SAFE(R) Drug Use 101
The most important tips for safer drug consumption and injection, plus strategies for avoiding and treating Skin and Soft Tissue Infections (SSTIs).
Safer Consumption Tips
Smoking
Use a clean pipe, stem, bowl or foil for sterile smoking. Make sure everyone has their own pipe or mouthpiece to avoid sharing of saliva or blood. This reduces the risk of blood-borne illnesses and viruses such as COVID-19. If you are smoking crack, use a filter like a brass screen or copper scrub pad.
Snorting
Crush powder as fine as possible and make sure everyone has their own straw. Alternate nostrils between hits and cleanse the nose with saline spray and antibiotic ointment to prevent open wounds.
Swallowing
Crush pills in thin paper or a drink. Mix your own drink so you know how strong it is. It can take up to an hour to kick in, so wait a while before consuming more.
Booty Bumping
Use a turkey baster or syringe without a needle. Lay on your side or pose with one leg elevated and apply lubricant to the barrel. Insert the barrel into the anus and press the plunger. Lay on your stomach or side while the dose is absorbed into the body. Avoid sharing equipment and get vaccinated for Hepatitis A.
Safer Injection Tips
Prepare yourself.
Find a safe, clean, well-lit area. Clean hands or fingertips with soap and water or an alcohol pad. Wipe injection area with a new alcohol pad in one direction.
Prepare your dose.
Using your own clean cooker mix dose with sterile water (add Vitamin C if meth or crack). Apply heat to the cooker with a lighter, moving it consistently around the bottom of the cooker. Add a filter (piece of cotton ball or a sterifilt on the end of your syringe), using clean fingertips, insert the tip of the syringe into the filter and pull up the solution.
Find a vein.
Body heat can help veins be more accessible — find a warm place or bundle up! Swing your arms back and forth to promote blood flow and expand veins. Use a tourniquet a few inches above the injection site to help the vein plump up. Insert the needle bevel up into the vein.
Register and Test Shot.
Before injecting, pull back slightly on the plunger to check for dark red blood (this means you hit a vein). If the blood is bright red, frothy and pushes back the plunger, you hit an artery, take the syringe out immediately and seek medical advice or attention! After registering, release the tourniquet before injecting. Inject a little of the solution to "taste" the strength. When you’re ready, inject the dose into the vein.
Skin and Soft Tissue Infection
What is an SSTI?
Skin and soft tissue infections (or SSTIs) are bacterial infections such as abscesses, cotton fever, and endocarditis. For people who inject drugs, they can be caused by improperly cleaned skin, a missed shot, non-sterile injection equipment, or contaminated drugs. It’s critical to provide both the equipment and safer injection education to promote the safest possible injection every time.
Signs of an SSTI
Bad odor or smell at the site of infection
Affected, red area expanding
Redness around edges, streaking away from the infection
Swelling
Tenderness
Thick pus
Fever/chills
Pain or loss of feeling
How to Manage SSTIs
Symptoms might not always appear at the injection site. If you miss a shot, apply ice or frozen items (frozen bagged food, snow, cold drink) on the same day and elevate. If swelling occurs the next day, apply heat regularly using a cloth soaked in hot water, or use a hand warmer. Avoid injection at or below the affected area. Do not squeeze or poke an abscess, this can introduce more bacteria to the wound. If things don’t improve after 3 days, or if you are experiencing chills, fever, extreme fatigue or pain in the abscess, seek medical attention. This may be a blood infection, which could be deadly.
How to Avoid SSTIs
Clean skin prior to injection, including injection site and fingertips. Use sterile equipment including syringes, cookers, and cottons. Use safe injection techniques (see front) to avoid missed shots and vein injury. Cover injection site with a band aid to prevent bacteria from entering.
