This section looks at some of what we call ‘injecting myths and bad habits’ and what you should know about them.
Research and experience has shown that the majority of injecting drug users learn their ‘injecting technique’, or ‘how to inject’ information, from other (often older) drug users. This can be both a ‘good’ and a ‘not so good’ thing’. Learning from other drug users shows that injecting drug users want to keep their friends and loved ones safe by teaching them how to use as safely as possible. However, in doing so, sometimes people who inject drugs pick up some ‘not so good’ habits, things that older or more experienced drug users may have been doing for years without even thinking about it. Some habits (practices or rituals) can not only lead to damaged veins, but also to the spread of bacteria and/or blood borne viruses (BBVs) such as hepatitis C (hep C).
You've probably heard the one about how injecting an air bubble can cause a stroke. Whilst it’s true that injecting air is generally 'not a good thing', it tends to be somewhat overstated as a risk, especially when compared to other more immediate risks. While some people who inject drugs pay little or no attention to hygiene or cross-infection risks whilst injecting, they display infinite patience in getting rid of the tiniest of air bubbles from their shot.
Compared to the size of the 'average' air bubble in a syringe, it would take a gigantic volume of air to cause any real circulatory problems.
People who inject drugs really need more information about much higher priorities such as hygiene and avoiding contact with blood so as not to risk BBV transmission.
Sometimes you’ll hear someone say "I thought I was out of veins, but I found a new one here". However, these veins never last because they are not in fact 'new' veins.
What happens is, as veins collapse and circulation gets restricted, the blood is 're-routed' through smaller and smaller veins. If the pressure in a small vein gets too great, it can 'blow up' like a balloon. The walls of these veins are very thin and fragile - sticking a needle into them usually results in a painful bruise. If you (or someone you know) are at the stage of finding these 'new' veins, seriously think about alternative routes of administration, because carrying on injecting can lead to serious, life-long, circulation damage.
For more information on non-injecting routes of administering drugs see Alternatives to Injecting.
It is not uncommon for people who inject drugs to lick the tip of the needle before injecting. While it is understandable that people would want to avoid losing or wasting any of their drug, this will add large numbers of bacteria to the needle and will greatly increase the risk of infection (especially fungal infections such as thrush). The amount of drug in the droplet that is 'saved' will be tiny, and because many drugs are not very effective when taken orally, it will make no noticeable difference whatsoever to the 'shot'. This is one habit or practice that is definitely unhealthy. You should not lick the needle tip.
Licking the injection site either before or after injecting (or both) is a common practice among people who inject drugs, and it may be part of an attempt to 'clean' the site. However, licking the injection site will increase the risk of bacterial infection, and could result in the formation of abscesses. Licking the injection site, either before or after injecting is unhealthy. After injecting, you should stop the bleeding with a clean sterile cotton ball or tissue, and you should wash your hands and the injection site both before and after injecting. You should not lick the injection site.
Check out AIVL's A Guide to Safer Injecting.
'Jacking back' refers to drawing blood back into the syringe after the drug solution has been injected. One reason people do this is to make sure that no drugs are wasted by being left in the tip of the syringe. As a small amount of the drug solution will be retained in the tip of the syringe (how much depends on the type of needle and syringe being used), this can make sense in terms of maximising the amount of drug getting into the body.
But, the small gains you get from doing this should be weighed against the extra damage you can do to the vein, including increasing the chance of vein damage and collapse through the increased suction that results. In fact, this practice heavily contaminates your injecting equipment with blood, making the transmission of BBVs like hep C much more likely if, say, the equipment is re-used by another person. It will also make cleaning your equipment (if you later find you need to re-use it) much more difficult. Jacking back increases the risk of vein damage, and increases the risk of BBV transmission.
Check out AIVL's A Guide to Cleaning Used Equipment.