If you have any questions, concerns about the following information, please email the

HIV educator

 

Scroll down for the following information:

1. If you use injection drugs..

2. If you use crack cocaine...

If you use injection drugs....

 

It is extremely important for regular injectors—particularly those who are physically dependent—to be able to prepare and safely inject drugs on their own. Having to rely on someone else to get you off can open the door to all kinds of abuse: don’t let anyone have this much power and control over you or your ability to function. Learn how to safely and properly inject yourself! Studies show that people who require assistance with injecting are exposed to more shared/unclean equipment than those who don't and are at greater risk for acquiring blood-borne diseases like HIV and Hep C.

 

 

Getting Ready

  • Wash hands using anti-bacterial soap before touching the injections site, syringe , cooker/spoon, cotton and drugs
  • Prepare injection on a clean surface such as a clean piece of paper, or an unread section of the newspaper.  (Hepatitis B and C can live on surfaces for many months)
  • Wipe spoons with an alcohol swab before each use.
  • Use a new syringe every time.  A reused needle can rip the vein, cause infections.  The needle gets dull after just one use.
  • Use a smaller needle and inject slowly when using smaller veins (i.e.: hands and feet).  Injecting too fast causes too much pressure and the veins may burst.
  • To inject solids such as pills or crack, crush them to a very fine powder between two clean spoons.  This makes it easier for the drug to liquefy.

 

Preparation

  • Add a pinch of powdered Vitamin C (ascorbic acid) to dissolve the drug.  It is less damaging to veins that vinegar or lemon juice.  (Lemon juice contains a fungus that can infect the eyes.)
  • Use a clean syringe to measure the amount of sterile water needed.  The mix being injected should include more water than drug; this will cause less vein damage.  If tap water must be used, boil it first to kill any bacteria.
  • Use a lighter under the cooker (bottle cap, spoon, etc.) to dissolve the mix.  Even though cocaine is soluble in water, heating/cooking separates impurities and therefore prevents infections caused from dirt.  You can remove the plunger from the syringe to stir the mix.

 

Filtering

  • Cool the mix before filtering, as wax and other additives need to set.
  • Drop a filter into the mix.  Slowly draw the mix into the syringe directly through the little hole in the filter.
  • Dental cotton pellets make the best filters because the fibers will not break off and be injected.  If dental cotton is too small, use 2 or 3 of them.  CAUTION:  Filters such as cotton balls, cigarette filters and q-tips require manipulation by hand to get into shape, or may contain chemicals that cause abscesses and infections.
  • For chalk-based drugs like cocaine, first place the filter in the needle barrel; pour the mixed drug into the barrel and plunge through into a spoon.  Then draw up trough another filter into the syringe.

 

A Couple More Things

  • If drugs need to be shared, they should be “piggybacked.”  Use a clean syringe to draw up the mix and separate the liquid in equal amount into two other syringes.

  • Hold syringe point up, tap and depress the plunger a little to pus out any bubbles.
  • Wrap a tourniquet 2 inches above the vein that is going to be used and tuck it under, this will make the vein fatter and easier to find.  Rubber tourniquets, or a pair nylons cause less vein damage because they are soft, wide, elastic and easier to release.  Always use a clean tourniquet because blood on ties can cause infections.

  • Wipe skin over the vein thoroughly with an alcohol pad before injecting.  This helps prevent track marks, infections, or abscesses. 

 

Insertion

  • Insert the point of the needle at a 45-degree angle into the vein with the bevel facing up.  Aim with the blood flow.  (Squeezing a ball, making a clenched fist, or rubbing and tapping the skin will help find a vein.  Applying a warm cloth over the vein, or taking a hot bath will also help veins dilate.)

  • Test to see if needle is in the vein by pulling back on the plunger a little (flagging).  If blood enters the barrel, it is ready to go.
  • Release the tourniquet and press the plunger down slowly.
  • Control the shot by injecting a small amount, topping and “feeling the hit.”  Proceed by injecting some more, stop again and then inject the rest.  Controlling the hit will prevent an overdose.  This is also a good idea when a new drug is used and a person is not sure of their tolerance.
  • Remove the syringe.  Use a clean tissue or clean toilet paper to apply immediate pressure on the wound.
  • Alcohol pads are NOT to be used to stop the bleeding.  Alcohol pads lead to bruising, more infections/track marks and slower healing.

 

Wound Care

  • After the wound has stopped bleeding, apply Aloe Vera, vitamin E, or antibiotic creams to help the healing process and prevent infection.  One cream recipe that some people use is equal parts of vitamin E cream, Preparation H, and antibacterial ointment such as Polysporin.  The sooner the site heals without bruising, the quicker it can be used again without leaving track marks.
  • Rotate injection sites to prevent track marks and abscesses.

 

Needle Disposal

  • Do not recap.  Recapping syringes increases the chances of needle stick injuries.  IF the point is ever broken off, place the needle into the barrel and return the plunger.  Minimal touching is in everyone’s best interest.
  • Discard used syringes in a hard plastic sharp’s container.  If you do not have a syringe container, you can use any strong unbreakable container such as a shampoo bottle, coffee tin, hard peanut butter container or juice bottle.  Sharps containers are available from the needle exchange.
  • If a sharps container is not available, then recap the syringe as follows:

  • 4    Place the cap on a surface with the hole up and gently stick the needle into the cap.  This method will prevent accidental needle sticks.  (Everyone should recap his or her own syringe.)

     

    Skin Popping (injection under the skin)

    • The skin in the thighs, forearms and legs are the safest areas to be used.  Skin-popping cocaine, speed, pills and methadone will cause abscesses.
    • Wash hands with soap and water and clean site with an alcohol swab.
    • Keep the skin area relaxed and insert the needle at a shallow angle.  Inject only enough drug to make a little bubble in the skin (25 to 50 units on an insulin syringe).  Deep insertion of the needle can cause abscesses.
    • When a bubble is injected, withdraw the needle.
    • Gently massage the skin to help absorb the drug.
    • If more liquid is being used, start over in a new site.

       

      Muscling

      • The safest areas are upper arms, thighs and buttocks.  Use the upper outer quarter of the buttocks.  Hitting the sciatic nerve (which is located towards the center of the buttocks)_ can cause paralysis.  Injecting speed, cocaine, pills and methadone into muscles can cause abscesses.
      • The needle should be at least on inch in length and 21, 22 or 24 gauges.  (Needle length should be short enough not to hit bone and long enough to not break off into muscle.)
      • Wash hands with soap and water and clean the site with an alcohol swab.
      • Withdraw the drug and make sure there are no air bubbles in the syringe.  If steroids are being used, expiry dates should be checked.  The right drug and the right strength must be measured.
      • Insert the needle with a quick jab.
      • Draw the plunger back.  If blood flows into the barrel, a vein or artery has been hit.  Pull the needle out a little and try again.  Once the syringe is free of blood, it is safe to inject slowly.

       

      Obtain new syringes, sharps containers, sterilized water, filters and ascorbic acid from Stay Sharp Needle Exchange.  Return used syringe containers when full.

       

      There is no need to reuse or share.

       

      The needle exchange will give as many syringes, filters and water as needed.

         

                      If you smoke crack cocaine

        Wise Crack – Crack Cocaine

        Harm Reduction Strategy

         

        Crack Cocaine

        -         Also called rock, stone, take, cookie, candy, and food.

         

        Buying

        Try to buy from the same person if possible so that you get to know the quality and to lessen your risk of being “vicked” (which is when you buy something that looks like crack but is not.)

         

        You can buy crack in $20.00 pieces.  You can also buy half-balls which equal six $20.00 pieces.  And 8-ball costs $200.00 and a half ball costs $100.00.  Like any other drug, it is cheaper to buy a quantity than buying by the $20.00 piece.

         

        Try not to buy from a user to reduce your risk of being ripped off.

         

        Before Partying

        Try to wear light, loose-fitting clothing, because you will end up sweating after smoking.

         

        Check the surroundings where you’re going to smoke.  It’s a good idea not to smoke with people you don’t get along with very well, or people who are hyper because smoking crack may make you more sensitive to noise and activity.

         

        While Partying

        Instrument of use (What you use to smoke).  Many things may be used to smoke crack-such as plastic inhalers, copper piping, small bottles (such as aspirin, mouthwash or water bottles), small liqueur bottles, car antennas, glass tubing and cans.

        Copper piping is not very good to use because when you are scraping for residue you are scraping some of the copper off and that gets into your lungs.

         

        Importance of Your Ash

        When putting ash in your pipe, make sure all the holes in the foil are covered.  Make sure there is enough ash to absorb the size of rock you put on.  It’s always better to put too much ash instead of not enough.  If you don’t put enough, the crack will just melt to the bottom of the pipe.

         

        Wise Crack

        If you break up the piece of crack, it will last longer.

         

        When lighting the rock, don’t put the flame right on the rock, put it above the rock.  It’s the heat you need, not the fire itself.  This way it burns slowly and is more effective.  Don’t do one take after another; try to space your takes out instead of chasing the high.  You don’t get any higher than you already are, and you’re only wasting your dope doing one after another.

         

        There are many different things people do when smoking.  Some people start picking white things off the floor.  Some peek out of doors or windows.  Some think that they’re being followed and some hallucinate.

         

        Try to drink lots of water while you’re smoking because you will get very dehydrated.

         

        Important Factors (Things to Know)

        Besides the feeling of getting “high” there are many other common effects you can get from smoking crack, such as:

        -         increased heart rate

        -         increased blood pressure

        -         feeling dehydrated

        -         increased alertness

        -         intense anxiety

        -         increased sex drive

        -         paranoia

        -         sweating

        -         muscle twitching

        -         hallucinations

         

        Sometimes, if someone feels very desperate for more cocaine, they may act violently, which can obviously cause harm to other people as well as legal problems for the person who acts violently if charged by the police.

         

        Doing the Chicken

        If you have not been taking care of your health, there is a good chance of you "doing the chicken”. People often do not recognize the people around them and often have no memory of what happened afterwards.  There is a chance of your heart stopping.

         

        This happens when you smoke a lot of crack, especially if you are stressed out or overtired, don’t have much food or liquid in your system or just generally have not been taking care of yourself.

         

        Same sensations or doing the chicken include severe increased heart rate and blood pressure and body twitches you can’t control.

         

        If this happens to you, please take a break, get some much-needed sleep, and get some food and water into yourself!  You will feel better in the long run if you are well rested

        and have been eating proper meals.  Try and listen to what your body needs.

         

        What to Expect After Partying

        If you party over a couple of days, your body and mind will be exhausted.  Usually you fall into a coma-like sleep for at least 13-18 hours, depending on how long you’ve been up.  Because of the coma-like sleep, many people are sexually assaulted.  Try to be aware where you fall asleep.  Your sleep is often more disturbed than usual.  Usually after sleep you have a large hunger and will eat continuously to fill that hunger.

         

        Some people feel guilty afterwards (because of excess money spent or because of neglecting or disappointing family and friends and themselves).  Try not to rush back to the “rock” to avoid those guilty feelings.  Take a rest and try to forgive yourself.

         

        Risks

        There are risks involved in all drugs, especially if you use a lot.  There are some health risks that you need to be aware of.

         

        Sexual Health – Try to make sure you have a safe place to crash after partying to lessen your risk of being sexually assaulted or robbed.  Also, if drug use makes you think less clearly, or take risks you normally would not, you may find yourself having sex with people you usually wouldn’t, or taking risks (such as not using a condom).

         

        HIV – Smoking crack can cause sores or burns in and around your mouth.  If you have mouth sores, performing oral sex (blow jobs) without a condom may increase your risk of getting HIV infection. Oral sex is higher risk for those who smoke crack regularly than those who don't. Use safe pipes (no sharp edges) like the pipes handed out at our office and use mouthpieces to prevent burns. And keep your lips lubricated with chap stick/vaseline to help decrease the risk of HIV/Hep C transmission

         

        General Health – Cocaine (like some other drugs such as alcohol) damages your body’s immune system (which helps your body heal).  This means that if you have a cut or burn, it will take longer to heal and be more likely to get infected.  If you are sick, even with a cold, it will take longer to get well. If you are not healthy, you will have a higher risk of getting infections like the common cold, tuberculosis (TV), hepatitis B and HIV.

         

         

         

        For help or information email: education@aidsguelph.org