Injection of recreational drugs is a method of introducing the drug into the body with a hollow needle and a syringe which is pierced through the skin into the body (usually intravenous, but also intramuscular or subcutaneous). Although there are various methods of taking drugs, injection is favoured by some users as the full effects of the drug are experienced very quickly, typically in five to ten seconds. It also bypasses first-pass metabolism in the liver, resulting in a higher bioavailability for many drugs than oral ingestion would (so users get a stronger effect from the same amount of the drug). This shorter, more intense high can lead to a dependency, both physical and psychological, developing more quickly than with other methods of taking drugs.
While a wide variety of drugs are injected, among the most popular in many countries are morphine, heroin, cocaine, amphetamine and methamphetamine. Prescription drugs, including tablets, capsules, or even liquids or suppositories, are also sometimes injected, especially prescription opioids, since many opioid addicts already inject heroin. Injecting preparations not intended for this purpose is dangerous because of excipients (fillers). Injecting codeine into the bloodstream directly is dangerous because it can cause pulmonary edema and anaphylaxis, and dihydrocodeine, hydrocodone, nicocodeine, thebaine and other codeine-based products are also moderate risk in this case.
Some manufacturers add the narcotic antagonist naloxone or the anticholinergics atropine and homatropine (in lower than therapeutic doses) to their pills to prevent injection. Unlike naloxone, atropine does indeed help morphine and other narcotics combat neuralgia. The atropine may very well not present a problem, and there is the possibility for soluble tablets having their atropine content reduced by putting them on an ink blotter and putting a drop of water on them and taking the remainder of the pill off the blotter and cooking it up. Canada and many other countries prohibit manufacturers from putting in active ingredients for the above given reason; their Talwin PX does not contain naloxone -- being a narcotic agonist-antagonist though, pentazocine and its relatives can cause withdrawal in those physically dependent upon narcotics.
Of all the ways to get drugs into the system, injection has the most risks by far as it bypasses the body's natural filtering mechanisms against viruses, bacteria and foreign objects. There will always be much less risk of overdose, infections and health problems with alternatives to injecting, such as smoking, snorting (nasal ingestion), or swallowing.
Viruses such as HIV and hepatitis C are prevalent among injecting drug users in many countries, mostly due to small groups sharing injection equipment combined with a lack of proper sterilization. Other health problems arise from poor hygiene and injection technique (be it IV, IM, or SC), such as cotton fever, also known as the shakes, phlebitis, abscesses, vein collapse, ulcers, malaria, gas gangrene, tetanus, septicaemia, thrombosis and embolism and the results thereof, lodging of pill fragments in small blood vessels, the lungs, and elsewhere, and local infections. Hitting arteries and nerves is dangerous, painful, and presents its own similar spectrum of problems.
Contents.
1 Harm reduction
2 Safer injection of illicit drugs
3 Alternatives to injection
Harm reduction
A clandestine kit containing materials to inject illicit drugs (or legitimate ones illegitimately). Note that it is quite common for an injector to use a single needle repeatedly or share with other users. It's also quite uncommon for a sterilizing agent to be used.
Compare this legitimate injection kit obtained from a needle-exchange program to the user-compiled one above.
Harm reduction is an approach to public health intended to be a progressive alternative to an approach requiring complete abstinence from drug use. While it does not condone the taking of illicit drugs, it does seek to reduce the harms arising from their use, both for the person taking illicit drugs and the wider community.
A prominent method for addressing the issue of disease transmission among intravenous drug users are safe needle exchange programs, in which facilities are available to exchange used injection equipment for safe sterile equipment, often without a prescription or fee. The idea is to reduce the practice of sharing used needles thereby hopefully reducing the risk of HIV infections.
Safer injection of illicit drugs
A philosophy of harm reduction promotes information and resources for injecting drug users. General guidelines on safer injecting various substances intravenously are typically based on the following steps.
The preparation area for drug preparation should be cleaned with warm soapy water to minimize the risk of bacterial infection.
The equipment required involves new syringes and needles, swabs, sterile water, filter, tourniquet and a clean spoon or stericup. In order to minimise the chance for bacteria and viruses to enter the bloodstream, people are advised to soap their hands with warm water. However, as people do not always have access to hot water and soap when they are injecting, the philosophy of harm reduction seeks to find the most realistic option that people can take. Alcohol swabs are commonly distributed with injecting equipment, and while they are less effective than hand washing, their use is more effective than nothing. The sharing any of injecting equipment, even tourniquets, is highly discouraged, due to the high danger of bacteria and viruses being transmitted via the equipment.
Sterile water is also recommended to prevent infection. Many needle and syringe programs distribute ampules of sterile water for this reason. Where sterile water is not obtainable, the harm reduction approach recommends tap water boiled for five minutes, and then allowed to cool.
Once the water and substance are combined in the mixing vessel and mixed, heat is sometimes applied to assist the mixing. Filtering is recommended by health services, as the mix can consist of wax or other non-soluble materials which are damaging to veins. Wheel filters are the most effective filters,however cotton wool or tampons can be used, although to be more effective, several filtrations should be undertaken.
Once the mix is drawn into the syringe, air bubbles should be removed by flicking the barrel with the needle pointed upwards in order to prevent the air entering the blood stream.
A tourniquet can be used to help people access their veins. The tourniquet should not be on too tight, or left on for too long, as this causes the veins to swell and stretch. When injecting, the needle’s 'hole' should face upward and be eased into the vein at a 45 degree angle. In order to prevent stress on the vein, the needle should be pointing towards the heart.
The plunger should be pulled back a little (known as ‘jacking back’) to see if the needle is in the vein. Blood should appear in the barrel of the syringe if this is the case. This process is known as registering.
The tourniquet should then be taken off and the plunger gently pushed. After injection, a clean tissue or cotton wool should be pressed against the injection site to prevent bleeding. Although many people use an alcohol swab for this purpose it is discouraged by health services as the alcohol prevents the injection site from clotting.
Dispose of injecting gear using a 'sharps bin' if supplied. Other rigid-walled container such as a bottles are recommended as a second best option.
Alternatives to injection
The safest alternative is, of course, not to take illicit drugs. The majority of legal systems around the world encourage this option. Harm reduction acknowledges that some people in a society will not choose this option and should at least be provided information on safer means of taking illicit drugs to minimise the individual health risks, and also the spread of viruses such as HIV and hepatitis C to the wider community.
Snorting, or nasal ingestion of drugs, is usually safer than injection in terms of the relative danger of transmission of blood-borne viruses. However, the membranes in the nose are very delicate and can rupture when snorting so users should have their own snorting equipment not shared with anyone else, to prevent viral transmission. As with injection, a clean preparation surface is required to prepare a drug for snorting. Nasal membranes can be seriously damaged from regular snorting.
Smoking, often called 'chasing the dragon', has negligible risk of bacterial or viral transmission and the risk of overdose is lessened compared to injecting. It still retains much of the 'rush' of injecting as the effects of the drug occur very rapidly. It is a far safer way to use heroin, with the best option being to use new aluminium foil, first passing a cigarette lighter flame over both sides to get rid of any contaminants.
Swallowing tends to the safest and slowest method of ingesting drugs. It is safer as the body has a much greater chance to filter out impurities. As the drug comes on slower, the effect tends to last longer as well, making it a favourite technique on the dance scene for speed and ecstasy. People rarely take heroin orally, as it is converted to morphine in the stomach and its strength is halved in the process. Pills like benzodiazepines are best swallowed as they have chalk or wax fillers in them. These fillers won't irritate the stomach, but pose serious health risk for veins or nasal membranes.
Shafting, or rectal ingestion, relies on the many veins in the anal passage passing the drug into the blood stream quite rapidly. Some users find that trading off some of the 'rush' for fewer health risks is a good compromise. Shafting usually involves about 1.5 ml of fluid mixed with the drug.
Women have the added option of shelving, where drugs can be inserted in the vagina. This is similar to the rectum, in that there are many blood vessels behind a very thin wall of cells, so the drug passes into the bloodstream very quickly. Care should be taken with drugs such as amphetamine that may irritate the sensitive lining of the rectum and vagina.
While a wide variety of drugs are injected, among the most popular in many countries are morphine, heroin, cocaine, amphetamine and methamphetamine. Prescription drugs, including tablets, capsules, or even liquids or suppositories, are also sometimes injected, especially prescription opioids, since many opioid addicts already inject heroin. Injecting preparations not intended for this purpose is dangerous because of excipients (fillers). Injecting codeine into the bloodstream directly is dangerous because it can cause pulmonary edema and anaphylaxis, and dihydrocodeine, hydrocodone, nicocodeine, thebaine and other codeine-based products are also moderate risk in this case.
Some manufacturers add the narcotic antagonist naloxone or the anticholinergics atropine and homatropine (in lower than therapeutic doses) to their pills to prevent injection. Unlike naloxone, atropine does indeed help morphine and other narcotics combat neuralgia. The atropine may very well not present a problem, and there is the possibility for soluble tablets having their atropine content reduced by putting them on an ink blotter and putting a drop of water on them and taking the remainder of the pill off the blotter and cooking it up. Canada and many other countries prohibit manufacturers from putting in active ingredients for the above given reason; their Talwin PX does not contain naloxone -- being a narcotic agonist-antagonist though, pentazocine and its relatives can cause withdrawal in those physically dependent upon narcotics.
Of all the ways to get drugs into the system, injection has the most risks by far as it bypasses the body's natural filtering mechanisms against viruses, bacteria and foreign objects. There will always be much less risk of overdose, infections and health problems with alternatives to injecting, such as smoking, snorting (nasal ingestion), or swallowing.
Viruses such as HIV and hepatitis C are prevalent among injecting drug users in many countries, mostly due to small groups sharing injection equipment combined with a lack of proper sterilization. Other health problems arise from poor hygiene and injection technique (be it IV, IM, or SC), such as cotton fever, also known as the shakes, phlebitis, abscesses, vein collapse, ulcers, malaria, gas gangrene, tetanus, septicaemia, thrombosis and embolism and the results thereof, lodging of pill fragments in small blood vessels, the lungs, and elsewhere, and local infections. Hitting arteries and nerves is dangerous, painful, and presents its own similar spectrum of problems.
Contents.
1 Harm reduction
2 Safer injection of illicit drugs
3 Alternatives to injection
Harm reductionA clandestine kit containing materials to inject illicit drugs (or legitimate ones illegitimately). Note that it is quite common for an injector to use a single needle repeatedly or share with other users. It's also quite uncommon for a sterilizing agent to be used.
Compare this legitimate injection kit obtained from a needle-exchange program to the user-compiled one above.
Harm reduction is an approach to public health intended to be a progressive alternative to an approach requiring complete abstinence from drug use. While it does not condone the taking of illicit drugs, it does seek to reduce the harms arising from their use, both for the person taking illicit drugs and the wider community.
A prominent method for addressing the issue of disease transmission among intravenous drug users are safe needle exchange programs, in which facilities are available to exchange used injection equipment for safe sterile equipment, often without a prescription or fee. The idea is to reduce the practice of sharing used needles thereby hopefully reducing the risk of HIV infections.
Safer injection of illicit drugsA philosophy of harm reduction promotes information and resources for injecting drug users. General guidelines on safer injecting various substances intravenously are typically based on the following steps.
The preparation area for drug preparation should be cleaned with warm soapy water to minimize the risk of bacterial infection.
The equipment required involves new syringes and needles, swabs, sterile water, filter, tourniquet and a clean spoon or stericup. In order to minimise the chance for bacteria and viruses to enter the bloodstream, people are advised to soap their hands with warm water. However, as people do not always have access to hot water and soap when they are injecting, the philosophy of harm reduction seeks to find the most realistic option that people can take. Alcohol swabs are commonly distributed with injecting equipment, and while they are less effective than hand washing, their use is more effective than nothing. The sharing any of injecting equipment, even tourniquets, is highly discouraged, due to the high danger of bacteria and viruses being transmitted via the equipment.
Sterile water is also recommended to prevent infection. Many needle and syringe programs distribute ampules of sterile water for this reason. Where sterile water is not obtainable, the harm reduction approach recommends tap water boiled for five minutes, and then allowed to cool.
Once the water and substance are combined in the mixing vessel and mixed, heat is sometimes applied to assist the mixing. Filtering is recommended by health services, as the mix can consist of wax or other non-soluble materials which are damaging to veins. Wheel filters are the most effective filters,however cotton wool or tampons can be used, although to be more effective, several filtrations should be undertaken.
Once the mix is drawn into the syringe, air bubbles should be removed by flicking the barrel with the needle pointed upwards in order to prevent the air entering the blood stream.
A tourniquet can be used to help people access their veins. The tourniquet should not be on too tight, or left on for too long, as this causes the veins to swell and stretch. When injecting, the needle’s 'hole' should face upward and be eased into the vein at a 45 degree angle. In order to prevent stress on the vein, the needle should be pointing towards the heart.
The plunger should be pulled back a little (known as ‘jacking back’) to see if the needle is in the vein. Blood should appear in the barrel of the syringe if this is the case. This process is known as registering.
The tourniquet should then be taken off and the plunger gently pushed. After injection, a clean tissue or cotton wool should be pressed against the injection site to prevent bleeding. Although many people use an alcohol swab for this purpose it is discouraged by health services as the alcohol prevents the injection site from clotting.
Dispose of injecting gear using a 'sharps bin' if supplied. Other rigid-walled container such as a bottles are recommended as a second best option.
Alternatives to injection
The safest alternative is, of course, not to take illicit drugs. The majority of legal systems around the world encourage this option. Harm reduction acknowledges that some people in a society will not choose this option and should at least be provided information on safer means of taking illicit drugs to minimise the individual health risks, and also the spread of viruses such as HIV and hepatitis C to the wider community.
Snorting, or nasal ingestion of drugs, is usually safer than injection in terms of the relative danger of transmission of blood-borne viruses. However, the membranes in the nose are very delicate and can rupture when snorting so users should have their own snorting equipment not shared with anyone else, to prevent viral transmission. As with injection, a clean preparation surface is required to prepare a drug for snorting. Nasal membranes can be seriously damaged from regular snorting.
Smoking, often called 'chasing the dragon', has negligible risk of bacterial or viral transmission and the risk of overdose is lessened compared to injecting. It still retains much of the 'rush' of injecting as the effects of the drug occur very rapidly. It is a far safer way to use heroin, with the best option being to use new aluminium foil, first passing a cigarette lighter flame over both sides to get rid of any contaminants.
Swallowing tends to the safest and slowest method of ingesting drugs. It is safer as the body has a much greater chance to filter out impurities. As the drug comes on slower, the effect tends to last longer as well, making it a favourite technique on the dance scene for speed and ecstasy. People rarely take heroin orally, as it is converted to morphine in the stomach and its strength is halved in the process. Pills like benzodiazepines are best swallowed as they have chalk or wax fillers in them. These fillers won't irritate the stomach, but pose serious health risk for veins or nasal membranes.
Shafting, or rectal ingestion, relies on the many veins in the anal passage passing the drug into the blood stream quite rapidly. Some users find that trading off some of the 'rush' for fewer health risks is a good compromise. Shafting usually involves about 1.5 ml of fluid mixed with the drug.
Women have the added option of shelving, where drugs can be inserted in the vagina. This is similar to the rectum, in that there are many blood vessels behind a very thin wall of cells, so the drug passes into the bloodstream very quickly. Care should be taken with drugs such as amphetamine that may irritate the sensitive lining of the rectum and vagina.
No comments:
Post a Comment