Taking ControlMainlining (Intravenous Injection)Hierarchy of safety for picking Intravenous Injection SitesVeins vs. ArteriesVeins vs. NervesExercises for enhancing Vein VisibilitySome Tips because that “Getting Veins Up”Muscle-Popping (Intramuscular Injection)Skin-Popping (Subcutaneous Injection)

This ar of the hands-on presents information on suitable injection technique (intravenous, intramuscular, and subcutaneous injection).

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As important as preparing her drugs as cleanly as possible is injecting them together safely and also as closely as possible.

This section of the manual presents info on proper injection an approach (intravenous, intramuscular, and also subcutaneous injection). In addition to mastering proper injection technique, folks that inject intravenously routinely must additionally be sure to practice good vein care, and everyone that injects have to be conscious of the miscellaneous things they can do—like rotating injection sites—that will aid them protect against infection and also maintain great health.



It is extremely vital for civilization who inject routinely —particularly those who room physically dependent—to have the ability to prepare and safely inject medicine on their own. World may take benefit of you as soon as they know that you count on lock for gaining off. You worthy to have control over her body and also what you have to do for yourself! Learn how to safely and also properly inject yourself!


Learning exactly how to inject properly, choose mastering any other complicated activity, takes practice. After a while, you will certainly no doubt be able to hit veins you’ve never used before on the very first try, causing minimal trauma come the injection site and also leaving a small puncture wound that barely bleeds. Girlfriend will develop ‘a feel’ for where your veins are and also how you should position and also insert your needle in order to gain a great hit.

Perhaps the safest way to learn just how to inject is to have actually someone who knows what they’re doing teach you. An competent injector deserve to walk you through the process of injecting, or possibly even demonstrate it, and also prevent girlfriend from making any dangerous mistakes. If possible, discover someone that you to trust to mentor you with this process. And talk with other injectors around the assorted tips and wisdom about injecting they’ve choose up over the years.


Hopefully, there space things in this hand-operated that will certainly be new and helpful even to those of united state who have actually been injecting because that a lengthy time. However, reading about how come inject and also actually doing it are two different things. If you are new to injecting, we have the right to only fist you to read this manual thoroughly prior to you begin and to walk slow and also be aware of every little thing you’re doing. If the hazard of injecting drugs seems too dangerous after you’ve read this booklet, deciding not to administer drugs via injection is a harm reduction solution that us whole-heartedly support.



Intravenous injection (mainlining), or injecting a substance straight into the bloodstream through a vein, is among the fastest methods to provide a drug right into your system. The is also the riskiest method to usage in regards to overdose (as compared to sniffing, smoking, or dental administration) due to the fact that the entire dose start the body as whole and really quickly. Injecting intravenously usually provides the user a “rush” the many human being report to be very pleasurable, a sensation that does not happen with intramuscular or subcutaneous injection. While each injection technique carries its very own risks, mainlining is may be the riskiest because it create a straight opening in between the bloodstream and also the external world. Heroin, cocaine, and amphetamine space three drugs the are commonly administered intravenously.



People that inject drugs often have one or two favorite areas to inject—sites that feel the many comfortable, are basic to access, and where you nearly always obtain a clean struggle on your an initial try. If it might seem awkward in ~ first, that is crucial to learn how to inject in other areas that may not seem together comfortable or easily accessible on your first pair of tries. If you save injecting in your favorite point out over and over there is no letting the veins repair themselves castle will become leaky, making your shot less satisfying and also harder come hit; could become seriously infected; and will eventually collapse or scar therefore badly that they come to be altogether unusable and also interfere through circulation. So, that is an extremely important to rotate the website you use to inject. Try to usage a new site for each brand-new injection and go ago to web page you’ve already used just after they’ve had actually time come rest and repair themselves.


In addition to discovering to inject in brand-new places, that is likewise important come learn just how to inject with either hand so that if the veins top top one side of her body need a rest or space otherwise unusable, you able to inject right into the veins ~ above the other side of her body—even if you should use her non-dominant hand to execute it. The following time you’re in withdrawal and really require to get off but can’t uncover a vein in her usual spot, you’ll be thankful you taught yourself exactly how to inject into the various other arm!



Any time girlfriend inject intravenously, you threat pushing bacteria, fungi, and any other infection-causing microbes that space on your skin straight into her bloodstream. The is thus extremely important to thoroughly clean her injection website prior to getting off. Alcohol pads job-related well because that this purpose, yet be sure to wipe in just one direction and also not in a circular activity which will reason the dirt and germs to remain on her skin. Rubbing alcohol, hydrogen peroxide, or plain old soap and also water or any type of other type of clean agent or disinfectant likewise work fine. Be certain not come touch the injection site with your fingers after you’ve cleaned it. Frequently cleaning the skin prior to injection is among the most important things you have the right to do to alleviate your danger of endocarditis, blood poisoning, and comparable infections (discussed in chapter 3).



Use gravity to lug blood to the limb you’re walk to usage to inject before using your tourniquet (tie): waver or hang your arms, make a fist, etc. Tie your tourniquet in such a means that it have the right to be conveniently removed if necessary. Try to for sure ‘rolling’ veins favor those in her forearms before you inject into them. Finally, be sure not to leaving the tourniquet ~ above for as well long. If girlfriend feel her limb becoming numb or an alert it transforming blue, undo her tourniquet and don’t retie it until you’re ready to inject.



Insert the needle into your vein with the needle bevel (opening) encountering up, at a 15 come 35 degree angle, and constantly in the direction of the heart. The much more perpendicular the needle is to the injection site, the greater chance you have of sticking the needle v the vein rather of right into it. (See illustration on adhering to page.)




Once you think she in a vein, pull the plunger earlier to watch if blood comes right into the syringe. If so, and the blood is dark red and also slow moving, you understand that did you do it hit a vein. You can now untie your tourniquet and proceed to inject your drugs. If no blood or only a really tiny amount of blood comes right into the syringe as soon as you traction back, you’re not in a vein and also will need to untie your tourniquet, pull your needle out, and shot again. If you continue to inject there is no being effectively positioned in a vein, you will do it be putting your drugs into the tissue neighboring the vein, under the skin, or some other place. That will most likely be painful and also become swollen, and also the results of her drugs will come top top much more slowly. You additionally risk abscess formation and also other possible problems.

If yes sir too much blood in her shot come tell if you’re properly registering, break-up the shot right into two and dilute each fifty percent with water. If the plunger of her syringe is forced ago by the push of the blood and also it is glowing red, frothy, and also ‘gushing,’ friend may have hit one artery. Stay calm and also slowly attract the syringe out and elevate the limb. 

Some human being like come ‘boot’ your syringe after ~ they’ve injected their drugs—that is, pull back the plunger, attract blood into the syringe, and re-inject it. Some injectors favor to do this numerous times, ostensibly to rinse out any type of drug solution that continues to be in the syringe. Because of every the blood involved, you might want to stop from booting if you recognize you’re walk to it is in cleaning her needle and also syringe and enabling someone else to use it. Be certain to extensively flush your needle and syringe through water after ~ booting if you setup to re-use it at a later on time, so the blood doesn’t clog the needle.



After you’ve efficiently injected her drugs, very closely pull the needle out of the injection site at the same angle in ~ which the went in. (To minimize bruising, friend should have actually untied her tourniquet before you injected your shot.) apply pressure to the injection website to stop any bleeding. If you’re obtaining off in a public place, that is a good idea to have actually some tissue, gauze, or Band-Aids roughly so you don’t gain blood anywhere your clothes. Don’t use alcohol pads ~ above a new injection wound: alcohol will reason it come bleed more, not less.



Don’t use creams, salves or oils you use to treat her track point out or bruising until the injection wound has begun to nearby (a pair of hours after injecting) otherwise girlfriend might cause an infection. Act missed shots (those that finished up somewhere other than in your vein) automatically with a heat water soak or compress to minimize the likelihood that irritation and also abscess formation. Warmth will open up the capillaries and bring disease-fighting white blood cells to the affected area.



Cocaine has a numbing impact on the veins and also causes them come constrict (shrink), therefore if you’re shooting coke, you should be extra careful to it is registered properly and make certain you’re in a vein before you inject her drugs. Also, chances are that if you’re shoot coke, you’ll be injecting many times in a short period of time v perhaps just several minutes between each injection. This have the right to be traumatic top top the veins and the surrounding tissues, and an outcome in a the majority of bleeding.

Try to usage a sterile, sharp needle because that each injection;make sure you save your injection equipment separate indigenous anyone else’s you’re obtaining off with;and shot to provide the area a good rest for a couple of days.

You might experience part pain and also swelling after such extreme activity.



Because crack comes in a solid form (rock), the is vital to dissolve the first. The safest means to do this is v powdered citric or ascorbic acid–ask your local syring organization program or health and wellness food store where to discover it. Stop lemon juice or vinegar, together these deserve to lead to severe infections.

To dissolve crack: placed crack and also citric or ascorbic mountain (about a pinch to a slab) in the cooker; add plenty of water; mash and also mix well. Shot to just use as much acid together you need, because extra will dissolve your drugs, and also acid have the right to be an extremely hard on your veins.



Because rate is often cut with together dangerous chemicals, the is really important no to miss out on your shot. Skin-popping speed have the right to be very painful, may cause an abscess, and will take it a long time because that the human body to absorb. If you get the shakes ~ doing a few shots, it may be useful to have a friend inject girlfriend if you are not making use of alone. Because the top quality of speed varies therefore dramatically, a tester shot is a good idea.



for selecting Intravenous Injection Sites 

The complying with is a failure of possible intravenous injection sites, start with the safest options and relocating toward the the very least safe ones.

ARMS: Arms, an initial upper then lower, space the most safe sites for injecting. You have to be mindful to secure the ‘rolling’ veins in the forearms before you inject into them. Arms space also good if she concerned around hiding your injection or track marks (although wearing lengthy sleeves in the summer can be a drag!).

HANDS: Hands space somewhat much less safe 보다 arms since the veins are significantly smaller and more delicate and also therefore an ext likely to bruise or end up being damaged. Circulation is likewise slower in the hands, resulting in healing to take it longer. If you’re acquiring off in your hands, be sure to use the thinnest needle feasible (highest gauge) or, if you can find one, a butterfly needle. It is in vigilant around rotating the sites, and keep in mind that it is daunting to conceal injection marks and also bruises ~ above the hands.

LEGS: Circulation in the legs might be poor, particularly in people who don’t use theirs a lot. Veins in the legs are an ext likely than those in the arms to construct clots that have the right to obstruct circulation and eventually break off and also lodge in the lungs or heart. Also, damaging the valves in the foot veins is an ext serious 보다 damaging those in the arms because they pat a greater duty in acquiring blood ago to the heart.

FEET: similar to the hands, the veins in the feet are usually smaller than in various other parts the the body, and also close come nerves, cartilage, and also tendons which you want to prevent hitting once you inject. Due to the fact that they are farther from the heart 보다 the veins in the hands, arms, and legs, blood circulates much more slowly in the foot veins and they thus require more time for healing and also repair. In addition, foot sweat and dirty socks act to stop wounds indigenous healing and also increase the opportunity of infection from bacteria.

GROIN: The femoral vein in the groin area is a huge and fairly easy vein to access, yet its place near the femoral nerve and the femoral artery do it quite a risky place to inject. Among the three, the femoral vein is located closest come the groin, with the artery and then the nerve located as you move outward. If she going to inject right into the femoral vein, an initial locate her femoral artery— wherein you execute not desire to inject—by recognize the pulse. Then relocate a short distance towards the within of her leg to uncover the femoral vein. Since it lies fairly deep, friend will most likely not be able to see it however will have to inject into it without seeing whereby the vein is.

NECK : The jugular vein in the neck is the riskiest place to inject because it lies really close come the carotid artery, a significant blood vessel the brings blood directly to the brain. Accidentally hitting the carotid artery could be fatal, and damaging the jugular vein in any means can interfere v blood circulation to the brain.




(Numbered in bespeak of safety) 




Know where You’re Hitting


 MORE tips FOR picking AN appropriate INJECTION SITE 

Taking appropriate care of the veins in her arms and other safer locations will prevent you from having to shoot increase in an ext dangerous ones.You must avoid using veins that room tender, hardened, or inflamed until (and if) castle heal. Heat compresses and the usage of appropriate creams can help speed the heal process.The larger and more visible the vein, the easier and also safer it usually is to hit. Deep veins space harder to hit, and trying to accessibility them boosts your opportunity of hitting a nerve or artery in the process. Top top the other hand, it might be daunting to store a needle effectively positioned in a really shallow vein, leading to you to accidentally skin-pop your hit.Areas that room farthest indigenous the heart, favor the hands and also feet, cure the slowest and have the poorest circulation. Locations nearest to the love (like the groin and the neck) have actually veins the are situated near major arteries and nerves which, if by chance hit, can reason serious, life-threatening damage.Injecting near a bone increases the opportunities that swelling and also pain will certainly occur.



You always want come inject into a vein and also never into an artery. Veins room blood vessels that carry blood native the extremities of the body back to the heart and lungs where it becomes re-oxygenated. Veins have no pulse, and the blood they bring is a deep, dark red because it is low in oxygen. Arteries lug blood rich in oxygen native the lungs and also heart to every the other parts of the body. Arteries have a pulse, and also the blood in castle is shining red and also frothy. Arteries are situated deeper in the body 보다 veins and also so space not clearly shows as many of your veins are.


You’ll know you struggle an artery if: 

The plunger of your syringe is forced ago by the pressure of the blood.When friend register, the blood in your syringe is bright red and ‘gushing.’ Blood in veins is dark red, slow-moving, and also “lazy.”It hurts in different ways from your usual injections

You deserve to avoid hitting an artery by:

Never injecting wherein you feel a pulse.Injecting only right into surface veins and not trying to hit those that lie deeper.

What to perform if friend hit an artery: 

Untie her tourniquet and also pull her needle the end immediately.Raise the limb over your head to avoid the bleeding, if possible.Apply firm pressure to the wound because that at least 10 minutes.If bleeding continues, apply a bandage or cloth wrapped an extremely tightly roughly the wound and also seek clinical attention immediately. The ns of blood indigenous hitting an artery deserve to be life-threatening if it’s no stopped.


Veins vs. Nerves 

Unlike part veins, nerves room not visible from exterior the body, although friend will absolutely know if did you do it hit one while injecting because you’ll experience excessive pain and no blood will get in the syringe once you pull back to register. You might feel an electrical “burn” follow me your limb.

 Hitting a nerve have the right to be really dangerous and result in paralysis or the loss of a limb. That a great idea to know where your major nerves are so that you can avoid lock when gaining off.


Exercises for enhancing Vein Visibility

If you the strong type, engaging in the following tasks can aid make your veins much more visible from exterior the body.

Push-ups, pull-ups, and also other exercises the strengthen the armsWeight-lifting, an especially bicep exercisesSqueezing tennis ballsWrist curls


Some tips because that “Getting Veins Up” 

If she having difficulty locating a vein come inject into, you might want try one the the following:

Put a warm compress on her injection site for five or ten minute to aid bring a vein come the surface. Once you’re cold, it have the right to be very complicated to accessibility a vein. (If you’re gaining off in a bathroom or somewhere else where there’s no a lot of heat, nothing unroll your sleeve or uncover your injection website until you’re ready to inject.)Lower your arms below your heart or swing castle in a circle.Lightly slap the injection site.Wrap your limb in Saran Wrap because that a couple of minutes. This trap the heat and also causes veins to rise to the surface.Caffeine and also nicotine have the right to both constrict veins. Shot injecting prior to you’ve had actually your an initial cup that coffee and/or cigarette. If you have had actually a cup of coffee or a cigarette, wait around 30 minutes to shot injecting again.Remain calm. It have the right to be exceptionally frustrating to be can not to get a hit, specifically if you’re in withdrawal. Possibilities are obtaining upset will only boost your difficulty, so take a couple of deep breaths and start end again in a quieter state of mind.



Some drugs, consisting of injectable steroids and hormones, need to be injected into a muscle instead of a vein, but heroin and also other opiates can also be administered using this method. The physical and psychoactive impacts that result from an intramuscular injection the a medicine come ~ above much much more slowly than those of an intravenous injection (half an hour to forty-five minute versus practically immediately), return the overall, accumulation intensity the the effects and the experience space virtually identical. Also, the “rush” that is developed when drugs like heroin room administered intravenously is not knowledgeable by people who inject intramuscularly.

Most if not all of the epidemic control and other safety and security precautions intravenous medicine injectors need to follow also apply to people who inject medicine intramuscularly. Muscle-popping to produce much much less bleeding than intravenous injection, if any type of at all, but the danger of transmitting viruses and also other blood-borne bacteria as a result of needle-sharing is as major as that is through intravenous injection. In addition, muscle-poppers room at high danger for abscess formation, especially if what castle inject has any kind of particles in that whatsoever. When muscle-popping, the is extremely crucial to inject only a systems that is as particle-free as possible.

Many the the building materials that need intramuscular injection come pre-prepared in fluid form. To stop contaminating your entire supply (especially if you’re sharing it with someone else), be certain to use only a sterile needle and syringe when illustration the liquid up from the bottle in which it’s stored. Muscling rate or cocaine is very painful and also dangerous, and also is likely to reason an abscess.



The buttocks, thighs, and also upper arms are the three best sites, respectively, because that intramuscular injection. The best is in the deltoid, the muscle on your upper, external arm wherein your shoulder and also your eight meet. If injecting into the butt, mentally division each cheek into 4 equal sections and inject into the top right or optimal left external section of each cheek. You can likewise use the front surface of your thighs around six inches above your knee to about six inches listed below your hip, or the external surfaces that your top arms between your shoulder and also your elbow. Constantly be careful to avoid nerves, blood vessels, or bones, and also rotate injection web page to prevent bruising, abscess formation, and the like. The is not unusual for her muscle to it is in sore for a few days after an injection. 


Be certain to closely clean the injection site before injecting (see ‘Mainlining’ section above for an ext detail).



Try to relax the muscle prior to injection. This will result in a much less painful injection and may protect against the soreness you generally feel the complying with day or two. Once injecting into a muscle, insert the needle in one rapid stab straight right into the injection website at a 90° edge to the body. Almost the entire needle should enter the muscle. You certainly want to draw your plunger earlier slightly to make certain no blood comes into the syringe. If blood walk appear, did you do it hit a blood vessel and need to pull the end and shot again. Inject your substance slowly.



Pull her needle out in the exact same direction and also angle at which you inserted it. Because you injected into a muscle, there should be small if any bleeding. You might want to apply a Band-Aid in any kind of case to avoid infection. Massaging the area lightly for a few minutes will help the drug absorb and reduce the pain. 


Hormones room to be injected only right into the thigh or buttock muscle. When injecting, be cautious of nerves, veins, and also bones. The buttock is the most common place human being inject. You have the right to switch buttock cheeks to stop bruises and sores. After friend inject into these muscles, you could be sore because that a job or two.

Do no inject much more than the prescribed amount; it will not speed up your treatment process. Girlfriend can cause serious liver damage and increase the danger of blood clots. Blood coagulation can show up in the veins of the legs and also can take trip to the lungs; this is referred to as Pulmonary Embolism, which deserve to be fatal. Human being who exhilaration cigarettes and also inject hormone are an ext likely to build Pulmonary Embolism. (This ar taken native Positive wellness Project’s “Safety Guidelines because that Injecting Hormones.”)


 S K i N – ns O ns P ns N G ( S U B C U T A N E O U S ns N J E C T i O N ) 


Skin-popping is the injection the drugs in between the body’s skin and fat layers. Choose muscle-popping, the results of her drug will come top top much an ext slowly than if you will do injected it intravenously, and you will certainly not endure a “rush.”

Skin-poppers need to follow all of the infection control and other safety precautions the intravenous and intramuscular injectors must follow. Although prefer with muscle-popping, skin-popping results in small or no bleeding at the website of the injection, the risk for bacterial or viral epidemic is actual if injection devices is mutual or drugs are not prepared and also injected hygienically. Also, skin-poppers room at greatly increased danger for abscesses, specifically if injecting crushed pills or another solution with particles in it. When skin-popping, it is an essential to use just a systems that is together particle-free together possible.



The upper and also lower arms and legs are probably the best locations for skin-popping.



As always, completely clean the injection site with alcohol, soap and also water, or various other disinfectant before injection. 


Slide the needle under her skin at a shallow angle, 15° come 45° at the most. Inject no much more than 1⁄2 cc of liquid (half that the volume of a 1 cc syringe) to form a little bubble under the skin. If your hit is an ext than 1⁄2 cc, inject right into two or more sites. The bang from the solution you injected will gradually decrease as the fluid is absorbed into the body, and also should disappear fully within a couple of hours. Skin-popping can be uncomfortable, and also the bang you create may hurt a bit. If girlfriend skin pop where the skin is loose, pinch the skin between your thumb and also forefinger and put the needle into the skin you’ve pulled up.

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Pull your needle out in the same direction as it go in. There need to not be lot bleeding in ~ the injection site as soon as skin-popping, but you can want to use a Band-Aid to protect against infection.