Injecting - Cleaning Used Works

[suffering_soul]

SWIMs friend began using the same time SWIM did, about a month ago. SWIM and his friend both shot up with brand new clean needles for the first time as well one time, but SWIM prefers to snort it, to not let his addiction get too out of control, as if he kept shooting it up, he knows that's all he would want to do... ever.

Anyway, one time SWIM and his friend went with experienced users to get some, and we were going to shoot it up, once we got back to the users house, where he thought his box of new needles were. Well they weren't there, and he only had his, which he was sharing with his girlfriend.

This person has been shooting up for 8 years, as well as sharing needles with random people along that time, yet insists he is clean. Anyway, they seem to think that pulling bleach into the needle and shooting it out, makes it safe to share with other people.

SWIM tried to get his friend not to share with them, and that it was pretty pathetic and low, because he could have just snorted it, or waited to get his own needle, but no. SWIMs friend yelled at him and told him "BLEACH KILLS EVERYTHING!", but SWIM is still pretty sure things can be transmitted through shared needles?

Is SWIM right, or is he making a big deal out of nothing? Does bleach really disinfect needles?

[Ididnotinhale]

Using bleach will help, it must be left in there for at least ten minutes. But that does not make it safe!

Even if swiy's friend has been tested for HIV it does not mean he doesn't have HIV.

HIV generally does not show up for about 6 months after catching it. During this time when it is untestable, it can still be transmitted. So even if swiy's friend has a signed paper from his doctor, swiy cannot be sure that his friend does not have HIV.

Never share needles! Especially if he has been sharing needles!

Depending where swiy lives, chances are he can walk into a pharmacy and pick up a box of sharps. (it is completely legal) Also, there are some websites where swiy can buy any size and shape of needle. Swim would suggest stocking up on needles so he is never tempted to share. Swiy might even want to hide a couple in his car.

Swim believes and has seen that once people start sharing they generally continue to do so out of convenience until they have caught something. (but many still continue sharing even if they have something because they believe bleach will stop everything from being passed on)

Swiy said that he prefers to insuflate H anyway, so why not do that?

Getting high is never worth risking your life, never share needles.

[radiometer]

The above is good advice. I got this from a government site, actually:

Question:

Will cleaning IV-drug needles and syringes with bleach before using them prevent you from getting HIV?

Answer:

You can be infected with HIV if you use needles and syringes contaminated with blood from a person who is HIV positive. **assorted not so helpful stuff**

There is some evidence that cleaning your needles and syringes with laundry bleach can lower your risk of getting HIV. In laboratory studies, HIV in syringes was killed after contact with undiluted bleach for at least 30 seconds. Watered-down bleach did not work, and neither did contact with bleach for less than 30 seconds.

Does this process work outside the lab? It's hard to know, because this is very difficult to study. But it's probably a lot better than not doing anything at all to kill the HIV in drug-injecting equipment.

Note: It is important to rinse the syringes and needles with water after cleaning them with bleach, so that you won't inject the bleach into your body. And how do you know when 30 seconds are up? Use a watch or a clock, or hum the song "Happy Birthday to You," all the way through, three times over.

Not exactly something I'd want to stake my life on without reading the study. I'm heartened to see decent harm-reduction advice on a gov website, however!

I was under the impression that insufflation is still fairly risky with heroin and that the easiest way to titrate "safe" doses is via smoking/vaporizing.

Reputation Comments on this post:

good info with source

[Solinari]

Bleach would help, that and boiling water, but it's definitely no guarantee and not worth the risk. My fiend has shared needles before, and got hep B, luckily hep B is like the measles, you can recover from it and then you become immune. Just like with the vaccine which is a weakened form of the virus designed to create anti bodies which is the same thing that happens in 99% of people that catch hep B, they fight off the virus and create the anti bodies and become immune. Apparently 1% will not recover and can develop chronic liver cirrhosis which could eventually kill them.

Hep C is much worse and there is no vaccine but i have been told it is possible to fight off the disease in a similar way to hep B, the percentages are just a LOT lower, but i can't say for sure.

I would also add that he was recently (well about 6 months ago, probably longer) tested for Hep C, and to his absolute relief he was negative. He made a pact, with himself, with a higher power, with what ever that he would never ever knowingly share needles ever again if the results were negative, and he hasn't done so since. However, stupidly he did take water from a cup that may or may not have been used before, after that he made a pact never to share ANYTHING ever ever again, water, spoons anything. The only way he would use the same water is with clean EVERYTHING, clean cups (never used) clean spoons never used and clean needles, but that's logically OK if everything is clean and fresh in the first place.

[dr_haldol]

Kill it with fire. No, honestly. Flaming it out a time should help. Should. Think this makes it safe.
But I DO NOT WANT to give any guarantee on that. No one can guarantee for your health.

[Solinari]

That reminds me actually, i heard using a microwave could help as well, but i am not too sure about putting the actual needle in there. I know you're not suppose to put metal in microwaves, but you can do it, Mythbusters did something about it, as long as the metal doesn't touch other metal it shouldn't spark, but try it at your own peril.

Basically i really don't think it's worth it, my fiend was lucky he never got Hep C, he actually got a used needle from someone he knew to have Hep C and boiled it, bleached it , used alcohol and just did whatever he could,. It was fucking stupid, it was asking for hep c, and he was so fucking lucky he didn't get it. You must understand though, needles were hard to come by in those days, no local exchange (nearest was an hour each way on a bus in a dodgy part of town), so the needles usually came from the someone that had diabetes and was a jagger.

I know it can be tempting to try and clean a needle when there is no way to get clean works, maybe it's 10 at night, and you're chocking for a hit.

I posted a Guide to Safer Injecting which is basically the same as the leaflet that comes with the packs of needles, but it doesn't include the part about cleaning works, however i found it via a link on that very guide. Since it seems to be a good guide i will post it ij another thread. But here it is here too Cleaning used works

[Solinari]

OK, i posted a Guide to Safer Injecting which didn't include the part about cleaning syringes/needles, but it did include a link, which i didn't notice till now.

Since there has been a thread about cleaning works i thought i would post this (sub) guide to doing it. Thanks again to http://helpingaddicts.net for making this available online.

Cleaning Used Works

All the information on this page is from the leaflet called 'Cleaning used works' and is available from drug services in the UK.


It is best to use new sterile injecting equipment every time. But if you are going to use your works more than once, clean them immediately after they've been used and again before re-use.

Practice this technique so you can do it without making any mistakes. This method is not guaranteed to make injecting with used works safe.

Sharing injecting equipment is always dangerous - there is a risk of catching hepatitis or HIV. But if you need to clean works that have been used by other people, this is the best way to do it.

It is always best to get enough injecting equipment from the needle exchange so you have clean works for every hit. Cleaning works using the method shown reduces the infection risks, it doesn't take them away. Please return all your used needles and syringes to the needle exchange (in the sharps box provided) so that they can be safely destroyed.


Get 3 clean cups - fill them yourself. If you haven't got 3 clean cups, you can use 1 cup and wash it between stages.

Fill the syringe completely to rinse and clean it. Draw cold water (water that has cooled is best) into the syringe and then flush it out (down the sink)
Do this twice
Empty the cup down the sink

Slowly draw household bleach* into the syringe, then flush it out (down the sink)
Do this twice
Empty the cup down the sink
* If you haven't got bleach, just use cold water again

Draw cold water (water that has boiled then cooled is best) into the syringe and then flush it out (down the sink)
Do this twice (This will rinse out all of the bleach from the syringe)
Empty the cup down the sink

[Flyers2008]

Like you said, it is best to use a new set of works every time, and for anyone in the Philly area, you can go ot the needle exchange anyday(if u need to know what days/times and locations, ask me) of the week and you can get as many as want. Usually they will give u what you have plus 10 i.e. Trade in 20 dirty and get 30 brand new ones back, and they also give you mini cotton balls, alcohol wipes, a couple kinds of oinment, clean little bottles of water, caps(for mixing), even condems if you want.

[myworld123]

Bleach will definitely get rid of any germs in SWIM's rig, but I'm not sure SWIM would wanna use that rig after flushing bleach through it. I sure as hell wouldn't.

By the way, stay away from the needle. Your right, keep using it, and that's the only way SWIM will ever wanna use any drug.

[Birkill]

Originally Posted by Solinari

Bleach would help, that and boiling water, but it's definitely no guarantee and not worth the risk. My fiend has shared needles before, and got hep B, luckily hep B is like the measles, you can recover from it and then you become immune. Just like with the vaccine which is a weakened form of the virus designed to create anti bodies which is the same thing that happens in 99% of people that catch hep B, they fight off the virus and create the anti bodies and become immune. Apparently 1% will not recover and can develop chronic liver cirrhosis which could eventually kill them.

Hep C is much worse and there is no vaccine but i have been told it is possible to fight off the disease in a similar way to hep B, the percentages are just a LOT lower, but i can't say for sure.

I would also add that he was recently (well about 6 months ago, probably longer) tested for Hep C, and to his absolute relief he was negative. He made a pact, with himself, with a higher power, with what ever that he would never ever knowingly share needles ever again if the results were negative, and he hasn't done so since. However, stupidly he did take water from a cup that may or may not have been used before, after that he made a pact never to share ANYTHING ever ever again, water, spoons anything. The only way he would use the same water is with clean EVERYTHING, clean cups (never used) clean spoons never used and clean needles, but that's logically OK if everything is clean and fresh in the first place.

I think swiy has got his heps the wrong way round as swims friend had hep c and got rid of it through a series of injections! Some one correct me if im wrong but im pretty sure im not!?

[g666d]

high percentage bleach is better than low percentage (sodium hypochlorite). Swim would soak for a few minutes, then flush out rig with alcohol (denatured spirits), then water.

[helene]

Swim has just uploaded onto DF a few videos from the Harm Reduction Works website. They all deal with cleaning syringes, how to do it properly if you really must do it, and how well it actually works to prevent the spread of HIV and Hep C. But of course, the only way to be 100% safe is to use new works every time.

Here are the links:

Does cleaning syringes work?

Cleaning works: how to clean a used syringe

HIV and hepatitis C survival in used syringes

Originally Posted by Birkill

I think swiy has got his heps the wrong way round as swims friend had hep c and got rid of it through a series of injections! Some one correct me if im wrong but im pretty sure im not!?

It's not nearly as simple as that, I'm afraid.

If someone is aware that they have come into contact with the hepatitis C virus, then a series of anti-viral injections can help to reduce the risk of them contracting the disease. However, as outlined below, hepatitis C is far more likely to result in long-term illness/ death than hepatitis A or B. Also, unlike A or B, there is no vaccine for hepatitis C. Have a read of the following info, which gives a brief outline of the differences between hepatitis A, B and C, the different routes of infection, treatment and immunisation.

Hepatitis A

Hepatitis A is the most common of the seven known types of viral hepatitis. Infection with the hepatitis A virus leads to inflammation of the liver, but complications are rarely serious.

How hepatitis A is spread

The hepatitis A virus (HAV) is found in the faeces of someone infected with the virus. It only takes a tiny amount of faeces getting inside another person’s mouth to cause hepatitis A infection. Personal hygiene, such as careful hand washing, can minimise the risk of the virus being passed on.

HAV is a common infection in many parts of the world where sanitation and sewage infrastructure is poor. Often people become infected with HAV by eating or drinking contaminated food or water.

Hepatitis A is also classed as a sexually transmitted disease (STD) because it can be passed on sexually, particularly during activities such as felatio, cunnilingus and anilingus. The washing of genital and anal areas before sex, and the use of condoms or dental dams can help to prevent this risk.

Hepatitis A can affect all age groups. Once a person is exposed to the virus it takes between 2 and 6 weeks to produce symptoms.

Treatment

There is no specific treatment for HAV and most people fight off the virus naturally, returning to full health within a couple of months. The doctor will advise avoiding alcohol and fatty foods as these can be hard for the liver to process and may exacerbate the inflammation.

Patients should get plenty of rest and eat a nutritious diet. They should also ensure they do not spread HAV by washing their hands after using the toilet and before preparing food. Patients with more severe symptoms may be monitored in hospital for a short period.

The infection usually clears in up to 2 months, but may occasionally recur or persist longer in some people. Once a person has been infected and their body has fought off the virus they are permanently immune. Occasionally symptoms may be severe and require monitoring in hospital.

There are rarely any complications with hepatitis A infection. Permanent damage to the liver is very unlikely, but in extremely rare cases the infection can be fatal, particularly in older people.

Immunisation

Hepatitis A immunisation is given in a series of injections. The first single injection in the arm gives protection for a year. The second booster injection at 6 to 12 months extends protection for up to 10 years.

The hepatitis A vaccine may be routinely recommended for young children living in areas with high incidence of hepatitis A, and anyone travelling to countries where hepatitis A is endemic. In addition, immunisation may be recommended for people whose sexual practices are likely to put them at risk.

Immunisation may also be recommended to prevent hepatitis A developing if a person suspects they have been exposed to the virus.

Hepatitis B

Hepatitis B is similar to hepatitis A in its symptoms, but is more likely to cause chronic long-term illness and permanent damage to the liver if not treated.

How hepatitis B is spread

The hepatitis B virus (HBV) is very common worldwide, with more than 350 million people infected. Those with long term HBV are at high risk of developing liver cirrhosis or liver cancer.

Hepatitis B is most frequently passed on through the exchange of bodily fluids with an infected person. HBV is estimated to be 50 to 100 times more infectious than HIV.1

HBV can be spread in the following ways:

By unprotected (without a condom) penetrative sex (when the penis enters the anus, vagina or mouth) with someone who is infectious. Also by sex that draws blood with someone who is infected.

By sharing contaminated needles or other drug-injecting equipment.

By using non-sterilised equipment for tattooing, acupuncture or body piercing.
from an infected mother to her baby, most commonly during delivery.

Immunisation of the baby at birth prevents the transmission of hepatitis B.
through a blood transfusion in a country where blood is not screened for blood-borne viruses such as HBV.

Hepatitis B cannot be spread through sneezing, coughing, hugging or coming in contact with the faeces of someone who is infected.

Treatment

In most countries a patient with a positive test result will be referred to a specialist who will carry out further tests to determine the degree to which hepatitis B may be affecting the liver, and what may be the best treatment options. In these tests a small sample of liver tissue may need to be taken (a liver biopsy).

In the majority of patients with active HBV, symptoms will not be severe and treatment will not be required. The patient will be monitored and after a few months the patient’s immune system should fight off the virus, giving the patient natural immunity.

In around 5% of adults, 30-50% of young children (aged 1-4), and 90% of infants, HBV infection will become chronic. The virus is more deadly to the young and those that are infected at birth have a 25% chance of developing a life-threatening liver-related illness.

Antiviral medication is given as treatment to those with chronic symptoms to help prevent further liver damage. These medications may be injected or given in pill form. Examples are Interferon Alpha, Lamivudine and Baraclude. Treatment usually lasts 6 months, during which the patient will be carefully monitored.

If a person lives with hepatitis B infection for a number of years then they may develop the following complications:

Chronic hepatitis.
Liver cirrhosis.
Liver cancer.

Regardless of whether the infection is producing symptoms or not, the patient will be advised to avoid alcohol, get plenty of rest and maintain a healthy diet.

Most adults infected with the hepatitis B virus fully recover and develop life-long immunity. Between 2% and 10% of individuals infected as adults will become chronic carriers, which means they will be infectious to others and can develop chronic liver damage. Infected children, especially newborn babies, are much more likely to become chronic carriers.

Immunisation

Three immunisation injections are given over a period of 3-6 months. A blood test is taken once the course of injections is completed to check that they have worked. Immunity should last for at least 5 years.

Hepatitis C

Hepatitis C, like other forms of hepatitis, causes inflammation of the liver. The hepatitis C virus is transferred primarily through blood, and is more persistent than hepatitis A or B. Worldwide, estimates suggest 170 million people are chronically infected with hepatitis C, with 3 to 4 million people newly infected each year.2

How hepatitis C is spread

High-risk groups are the same in many societies and cultures. They include injecting drug users, people who receive transfusions of unscreened blood, haemophiliacs, dialysis patients and people who have unprotected sex with multiple sex partners.

The hepatitis C virus (HCV) can be spread in the following ways:

By sharing drug-injecting equipment (needles, heating spoons, etc). This is the primary transmission route for HCV and HIV outside sub-Saharan Africa.

By using non-sterilised equipment for tattooing, acupuncture or body piercing. This can be a problem in countries where tattooing or scarification is a traditional ritual practice.

Through exposure to blood during unprotected sex with an infected person. Blood may be present because of genital sores, cuts or menstruation. Sexual transmission is an uncommon way of becoming infected with hepatitis C.

Rarely, from an infected mother to her baby during childbirth. The risk may be greater if the mother is also infected with HIV.

Through blood transfusion. In many developing countries blood is not screened (tested) for the hepatitis C virus. All blood for transfusion in the UK and USA is tested.

By sharing equipment used to snort cocaine. Usually this is a rolled banknote, which can become contaminated with blood from a person’s nose.

Hepatitis C cannot be passed on by hugging, sneezing, coughing, sharing food or water, sharing cutlery, or casual contact.

Treatment

To determine the extent to which the liver has been affected by hepatitis C, two more tests will be carried out.

The first is a liver function test (LFT) which measures substances (specific proteins and enzymes) in the patient’s blood, showing how effectively the liver is working.

The second is a liver biopsy. A fine hollow needle is passed through the skin into the liver and a small sample is taken. The sample is then examined under a microscope to gauge the amount of liver damage (inflammation, scarring and cirrhosis).

Treatment for hepatitis C has improved in recent years, but at maximum efficacy it is still only successful at clearing HCV in around 30%-50% of patients.

Treatment combines the antiviral drugs interferon and ribavirin. Interferon can be used alone but is then less effective (around 10%-20%). The antiviral drugs may cause significant side effects that may be intolerable for some people. These include:

headaches.
flu-like symptoms.
nausea.
tiredness.
body aches.
depression.
skin rashes.

The cost of this antiviral treatment is high, making it difficult to access in low-income and developing countries. A patient will also require regular check-ups to monitor their progress.

It is important to remember that if HCV treatment is effective and the infection is cleared, this does not mean the patient has future immunity to hepatitis C.

About 20% of individuals who become infected with HCV will clear the virus from their body within 6 months, though this does not mean they are immune from future infection with HCV.

The other 80% of people will develop chronic hepatitis C infection, during which the virus may cause mild symptoms or no symptoms at all. These people will however carry the hepatitis C virus for the rest of their lives and will remain infectious to others.

If a person lives with hepatitis C infection for a number of years then they may develop the following complications:

Chronic hepatitis.
Liver cirrhosis.
Liver cancer.

Prevention

Currently, there is no vaccine for hepatitis C, but research is in progress. Like HIV, HCV can mutate easily, which makes vaccine development complicated. As no vaccine exists, all measures should be taken to prevent HCV transmission.

Injecting drug users should never share any needles, syringes or mixing spoons, as blood can be transferred between users.

Infection through penetrative sex does occur, although it is not common. If a person is infected with HCV, it is advisable for them to use a condom for penetrative sex to ensure that they do not pass on the virus to their partners through any open genital cuts or sores.

People should avoid sharing toothbrushes, shaving equipment (especially razors), or anything else that may be contaminated with infected blood.

The doctor will advise the patient of any precautions necessary to avoid infecting others with the virus.

Reputation Comments on this post:

Great links, thorough information, detailed response

[[tanarilla.]]

My bunny is sure that there is no knowing whether bleach actually kills HIV, unless of course one can test it. The only medically accepted way to sterilize something [note:most plastic CANNOT be sterilised using heat, if the syringe is made of plastic, you cannot sterilise it using this device](sterilizing means killing ALL the germs; anything else is called DISINFECTION) is by using an autoclave. Obviously, unless you are a medical professional or work in a tattoo shop you will have no access to these whatsoever. However, a way which one can sterilize their own stuff, but one else's, for their own personal use, and not reconmended for sharing are gluteraldehyde-based chemical baths. My bunny does not know how you can get access to chemical sterilisation tools. Also, there is a problem that you can only use one prepared solution once, because you would infect the sterile bath with your works if you put them in it again.
Boiling is one of the least effective ways to sterilise something. It takes at least half an hour of boiling to call something partially disinfected. The thing you boil the needle in would have to be sterile, the equipment that you use to remove it from the water, the general area where it's being held and dried would have to sterile. This environment is impossible to create in a home. As for the bleach, on the other hand, it does rarely kill Hepatitis. Even though, it's more effective than boiling. [note: the bleach has to be pure and undiluted, and the needle would have to be flushed and rinsed for at least 30 seconds]

The conclusion: there is no possible way of knowing that your friend hasn't caught anything, only by getting tested.

My bunny has visited too many unprofessional and unclean places when she got her piercings to know this. Fortunately, she has never been pierced with a used needle, thank fuck for that.

[tanarilla.] added 21 Minutes and 28 Seconds later...

Erm, also. One good way to partially sterilise something in your own home:
- Turn on your oven on max. possible temperature.
- take one stainless steel [this part is very important] container, preferably a new one, that you have not used before. Wash it really well with undiluted bleach. Soak it in a bleach bath for 5 mins, don't use the bleach that you used to rinse it. [for soaking, use your sink that you previously cleaned before. Guess, with bleach.]
- remove plastic syringe from needle.
- place needle in the container.
- put it in the oven for 20 mins at least, no more than an hour.
- prepare bleach bath for your syringe, again, in a previously cleaned stainless steel container, as above. Leave for 5 mins.
- When your needle is well cooked [haha] take it out from the oven, leave it to cool down, leave it in the container.
- re-attach needle and syringe. Now, prepare a new bleach bath. Suck up the bleach, leave it in there for about 30 seconds. Repeat this a few times. Don't shoot the bleach into your container, use the sink.
- Boil some water, leave it to cool down. Again, flush needle with this water to get rid of the bleach residue.

Throughout this whole procedure my bunny reconmends that you wear a new, clean pair of latex gloves, especially when you touch the needle, and clean the area where you are preparing all of this very well beforehand and afterwards.
This does not guarantee anything, but my bunny believes that at least it lessens your chances of infecting yourself and other.