Boulder Care

Safer Use

This content is provided for educational and informational purposes only and does not constitute providing medical advice or professional services. The information contained herein should not be used for diagnosing or treating a health condition, and those seeking medical advice or guidance should consult with a licensed and qualified healthcare provider. Always seek the advice of a qualified healthcare provider regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have learned here or elsewhere.

If you think you may have a medical emergency, call 911 or go to the nearest emergency department immediately. No physician-patient or provider-patient relationship is created by this website or its use. Boulder Care makes no representations, express or implied, with respect to the information provided herein or to its use.

Key Points

  1. Protect yourself from overdose by using with other people around and taking turns. Use only one drug at a time and start with a test dose. Keep naloxone (Narcan) with you.
  2. Protect yourself and others from infections. Use your own clean needles, syringes, and works every time you inject. Throw them away in safe containers.
  3. Protect your veins. Use a new needle each time because used ones damage veins. Rotate your site so you have time to heal. Avoid using your hands, feet, neck, and groin if you can. If you have a site that is red, warm, swollen, painful, has a lump, or has pus coming out of it, get medical care right away.

Safer Use

If you are continuing to use substances, we want you to be as safe as possible. This is also referred to as “harm reduction.” Here are some of the best ways to protect yourself:

Protection from Overdose

Don’t Use Alone

  • Using with others you trust allows them to help you if you overdose. If you do use alone, tell someone nearby beforehand and leave your doors unlocked.

Narcan (Naloxone)

  • Narcan can reverse an overdose if given quickly enough. Make sure you and the people you use with have Narcan. Boulder can prescribe Narcan for you, or look for sources of free Narcan in your community. Know how to use Narcan. This video teaches Narcan use.
  • Narcan could wear off before the drugs do, so the person could have overdose symptoms again. If you need to use Narcan on someone, call for help. It is important to have medical help after the overdose.
  • Narcan can only work to reverse overdose with opioids. If the Narcan doesn’t seem to help, it could be because there are other drugs involved. Call 911 and give rescue breaths if it is safe to do so.

Take Turns

  • When using with someone else, each of you should use at a different time so that if one of you overdoses, the other can give Narcan and call for help.

Use a Test Dose First

  • Every batch of opioids can be a different strength and could contain other substances, including fentanyl. Even taking a usual amount can lead to an overdose. Or if you haven’t used in a while, your tolerance is lower. If injecting or snorting, use a small amount first to see how your body reacts.

Fentanyl Testing Can Help

  • Fentanyl can be in anything: methamphetamine, cocaine, even pills. Some communities offer test strips for fentanyl so you can know what you’re actually taking. If you have a local syringe exchange program or Harm Reduction Coalition, fentanyl testing may be available there. Testing strips can also be ordered online.

Mixing Drugs Is Dangerous

  • Most overdoses happen when mixing opioids with other substances like alcohol, benzos, meth, or cocaine.

Safer Injection

Don’t Share or Reuse Equipment

  • Use a new syringe, rinse water, cooker, cotton and tie (some people call these “rigs” or “works”), every time. Boulder will work with you to find local sources of new injection supplies.

Cleaning with Bleach

  • If you must share or reuse a needle, soak your syringe and needle in bleach for at least 2 minutes for the best chance to kill HIV (Human Immunodeficiency Virus) and Hepatitis viruses.

Get Rid of Used Syringes Safely

  • You can use a thick plastic container, like a laundry detergent bottle. Mark the bottle as “Hazardous” or “Used Syringes.” Secure the lid when throwing this away.

Safer Vein Care

Before You Inject

  • Clean your hands with soap and water or a hand sanitizer. Clean the injection site with soap and water or alcohol swabs.
  • Use clean water. If the only water you can find is a toilet, take the cover off the tank and use that water. Avoid using water from the toilet bowl.
  • If you need to break down your drug to inject it, ascorbic acid (Vitamin C) is the safest option. It is less painful and safer than lemon juice and vinegar. Use as little ascorbic acid as possible because it can still irritate your veins.

Choosing the Best Vein

  • Arms are the safest, followed by the legs. Try to avoid hands and feet. Injecting in the groin or neck can lead to serious infections, bleeding, and nerve damage.

Rotate Injection Sites

  • Inject at least an inch away from the last site in order to let it heal.

Keep an Eye Out for Infection (see Preventing and Treating Infections)

  • Skin that is infected can be red, painful, swollen, hot, and may drain fluid (infection example photo). You may see or feel a hard bump around the site. Do not try to push the fluid out; you could make the infection worse. Infections are serious and can also affect your heart.
  • If you think you might have a skin infection or feel very sick and feverish, call your primary care provider right away. If it is after hours or you don’t have a primary care provider, go to your local urgent care, walk-in clinic, or Emergency Department.

Summary

If you are injecting substances, you can take charge of your health and prevent injury to your body by using safer injection practices. Using your own syringe and works can also help prevent getting or giving an infection.

Make sure you and the other people you use with have Narcan nearby before injecting and know how to use it. If there are harm reduction resources in your area, your care team can help you find where they are.

Actions You Can Take

  1. If you have symptoms of a skin infection or feel feverish, seek medical attention right away at a provider near you (Primary Care, Urgent Care, or Emergency Department)
  2. If you have shared needles or works and are worried you might have been exposed to infections like Hepatitis C or the Human Immunodeficiency Virus (HIV), talk to your team clinician about getting tested.
  3. If you want more information about any of the topics covered in this information sheet, talk with a member of your care team. You can also review the resources listed below.

Resources and References

For more information about safer use, you might want to check out these websites:

Questions, concerns, or feedback?

You can send a message to your Care Team in the app with non-urgent questions or feedback, or you can always call Boulder's 24/7 Support at 888-316-0451.

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