Transcript SAFER INJECTION PRACTICES

SAFER INJECTION PRACTICES
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; it’s up to you to make sure that you take care of
yourself.
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. It’s
worth making the effort to stay healthy.
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.
 Don’t 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 don’t forget to use a brand new, sterile syringe each time you
inject.
 Don’t hit in the same spot over and over; try rotating where you
inject.
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 can’t 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 it’s growing and hurts really badly you
need to go to the doctor. You don’t want to risk Cellulitis
or Endocarditis.
 Don’t pop it yourself, it can be dangerous.
 See a doctor if you’re unsure about anything.
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 don’t
forget to wash up first; they get infected easily.
Safer Injection Practices
 You always want to shoot with the flow of blood, that
means always shoot towards the heart; so if you’re
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 aren’t long enough and don’t 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, don’t 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.
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 doesn’t stop, call 911.
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.
 It’s a good idea to get a tetanus booster shot if you muscle.
 Don’t muscle Coke or Speed, it’s more painful and more likely to
develop an abscess.
 Use an IM needle, it will help lower the risk of soft tissue
infections.
IM Shots
These are the best locations for muscling
REMEMBER:
 Try and find somewhere that’s clean, well lit, private and that
has running water.
 Always use clean supplies and don’t share anything except your
lighter.
 Clean the injection site before fixing.
 Rotate injection spots, so you don’t 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.
 Don’t re-use cookers or cottons. Cotton fever is not a loose piece
of cotton; it’s an infection caused by bacteria, and it is
preventable.
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. Don’t buy antibiotics on the street, or use
someone else’s.
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 don’t 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.
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.
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.
Glossary

Staph Infection - Staph is the shortened name for Staphylococcus (pronounced: staf-uh-lowkah-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.