Safer injecting

Exchange Supplies – Tools for harm reduction

Injecting opioids is associated with a variety of problems, such as damage to the skin and veins and an increased chance of contracting and transmitting infections. By focusing on safer injection practices, this page includes information on how to reduce the problems and risks associated with opioid use.


  • Smoking heroin instead of injecting heroin has:
    • a lower risk of viral transmission
    • a lower risk of overdose
    • fewer health risks.

  • If you inject, always inject yourself. The risk of tissue damage and bacterial infection is higher if a friend does your injection.

  • When you inject, always avoid injecting into muscle or under the skin
    • hit the vein, as your blood is better at killing bacteria than your muscle
    • there is a high risk of infections and gangrene if you inject into a pulse/an artery.

  • Use a fresh, sterile needle whenever you inject – needle tips deteriorate quickly with use, increasing tissue damage, which can make injecting into a vein much more difficult and infections more likely. Reusing needles also increases the infection risk due to the spread of bacteria/viruses.

  • Do not share needles, syringes, cookers/spoons or other drug-injection ‘works’ with other drug users, not even partners.

  • Wash your hands first and use a clean surface to prepare the injection.

  • Use sterile water to dissolve your drugs from a needle-exchange/NSP or boiled water that has cooled. Avoid using bottled water as it is not sterile.

  • Try to use as little citric acid as possible to dissolve heroin. A lot of citric acid can damage both skin tissue and veins, giving bacteria a better chance to grow. Furthermore, increased tissue damage can make injecting into a vein much more difficult.

  • Try to use the smallest size needle for the injection site to reduce damage to veins, which can make injection difficult and increase the risk of infection.

  • If you inject more than one type of drug (eg speedballing), you should be aware that certain drugs (eg cocaine) can encourage the bacteria in heroin to grow.

  • After use, throw away your ‘works’ in a disposal container or a puncture-proof, child-proof container and return the container to your local needle-exchange/NSP.

  • Remember, there is no way that you can tell whether your drugs are contaminated and likely to cause infection.

Image © Exchange Supplies. Used with permission.