Safer Injection Practices for HCV Patients Who Inject Drugs
Hepatitis C has emerged as the most serious problem in Australia
for people who inject drugs. The majority of people who have
injected drugs have hepatitis C. This means that people who inject
drugs who do not yet have hepatitis C are at great risk of
An estimated 65 to 90% of people who have shared equipment to
inject drugs have the virus. Even those people who have shared
injecting equipment once or twice have possibly caught hepatitis C.
It doesn't matter what is injected - heroin, methadone, pills,
speed or steroids. It is how the drugs are injected that is a
potential risk for transmitting infection .
Like anyone with hepatitis C, if you inject drugs you need
adequate medical follow-up after a hepatitis C diagnosis is made.
Awareness of infection is important, as is knowledge of safe
injecting practices and recommended lifestyle changes.
If you inject, you should consider three health risk factors.
Firstly, there is the unknown strength of street drugs and that
people have different drug tolerances.
Secondly, street drugs may contain dangerous impurities.
Finally, if you already have hepatitis C, there is the possibility
of reinfection with another strain of hepatitis C or other viral
infections like HIV or hepatitis B.
Some drugs, due to their specific effects, impair health and
increase susceptibility to illness. If you inject, you may be
advised to consider the possible health complications involved.
You can reduce risks by:
- Swallowing, snorting or smoking drugs (don't share 'straws' if
- Washing your hands before and after shooting up
- Wipe down all surfaces where you'll be preparing your hit
- Avoid all contact with anyone else's blood, including traces
you might not be able to see
- Use a new fit for every hit - as a last resort, use fits
cleaned as described below
- Don't share any equipment when preparing and injecting your
drugs - use all your own gear
- Don't use hits prepared by someone else at some other time
- Immediately after each use, flush your fit with clean cold
water even if you don't think you'll use it again. This helps
remove blood and infection particles from the fit and has the added
advantage of removing all traces of whatever drug you're shooting
- Dispose of your fits safely - eg. put them in sharps bins, back
in your fit pack or into empty plastic resealable drink
- Avoiding binge drug use
- Avoiding drinking alcohol heavily when using.
We don't know that disinfection or cleaning really works so be safe
and use all new equipment every time you hit up. Reusing fits
should be a last option only. If you're cleaning fits, remember the
Immediately after use, rinse fit in cold water until signs of
blood are gone. Squirt water down sink or into an old drink bottle.
Do this as soon as you've used the fit since dried or clotted blood
is hard to wash out and can block the fit. Always use cold water as
hot water will clot blood in the fit and block it.
Fill the fit with fresh high-strength bleach. Use the strongest
bleach available (which is usually the most expensive). With the
fit full of bleach, replace the cap over the needle and shake it
for 30 seconds or more. Time this on a watch or count it out
slowly. Then squirt the bleach out into the sink or an old drink
bottle. Now repeat the bleach process, again shaking for thirty
With another container of fresh clean water rinse the fit out at
least two times. Again, squirt the water down the sink or into an
old drink bottle, not into your containers of bleach or clean
water. Empty all your containers down the sink when you are
Remember that this way of cleaning fits can't be guaranteed to
kill the hepatitis C virus. Taking time with the above steps
improves your chances of avoiding transmission of hepatitis C, but
ideally, use new clean equipment for every hit. Look for your
nearest needle and syringe exchange service.
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