SAFER INJECTION PRACTICES

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SAFER INJECTION PRACTICES
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Why is safer injection important ?

• For the prevention of morbidity and mortality
  related to injection drug use.
• In other words, to keep from getting sick or
  dying.
• You are the one who really knows if you are
  injecting safely its up to you to make sure
  that you take care of yourself.

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Examples

• Injection drug use is a factor in one third of
  all AIDS cases in the United States and more
  than one half of all new HIV infections.
• People who inject drugs make up ½ of all new
  Hepatitis C infections in the United States the
  prevalence of HCV amongst injection drug users is
  estimated at 73. 10 60 of these will develop
  some form of chronic liver disease.
• Hepatitis B is found in semen, blood and saliva
  it is spread by contaminated syringes and
  unprotected sexual contact.
• This is all preventable by taking a few
  precautions. Its worth making the effort to stay
  healthy.

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Abscesses and Soft Tissue Infections

• 87 of our clients report having 1 or more soft
  tissue infections in the past, 25 of those
  people had a current soft tissue infection at the
  time of their interview. To avoid getting an
  abscess or other soft tissue infection
• Always use a clean, fresh cooker.
• Always use new cotton.
• Before injection, clean up with soap and water
  or use an alcohol swab where you are going to
  shoot. This is one of the best ways to keep from
  getting abscesses.
• Dont use alcohol pads on the injection site
  after injecting. It keeps your blood from
  coagulating properly, and you want a scab to keep
  the germs out.
• And dont forget to use a brand new, sterile
  syringe each time you inject.
• Dont hit in the same spot over and over try
  rotating where you inject.

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What to do if you have an abscess

• Keep it clean by washing with soap and water.
• Soak it in hot water or use a wet towel if you
  cant do that.
• Keep it covered with a clean bandage or cloth.
• If you have chest pains, see red streaks coming
  out of the abscess, or its growing and hurts
  really badly you need to go to the doctor. You
  dont want to risk Cellulitis or Endocarditis.
• Dont pop it yourself, it can be dangerous.
• See a doctor if youre unsure about anything.

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Safer Injection Practices

• The more a needle pushes through the inside of a
  vein, the more clotting scar tissue develop and
  the inside of the vein gets smaller and smaller.
  You want to rotate injection sites to keep your
  veins as healthy as they can be.
• When using the same vein over again, move the
  shot up towards the heart this will help the
  blood to flow better once the shot goes in.
• Always shoot up towards the heart, and with the
  bevel of the needle up.
• Blood moves slowly in the legs due to gravity.
  Try shooting somewhere else if at all possible,
  and never shoot in the groin.
• Deep Vein Thrombosis and Emboli are more likely
  to originate in the leg veins.
• Veins in your hands and feet are small, they roll
  and can be easily damaged. Be careful and take
  your time if using them. And dont forget to wash
  up first they get infected easily.

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Safer Injection Practices

• You always want to shoot with the flow of blood,
  that means always shoot towards the heart so if
  youre shooting in your neck, you have to point
  the needle down. Keep the bevel of the needle
  facing up.
• If you are muscling, use a longer IM needle. The
  insulin syringes arent long enough and dont
  reach the muscle. This opens you up for
  infections like botulism, tetanus, necrotizing
  fasciitis, as well as cellulitis and abscesses.
• You want to inject into veins, not arteries.
  Arteries carry the blood from the heart to your
  body, and have a pulse. If it has a pulse, dont
  stick the needle in.
• If you are back-loading, make sure that the
  needle and cooker have never been used before.
  Throw them away afterwards so that there is no
  confusion later.

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Warning Signs That You Hit An Artery

• The blood flow is so strong it forces back the
  plunger.
• The blood is frothy when you register.
• You bleed heavily after taking out the needle.
• The shot hurts and bruises quickly.
• Injection site becomes swollen, hot, red and
  sore.
• If the redness spreads quickly.
• If you hit an artery pull out, hold your arm or
  leg over your head, and apply pressure for 10-15
  mins. If the bleeding doesnt stop, call 911.

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IM Shots

• Be sure that everything is brand new and clean.
  If you are muscling, you are at greater risk for
  infections.
• You can shoot on your thigh between the hip and
  the knee.
• You can shoot on the top outside of your butt
  cheeks.
• You can shoot into your shoulder.
• Relax your muscle before hitting, it will hurt
  less.
• Make sure you rotate injection sites.
• Its a good idea to get a tetanus booster shot if
  you muscle.
• Dont muscle Coke or Speed, its more painful and
  more likely to develop an abscess.
• Use an IM needle, it will help lower the risk of
  soft tissue infections.

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IM Shots

• These are the best locations for muscling

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REMEMBER

• Try and find somewhere thats clean, well lit,
  private and that has running water.
• Always use clean supplies and dont share
  anything except your lighter.
• Clean the injection site before fixing.
• Rotate injection spots, so you dont get an
  infection and to help veins last longer.
• If you use a tourniquet, your veins will thank
  you.
• Drink plenty of water, helps your blood flow
  better.
• Dont re-use cookers or cottons. Cotton fever is
  not a loose piece of cotton its an infection
  caused by bacteria, and it is preventable.

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Staph MRSA Prevention Reduction

• Anyone can get a Staph infection, many people who
  have Staph think they have a spider bite.
• You are more likely to get Staph if you have a
  cut or scratch, or if you have contact with
  someone who has a Staph infection.
• The best way to prevent a Staph infection is to
  keep hands and wounds clean. If you have a wound,
  cover it with a bandage.
• Most Staph infections are easily treated with
  antibiotics, go see a doctor.
• Some infections like MRSA are really hard to
  treat, and need immediate medical attention. If
  there is something weird going on with your skin,
  see a doctor. Dont buy antibiotics on the
  street, or use someone elses.

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Girls are different

• Women usually have smaller more delicate veins,
  so it is especially important to use a tourniquet
  and rotate where you shoot.
• Take control of your using by learning how to
  inject yourself. You dont have to wait for your
  boyfriend to go first.
• Your risk of contracting something nasty goes way
  down when you prepare and inject your own drugs.
• Women, especially women of color are at a much
  higher risk of contracting HIV. Take control of
  the situation.

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Glossary

• Naloxone - Naloxone is a drug used to counter the
  effects of opioid overdose, for example heroin or
  morphine overdose. Naloxone is specifically used
  to counteract life-threatening depression of the
  central nervous system and respiratory system. It
  is marketed under various trademarks including
  Narcan, Nalone, and Narcanti.
• Cellulitis - Cellulitis is an inflammation of the
  connective tissue underlying the skin, that can
  be caused by a bacterial infection. Cellulitis
  can be caused by bacteria, and often occurs where
  the skin has previously been broken injection
  sites, cracks in the skin, cuts, burns, insect
  bites, surgical wounds. Treatment requires
  appropriate antibiotics. Skin on the face or
  lower legs is most commonly affected by this
  infection, though cellulitis can occur on any
  part of the body. Cellulitis may be superficial
  affecting only the surface of the skin but
  cellulitis may also affect the tissues underlying
  the skin and can spread to the lymph nodes and
  bloodstream. It is unrelated to cellulite, a
  cosmetic condition featuring dimpling of the
  skin.
• Endocarditis - Endocarditis is an inflammation of
  the inner layer of the heart (the endocardium).
  The most common structures involved are the heart
  valves. As the valves of the heart do not
  actually receive any blood supply of their own,
  defense mechanisms (such as white blood cells)
  cannot enter. So if an organism (such as
  bacteria) establishes a hold on the valves, the
  body cannot get rid of them.
• Thrombosis - Thrombosis is the formation of a
  clot (or thrombus) inside a blood vessel,
  obstructing the flow of blood through the
  circulatory system (your veins, arteries and the
  blood that circulates through them). Thrombosis
  can develop into an Emboli.

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Glossary

• Emboli - an embolism (or Emboli if there are more
  than one) occurs when a clot migrates from one
  part of the body (through circulation of the
  blood) and causes a blockage (occlusion) of a
  blood vessel in another part of the body. Emboli
  often have more serious consequences when they
  occur in areas of the body that have no redundant
  blood supply, such as the brain, heart, and
  lungs. A redundant blood supply is when an area
  of the body receives blood from more than one
  source if a part of the body recieves blood from
  only one source and that source gets blocked with
  an Embolism, this is very serious condition and
  requires medical attention.
• Abscess - An abscess is a collection of pus that
  has accumulated in a cavity formed by the tissue
  on the basis of an infectious process (usually
  caused by bacteria or parasites) or other foreign
  materials (e.g. splinters or bullet wounds). It
  is a defensive reaction of the tissue to prevent
  the spread of infectious materials to other parts
  of the body.
• The organisms or foreign materials that have
  gained access to a part of tissue kill the local
  cells, resulting in the release of toxins. The
  toxins trigger an inflammatory response, which
  draws huge amounts of white blood cells to the
  area and increases the regional blood flow.

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Glossary

• Staph Infection - Staph is the shortened name for
  Staphylococcus (pronounced staf-uh-low-kah-kus),
  a type of bacteria. These bacteria can live
  harmlessly on many skin surfaces, especially
  around the nose, mouth, genitals, and anus. But
  when the skin is punctured or broken for any
  reason, staph bacteria can enter the wound and
  cause an infection. S. aureus most commonly
  causes skin infections like folliculitis, boils,
  impetigo, and cellulitis.Infections caused by S.
  aureus can occasionally become serious. This
  happens when the bacteria move from a break in
  the skin into the bloodstream. This can lead to
  infections in other parts of the body, such as
  the lungs, bones, joints, heart, blood, and
  central nervous system. Staph infections are
  common in areas where many people are in close
  contact, and can be prevented by keeping clean as
  well as keeping wounds clean and covered.
  Treatment requires appropriate antibiotics.
• MRSA - A strain of Staphylococcus that is
  resistant to many antibiotics. Requires medical
  treatment.
• Necrotizing Fasciitis - commonly known as
  flesh-eating bacteria, is a rare infection of
  the deeper layers of skin and subcutaneous
  tissues, easily spreading within the
  subcutaneous tissue. Many types of bacteria can
  cause necrotizing fasciitis of which Group A
  streptococcus (also known as Streptococcus
  pyogenes) is the most common cause. Amputation of
  the affected organ(s) may be necessary. Repeat
  explorations usually need to be done to remove
  additional necrotic tissue (dead tissue).
  Typically, this leaves a large open wound which
  often requires skin grafting. The associated
  systemic inflammatory response is usually
  profound, and most patients will require
  monitoring in an intensive care unit.