized water or distilled water | * '''Sterile water''' - It is important to use deionized water or distilled water when injecting substances as tap water may contain harmful impurities. It is also important to change the water at a regular interval to prevent bacteria growth within the water. Placing a small amount (10ml max) in a shot glass and using this for IV/IM purposes is a good way to ensure a fresh water supply. | ||
* '''A buddy!''' - If possible, | * '''A buddy!''' - If possible, do your best not to I.V./I.M. alone. Things can go wrong. The risk of overdose is significantly increased when injecting and having someone there to call 911 or give you medical aid can literally be the difference between life and death. | ||
* '''Micron filters''' - These are used to filter out solid impurities in the drug solution. A cotton filter is better than nothing, but a micron filter is the best. | * '''Micron filters''' - These are used to filter out solid impurities in the drug solution. A cotton filter is better than nothing, but a micron filter is considered to be the best. | ||
==Procedure== | ==Procedure== | ||
In the interest of harm reduction, the use of any substance via I.V./I.M. administration is not an advisable from a health and safety point of view. It should be noted that I.M. administration is more commonly found when using drugs like [[ketamine]]. | |||
==== | ==== I.V. Injection==== | ||
#Dissolve the chosen substance in water, be careful not to exceed the amount of water that your syringe can hold. | #Dissolve the chosen substance in water, be careful not to exceed the amount of water that your syringe can hold. | ||
#Heat the solution up, suck the solution into the syringe through the filter | #Heat the solution up, suck the solution into the syringe through the filter. | ||
#Using a fresh needle, prep your injection site with an alcohol swab. | #Using a fresh needle, prep your injection site with an alcohol swab. | ||
#If using the traditional crook of the elbow injection site, you may need to apply pressure above the vein to make the vein stick out more. This is | #If using the traditional crook of the elbow injection site, you may need to apply pressure above the vein to make the vein stick out more. This is typically achieved through "tying off", which refers to the practice of wrapping a solid band or tourniquet around the upper forearm so that blood constricts and the veins become more visible. | ||
#The needle will most likely have a slant. It is important to angle the slanted edge toward your skin, so the point of the needle penetrates the vein and injects downwards. | #The needle will most likely have a slant. It is important to angle the slanted edge toward your skin, so the point of the needle penetrates the vein and injects downwards. | ||
#Once you have penetrated yourself with the needle, pull back on the plunger of the syringe. If you see blood, you've hit a vein and are good to inject. If you see nothing or feel a suck back, '''you are not in a vein; you are in subcutaneous tissue, do | #Once you have penetrated yourself with the needle, pull back on the plunger of the syringe. If you see blood, you've hit a vein and are good to inject. If you see nothing or feel a suck back, '''you are not in a vein; you are in subcutaneous tissue, do NOT inject! Repeat steps 1-5 until you hit a vein.''' | ||
#Once you are in a vein, push the plunger down *SLOWLY*. Especially if IVing | #Once you are in a vein, push the plunger down *SLOWLY*. Especially if one is IVing a strong [[opiate]], such as [[heroin]], it is highly advised to not not rush the injection no matter what. | ||
#Once all of the solutions has been injected, slowly remove the needle and use a new alcohol swab to clean the injection site. There may be a little blood. | #Once all of the solutions has been injected, slowly remove the needle and use a new alcohol swab to clean the injection site. There may be a little blood. | ||
==See also== | ==See also== | ||
*[[Responsible use]] | *[[Responsible use]] | ||
*[[Routes of administration]] | |||
*[[Preparation]] | *[[Preparation]] | ||
==External links== | ==External links== | ||
*[http://harmreduction.org/drugs-and-drug-users/drug-tools/getting-off-right/ Getting Off Right Safety Manual (harmreduction.org)] | *[http://harmreduction.org/drugs-and-drug-users/drug-tools/getting-off-right/ Getting Off Right Safety Manual (harmreduction.org)] | ||