If you shoot drugs — heroin, crack, crystal, cocaine, pills or steroids — you can take steps to stay healthy, even if you don’t want to or can’t quit. This is called harm reduction.

Every time you inject a hit, you make a direct, open path to your bloodstream. This makes it easy for you to get HIV and other viruses, such as hepatitis B and C, which are passed on through infected blood. All the drug equipment you use — needles, syringes, rigs, spoons, cookers, filters, water — can spread these viruses. Hep B and C can live outside of the body for a long time and can be spread through just a tiny drop of blood. Even if you already have HIV or hepatitis, try to avoid getting re-infected with a different form of the virus that could make you more sick and could be harder to treat. Try to shoot safe, every time. Protect yourself, your shooting partners and other people you care about.

The safest way to avoid getting or spreading HIV, hepatitis B and C, and other infections if you shoot up:

• Use a brand-new clean needle/syringe/rig every time you shoot.
• Try not to share needles, syringes or any other drug use equipment — filters, spoons, cookers, water, ties, pipes.
• When shooting with others, make sure you have your own needles, syringes and other equipment. Mark yours so you can tell them apart.
• Consider a drug substitution that doesn’t have to be injected (replacing your drug of choice with something less harmful, such as methadone instead of heroin).
• Before you shoot, wash your hands and injection site with soap and water. Use just water, alcohol pads or Sani-Wipes if that’s all you have. This will help keep germs on your skin from getting into your bloodstream.
• Use a different injection site (rotate) each time you shoot — it helps save veins. Go back to sites you’ve already used only after they’ve had time to heal. Try to avoid dangerous injection sites on your body: groin, thighs, breasts, wrists, neck.
• Inject your drugs in as clean a place as you can find. There are germs on everything the needlepoint touches, including fingers and clothes. The less it touches, the cleaner it is.
• After you shoot, recap the needle and put it in a sealed puncture-proof container like a pop bottle so nobody can use it again. Bring it to a needle exchange or give it to an outreach worker. If there is no needle exchange near you, put the needle in a sealed container and throw it in the garbage. Do not dump it where someone could find it and get hurt.
• Practice safer sex — use condoms and dams. HIV and hepatitis are also spread through sex.

How to clean your cooker:

Step 1: Rinse your cooker — spoon, bottle cap or whatever you use — by rubbing it under fresh cold water.
Step 2: Wash it with warm water and soap, or even better, soak it in a glass of bleach for 2 minutes. Then rinse it again with fresh cold water. If you don’t have soap or bleach, rinsing it with fresh cold water is better than nothing.

How to clean your own syringe if you can’t get a new one:
All 3 steps will take just 3 minutes

Step 1: Fill the syringe completely with fresh cold water (hot water will clog it). Shake or tap it for at least 30 seconds, making sure to get everything inside the syringe really wet and loosened up. Squirt out the water and discard it. Repeat this.

Step 2: Fill the syringe all the way up with full-strength bleach (some cheaper bleach is not full-strength, so check the label). Shake or tap it for at least 30 seconds. Squirt out the bleach and discard it. Repeat this, using new bleach.

Step 3: To rinse out the bleach, fill the syringe again with fresh cold water. Shake or tap it for at least 30 seconds. Squirt out the water and discard it. Repeat this. It’s very important that all the bleach is rinsed out before you use the syringe again.

Do not share needles, syringes or any other drug use equipment with anyone.
If you can’t use a new needle every time, make sure to re-use only your own. (The more you use the needle, the duller it becomes, and the more painful and damaging the injection is.)

If you plan on re-using your own syringe, rinse it with fresh cold water as soon as you can after shooting, to get all the blood out before it hardens inside.

If for some reason you absolutely must share, always clean the syringe with bleach and fresh cold water between each use. Your needle exchange may have bleach. Be aware that bleach may not kill hepatitis C. Cleaning and re-using a syringe is not nearly as safe as always using a new sterile syringe.

To find a needle exchange program (NEP) near you, where you can get new syringes and other drug use equipment for free, call your public health department or local AIDS agency. NEPs also offer information and support.