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Safer injecting and safer smoking tips

Using safer injecting and smoking practices is important to minimize harm, such as vein damage and infections like hepatitis B, hepatitis C and HIV. Here are some practical tips for safer use. Talk to a harm reduction worker for more information and education.

Safer injecting practices

Preventing hepatitis B, hepatitis C and HIV:

  • Use new supplies every time: Always use a new needle and syringe, cooker, filter, sterile water and alcohol swab with each injection.
  • Never share injection supplies: Sharing equipment can pass infections through small amounts of blood.
  • Access new supplies: Contact a harm reduction worker to get new supplies.

Tips for safer use:

  • Clean your environment: Wash your hands and prep surfaces with soap and water or an alcohol swab. Clean the injection site with an alcohol swab before injecting to prevent infections.
  • Inject into a vein: Avoid injecting into arteries or surrounding tissue to prevent serious health issues, such as abscesses, scarring and infections. 
  • Choose the safest vein and rotate sites: The veins in your arms are the safest places to inject. Avoid using veins in your neck, face, wrist, groin or genitals. Rotate injection sites to help prevent vein damage and infections.
  • Inject toward the heart: Insert the needle in the direction of the blood flowing back toward the heart, at a shallow angle and with the needle hole (bevel) facing up. This will prevent complications, like vein damage. 

Safer smoking practices

Preventing hepatitis B and hepatitis C

  • Access new supplies: Get safer smoking supplies, including straight stems or bowl pipes, mouthpieces, brass screens, wooden push sticks and alcohol swabs, from a harm reduction worker.
  • Never share smoking supplies: Sharing equipment can pass infections through small amounts of blood. 
  • Take care of your mouth: Use pipes and mouthpieces from a harm reduction service to prevent burns, sores and cuts.

Tips for safer use

  • Clean your environment: Wash your hands and prep surfaces with soap and water or an alcohol swab before smoking.
  • Use proper equipment: Avoid makeshift pipes, which can release harmful fumes or cause injuries. Avoid steel wool (Brillo), which can lead to inhalation of small hot fragments and burn the mouth and throat.
  • Exhale immediately: Holding in the vapour can burn your lungs. 
  • Replace damaged supplies: A scratched, chipped, cracked or burnt pipe may lead to burns, blisters and cuts, increasing the chance of infections. 

General safer use practices

  • Keep naloxone with you: Know how to use naloxone, call 911 and give breaths — it can save a life.
  • Avoid using alone. 
  • Be aware of unknown ingredients: Drugs may contain unexpected substances. If possible, get drugs checked and stay informed about the local drug supply. 
  • Start low, go slow: Always begin with a small amount to see how strong the drug is.
  • Dispose of supplies safely: Place used injecting or smoking supplies in a sharps container or hard plastic bottle and drop it off at a harm reduction service. 
  • Practise safer sex: Use condoms and lube to reduce your chance of getting HIV and other sexually transmitted or blood-borne infections (STBBIs). 
  • Know your status: The only way to know if you have a STBBI is to get tested. 
  • Wound care: Tell a trusted healthcare provider or harm reduction worker about any wound you may have, no matter how small. 
  • Seek support: If you're looking to reduce or stop your substance use, reach out to a harm reduction worker or a healthcare provider for help.

Acknowledgements

CATIE thanks all the community and medical reviewers who contributed their expertise to this resource.

Production of this publication has been made possible through a financial contribution from the Ontario Ministry of Health, the Public Health Agency of Canada and Health Canada’s Substance Use and Addictions Program. The views expressed herein do not necessarily represent the views of our funders.