Risks of Injecting Drugs

Injecting drugs such as heroin, cocaine, amphetamines or other substances greatly increases the risk of serious and even fatal harm from substance use. This harm can come from:

The drug itself

• If you inject any drug you are more likely to become dependent (addicted).
• If you inject amphetamines or cocaine you are more likely to experience psychosis.
• If you inject heroin or other sedatives you are more likely to overdose.

• If you inject you may damage your skin and veins and get infections.
• You may cause scars, bruises, swelling, abscesses and ulcers.
• Your veins might collapse.
• If you inject into the neck you can cause a stroke.

Sharing of injecting equipment

• If you share injecting equipment (needles & syringes, spoons, filters, etc.) you are more likely to get and spread blood-borne infections like Hepatitis B, Hepatitis C and HIV.

It is safer not to inject drugs. The best thing to do is stop injecting drugs and seek drug addiction treatment. But for people who cannot or will not stop injecting drugs, the following steps may be taken to reduce personal and public health risks:

• Always use clean equipment (e.g., needles and syringes, spoons, filters, etc.)
• Always use a new, sterile needle and syringe, and only use syringes obtained from a reliable source (such as pharmacies or needle exchange program)
• Never share syringes, water, or drug preparation equipment with other people
• Clean the preparation area, and use a new or disinfected container ("cooker") and a new filter ("cotton") to prepare drugs.
• Clean your hands
• Clean the injecting site with a new alcohol swab prior to injection
• Use a different injecting site each time
• Inject slowly
• Put your used needle and syringe in a hard container and dispose of it safely

If new, sterile syringes and other drug preparation and injection equipment are not available, then previously used equipment should be boiled in water or disinfected with bleach before reuse.

If you use stimulant drugs like amphetamines or cocaine, the following tips will help you reduce your risk of psychosis:

• Avoid injecting and smoking
• Avoid using on a daily basis

• Avoid using other drugs, especially sedatives or alcohol, on the same day
• Use a small amount and always have a trial "taste" of a new batch
• Have someone with you when you are using
• Avoid injecting in places where no-one can get to you if you do overdose
• Have a telephone nearby so you can call for an ambulance

Persons who continue to inject drugs should periodically be tested for HIV. For information on locating an HIV testing site, visit the National HIV Testing Resources Web site at www.hivtest.org.

Sources: World Health Organization, ASSIST manual V3.0, and Centers for Disease Control and Prevention, How can injection drug users reduce their risk for HIV infection?