Setting

• Find a safe place for use
• If injecting, have access to clean water
• Stay inside or away from the elements.
• Use with someone else or call the Never Use Alone hotline (877-696-1996)
• Alternate use
• Have naloxone present

Supplies

• Minimize sharing of all supplies - even sharing non-needle supplies has been associated with HIV and HCV transmission

Needles

• One shot = one new needle and syringe each time.
• If re-used even for a few uses, needles become dull, leading to a larger puncture and higher risk for infection
• Sharpening a needle can lead to burrs, cause damage to veins, or result in needle breaking off in vein

Pipes

• Use glass stems and pipes to inhale smoke or vapors. They’re cleaner and less likely to break or release toxic fumes.
• Each person should use their own pipe. This helps to prevent spread of respiratory illnesses like TB & COVID-19.
• You can also reduce risk of HIV and Hepatitis C
• Burns, cuts, and dry lips can lead to bacteria entering the bloodstream
• Plastic mouth pieces help prevent lip burns
• You can use lip balm while smoking to keep lips from drying
• Use alcohol wipes for hands, pipes, and other equipment

Substances

• Test your supply
• Use drug checking services or drug test strips
• Go slow, especially if your drugs are coming from a new supply or supplier
• If mixing with water:
  • Use sterile water
  • If not, then boil
  • If no boiled water, use tap/bottled

How to Use Fentanyl or Xylazine Test Strips

1. Put a small amount of drug in a clean container
2. Mix with water
3. Place the wavy end of the test strip down in the water and let it absorb for about 15 seconds
4. Take the strip out of the water and place it on a flat surface for 2 to 5 minutes
5. Counterintuitive, but two lines = negative for the drug

Sites

Choose Safer Injection Sites

• Preferentially access arms, hands, and feet
• Avoid areas with increased infectious risks (groin)
• Avoid areas with major blood vessels nearby (groin) as accidental injection here could result in loss of limb or death

Skin

Safer Skin Prep

• Clean hands with soap and water or hand sanitizer
• Clean skin prior to injecting with an alcohol wipe

Wound Care

• Cleanse the area with soap and water, saline, or antimicrobial spray
• Moisturize with Vitamin A&D ointment, possibly medical grade honey or antibiotic ointment
• Keep covered with nonadherent dressing followed by gauze

Sharing

• Injection drug use accounts for ~1 in 10 HIV diagnoses in US
• Sharing equipment increases risk - HIV can survive on a used syringe for 42 days
• Do not share needles – visit Prevention Point for free syringes and supplies

How to Use Narcan

Photos created by Very Well Health.

1. Hold the spray with your thumb on the bottom of the plunger and place your index and middle fingers on the side of the nozzle.

2. Tilt the person's head back and support their head with your hand.

3. Insert the nozzle into a nostril, until your fingrs on either side of the nozzle are against the bottom of the person's nose. Press the plunger firmly to release the full dose.

4. Call 911. If the person doesn't respond in 2 minutes, administer a second dose. Roll the person on their side and prop their hands under their head.