From Issue 7 – this article was titled ‘Hygiene Do’s & Don’ts, Compiled by users for users’. Updated 1/12/15
Good and Bad Habits…
We all have them -in life, in private. But no, we are not going down the nose picking road here, we are talking drug use after all -we are looking at common bad habits that we have, in our community. So next time you see someone licking the tip of their needle before they have a hit – you can say WHY it is a bad habit, rather than privately thinking ‘gross!’ and watching them then stick that same spike in their vein straight afterwards.
Bad habits, in junkville, can lead to an early death. But habits can be changed! Now readers’, here is a germ that is central to our hygiene story, staphylococcus ; it is a germ that actually lives on most of our skins somewhere sweaty, most days, or every day. That’s correct, no wonder infections just take hold so fast! it is a bloody terrible bacterium really, and one most junkies get to know well, as it is the germ that’s behind our local abscess, or our endocarditis, even our osteomyelitis and cellulitis!
Staphylococcus. aureus (it’s proper name) is the most common species to cause Staph infections. It will infect virtually any site on our body if given the right conditions, which is why hygiene and injecting, are so important to talk about with injectors; we already potentially give germs a free ride into the bloodstream and we create little tears and nests with every hit, just ready for an infection to take a hold. We throw a lot of crap at our ol’ bodies, and yes we are still walking around, but we all know of someone…Someone who was in hospital for 6 weeks and nearly died from endocarditis, or another guy who lost his leg from a chronically infected ulcer, or another who has half their limb missing from some necrotic infection, and your pal’s scarred up and covered in big holes everywhere from abscess after abscess…
It happens to others, it happens to people, friends, and we have to prevent it happening to us. Prevention is like the key to the body’s padlock. Use it and you stay in charge.
Those Good Habits…
* DO – Bin the old filter that’s stuck on your spoon, rinse your spoon off thoroughly, & wipe its length in one direction with an alcohol swab. Yes it can be hard, you want to save it for later; its a breeding ground for germs you know? If you really MUST save one or 2, have a sterile syringe packet, opened at the top, and put your filters in there. Don’t seal the wrapper, you don’t want moisture, just cool air. Put packet carefully in a lunchbox type container, with lid. Never leave it longer than 8-12 hours absolute maximum. It will be a total germ fest by then and after that.
* DO- Rinse your spoon thoroughly before tipping your gear in. Spoons roll around in kitchen drawers & on dirty sinks & may have traces of food or washing up liquid on them. Give them a good rinse under a running tap then use an alcohol swab and swab across them in one direction only – so you don’t move any bacteria around. Alcohol will evaporate so don’t worry that it may end up in your hit. Never blow the spoon dry either (imagine those minutes flickers of spit landing on your spoon!).
* DO – Have a head for hygiene if you are dealing gear. Don’t cough on the powder (you can transmit dangerous bacteria, particularly if you have a throat, chest, mouth infection), don’t shovel it about on a dirty table or tile, don’t package it in grubby bits of paper etc. Spare a thought for your customers and mates. Be Hygienic.
* DO – Keep any drugs that you are saving in a syringe, in the fridge. Never leave a syringe full of gear sitting near a heater or in the sun as this gives bacteria a chance to multiply – fast. If you have to save mixed up gear in a works, push the liquid right up to the top so you don’t leave any air in your works. Where there’s air, bacteria have a chance to grow. If you’re worried about it leaking out, get yourself a little container like a cigar or pen case, put your works back in its wrapper and into the container. We reckon, from combined experience, reality as well as good science, don’t leave it longer than 12 hours at the absolute most in the fridge, even less to be on the safe side. Better still, leave all your gear in powder form for mixing up later, and not in liquid.
* DO- Washing Vs swabbing. BP’s lengthy research into this matter around whether to swab or not we have reached the conclusion that best practice is to wash your hands with an antibacterial soap – like Carex rinse them well with clean water and thoroughly swab the site, starting from the centre out to the edges, so you don’t spread any germs around. This is especially important for those who have had endocarditis in the past or currently have an abscess or cellulitis.
* DO – Use sterile works (or at least works YOU KNOW are yours) for each
injection. Both barrel and spike need to be your own (or sterile), to prevent you from contracting a blood bome disease or infection like Hepatitis C, HIV, or Hep B. Mark your syringe to identify it as your own, especially when having one of those all nig coke sessions with other IV users use if you live or inject with others – something that will clearly tell you it’s yours, so it won’t get mixed up with other people’s. Scratching off a number on the barrel: a pen mark etc. Remember to mark the barrel not the wrapper and always keep your works somewhere safe (even if you have to hide them so others can’t use them in your absence) If you’re having one of those all night coke sessions where it’s so easy to get syringes mixed up, keep a pen next to you 8 mark each syringe as you go, if you have no pen you can bite the flat top of the plunger, bending it slightly.
* DO – Use your own equipment; water (sterile water ampoules are best, boiled then cooled kettle water is 2nd best, then cold tap water), your own tourniquet (never let someone else use it), your own spoon (unless all of you have a new syringe), your own – new filter, and preferably, your own citric or ascorbic acid (use single use sachets). You never know what dirt has got in someone’s tub of citric or vit C -they can be gross! This all helps to ensure you don’t get anyone else’s blood or bacteria into your hit.
* DO- Get into the habit of washing your hands before and after every hit. Even if you’ve only access to plain water. Pay particular attention to washing in-between the fingers as this is where most germs collect. It can take a bit of effort since as soon as you get your gear you want to get it in the spoon ASAP! But just take a minute – that’s all you need – to give your hands and fingers a good clean. You’ll be surprised how quickly it becomes a habit – and a bloody good one! Naturally, if you are injecting someone else or vice versa, it is CRUCIAL to wash your hands, before AND after a fix – remember you can be re-infected with other strains of bacteria or viruses, like Hep C. If you inject in your feet, make sure you give them a good wash first to for fuck’s sake! Just imagine what lurgies might exist inside your socks! (staph remember!)
* DO – Try whenever possible to use antibacterial soap, like Carex, that comes in a pump style container. This is because a bar of soap can actually collect bacteria as it sits wet, and slimy on the sink. You can buy it for a quid at m o s t p o u n d shops. If there isn’t anything clean to dry your hands w i t h , then just give them a good shake. There’s no point washing them only to dry them with a grubby towel. Get into the habit 0l washing your hands before & after a hit – use a pump style antibacterial soap like Carex – Injectors just gotta take that bit extra care.
* DO – Use a a tissue and NOT an alcohol swab to wipe away blood AFTER your hit. Many of us use alcohol swabs to wipe blood away after a hit but it is actually a bad habit. The alcohol in the swab prevents your blood from clotting as fast and therefore your site actually heals slower. Always use a dean tissue after a hit – not one that you’ve blown your nose on – remember what fuck off germs live there!
Those Bad Habits…
* DON‘T – Use your fingernail to scoop gear out of the bag and into your
spoon. Ever thought of what sort of shit ends up under your nails? Through the course of the day you might pick your nose, scratch your dog, stump out 20 fag ends, eat with your fingers, wipe your bum, squeeze a pimple, pick your toenails etc etc.Now imagine what could be under those nails!! If you’ve got clean works, turn your syringe upside down and use the flat top of the plunger as a scoop. Nice and sterile and perfect for the job! PS: This is also good for getting citric or ascorbic acid out of the tub without getting germs into the container.
* NEVER – Lick the end of your spike before a hit! A lot of people do this and it is one of THE MOST unhygienic things you could do. Your mouth is full of germs, more than your arse apparently, (and you wouldn’t stick your spike up your arse before a hit now would you?) and especially if you have a cough, throat, chest or mouth infection, you could be carrying a Streptoococcus bacteria. By licking your spike before or during getting a hit, you are transferring that bacteria onto your spike and into your bloodstream through injecting, potentially leaving you exposed to contracting the life threatening endocarditis or other infections. NEVER DO IT – & tell your mates not to either. PS. Don’t touch, blow or wipe the end of the spike with your fingers either, no matter how clean you think they are. If you have touched or licked it, use another one or, if you haven’t got a new one, wipe the spike with a swab in one direction, from bottom to top. Never lick your site before or after your hit either -you are just moving germs around and straight onto your fresh injection hole.
* DON’T – Use the same spike that you draw your gear up with – to inject. When you are drawing up your gear, your spike can and usually does, get barbed, bent, covered in crap from the gear’s cut, or blocked with sediment. So draw up with one spike or syringe, then squirt the liquid into a brand new one. Not only is this more hygienic but you’ll be doing your veins a big favour. They’ll last a lot longer if you use sharp spikes -that is really true. The more barbed it is, the more tearing it does to the veins lining (see BP no. 6) and the more chance there is of thrombosis, clotting or vein collapse.
* DON’T • Leave the water you’re going to use for injecting, sitting out on the table for any length of time. It only takes a minute to get some more clean water and if you’re using with others, make sure you have a glass that you will recognise as your own and don’t let ANYONE use it. In order of preference, use sterile water amps, or water boiled for a few minutes then cooled, or tap water, then bottled water. If you haven’t got a clean container to put your water in, try using your syringe packet. Peel it open at the top leaving a small pocket exposed, take your works out, then carefully fill it up with water. It’s a great idea when you have to make do with what you have – and you’re being hygienic too! If you don’t have to use heat, you can even use it as a spoon! Remember, water can transmit Hepatitis C virus, so do’t let others used works get near yours!
* DON T Re-use your water when rinsing your works. Sometimes, some idiot will rinse their works out by drawing up water from a cup then squirting it back in the same cup. This is not good! It is a good idea though to always rinse your works out after using them as habit- just in case you get stuck with no works later. So if you do rinse your works, draw up from one cup and squirt it out into another, empty container. Do it at least 5 times to make sure you’ve rinsed it well and then when you have to re-use it in an emergency, rinse the syringe out at least 5 times again, before you reuse it. Never re-use an old works without rinsing it well first. It’s a good way to get a dirty hit. Seriously, we reckon this caused it to happen toto one of us! Obviously bleaching your old works is even more hygienic but remember to rinse, rinse, rinse, with clean water afterwards. 1mls are much less able to transmit virus that detachable needles like 2mls,5mls,10mls, etc.
DON’T let other people inject you all the time -you will always or eventually end up getting the raw deal -the last go on the shared syringe, (I hope that doesn’t happen often these days..) your injection being done by a now stoned person, unnecessary loss of power and control (your putty in another’s hands), you have half lost control of any hygiene and BBV prevention interventions, you’re easier to rip off. Occasionally it is OK of course, if you trust the person. But make sure you mix up the hit and get it ready, and they wash their hands before and after. You wouldn’t accept any less from a nurse in hospital!
* DON’T – Leave your spike exposed to air for long. Once you’ve prepared your shot, get it in your vein. Don’t leave it sitting around with the spike exposed to the air -coughing, sneezing, cigarette ash, all these minute particles may settle on your spike. If a spike has been exposed to the air for a while, use an alcohol swab & wipe along the spike in one direction only. From bottom to top. But make sure your hands are clean! Remember loads of old skin (including when people change bandages and dressings) can fly around and settle on things – not what you want on your spike before injecting!
* DON’T – ever bite a bit of filter off with your teeth. Gross! Again, your mouth is full of bad germs so use scissors whenever you can. Same goes for tearing a filter off with dirty fingers. Swan filters or surgical cotton wool is presumed best. Always remember to wash your hands first!
BP issue 7