Safer drug use

The importance of safer injecting

HIV can be transmitted by sharing injecting equipment, including water, spoons, needles and syringes. Safer injecting will reduce the chances of you passing on HIV, reduce the chances of you picking up other blood-borne infections, protect you from dirty hits, and protect you from pain and injury when you inject.

Essentials of safer injecting

Get hold of new needles. Find out where there is a needle exchange that provides them free of charge. They will usually offer other services as well.

Always use new needles when you inject. Have a plan to make sure that you have new needles with you when you need them so you never end up sharing needles with others.

Learn how to clean needles. This can be important for situations when you cannot get new needles.

Where to get new needles

Getting free access to new needles differs according to where you live in the UK. Some areas have needle exchanges, others have mobile services, and others have a pharmacy-based service.

Needle exchanges

These are specialist projects set up primarily to exchange used needles and syringes for new ones. They usually offer more than simple needle exchange – sometimes this includes primary health care. Workers in needle exchanges are normally very friendly and non-judgemental.

Mobile or outreach schemes

These are not usually run from a fixed location. These schemes might move from one venue to another, or be housed in a van or bus that visits certain locations at set times, or even be a home delivery scheme.

Pharmacy-based schemes

In some areas, needle exchanges are operated through chemists. Some schemes require minimal registration details, although other are more informal. Even if there is no formal scheme, chemists may sell needles.

How to find needle exchanges

Your HIV clinic will be able to help you. Most needle-exchange services will offer safer injecting advice, primary healthcare, safer sex advice, condoms and referrals to other specialist services.

Cleaning injecting equipment

It’s best to have a new syringe and needle for every injection. If this is not possible, cleaning your injecting equipment will offer some protection against the transmission of HIV and other infections.

Bleach method

Fill a container with clean, cold water. Draw the water up the needle and fill the syringe, flush out the syringe away from the clean water and repeat. Then fill the container with household bleach, and repeat the cleaning process. Finally, repeat the process again with clean water.

This will kill HIV, provided the bleach is of sufficient strength. Thick bleach can be difficult to draw up a needle, and can also be difficult to flush out, so use thin bleach whenever possible.

Washing-up liquid method

Fill a container with clean, cold water. Draw the water up the needle and fill the syringe, flush out the syringe away from the clean water and repeat. Add a generous squirt of washing-up liquid into another container and dilute with cold water. Repeat the cleaning process, making sure you do not squirt the dirty water into the container with the washing-up liquid. Finally, clean with clean water, using the same process as described above.

Washing-up liquid can kill HIV, but again, thick washing-up liquid can be difficult to draw up fine needles, and bubbles can be left in injecting equipment by this process, so it needs to be thoroughly flushed out before the equipment is used for injecting.

Boiling method

Boiling equipment for five minutes will kill HIV and other infections. However, most disposable syringes will melt if boiled.

Disposing of used injecting equipment

Your local drugs team will be able to tell you about the disposal facilities in your area. Never over-fill containers given to you to dispose of your injecting equipment - two-thirds full is the maximum. With larger syringes, you can put the needle into the barrel of the syringe and push the plunger in until it bends the needle. Put the used equipment in a bag and place in a bin. You can put smaller syringes and needles in a drinks can, crush the can, then put it in a bag and place in a bin.

Dealing with overdose

The risks of overdosing can be reduced by:

  • Being sure of the drug you are injecting.
  • Being sure of the strength of the drug supply.
  • Not returning to the same dose of a drug after a break, as your tolerance of this drug will have been reduced.
  • Not injecting alone or in a place where you cannot be easily found.
  • Taking a reduced dose of any new supply.

If you find someone who has taken an overdose:

  • Lie the person on their side with their airway clear – this will make sure that they don’t choke on their own vomit or suffocate.
  • Call an ambulance immediately.