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You’ve only got one set of veins. If you take care of them, they’ll last longer!

Always:

• always wash your hands and injection site before and after every injection;
   
• always clean your mixing equipment;
   
• always use a new sterile needle and syringe every time;
   
• always rotate your sites;
   
• always remove all rings and tight bracelets before injecting (in case your arm swells); and
   
• always consider smoking, snorting, swallowing or shafting when you need to rest your veins.

Never:

• never re-use injecting equipment;
   
• never go back and inject where there is redness, pain, swelling or infection;
   
• never jack back blood and ‘flush’ the syringe after your shot - this doesn’t get more drugs
  into your system, but it does cause vein damage;
   
• never use a tourniquet unless you have to (and if you do, release it before injecting); and
   
• never inject highly irritant substances like pills (especially benzos!).

Collapsed veins never recover. Go slow. Be gentle.

In Queensland, for further information on vein care and injecting contact the Alcohol and Drug Information Service on (07) 3236 2414 or regional freecall on 1800 177 833.

Below is the information the briefing paper gives to pharmacists to support the text on the calendar card.
It will hopefully be of interest both to professionals and injecting drug users.

The aim of the vein care information is to prolong the life of injection sites in the arm as this will hopefully prevent, or at least delay, the progression to more dangerous injecting sites (such as hands, legs, feet, armpit, breast, neck, etc.), or delay many serious health consequences of injecting in these sites.

Many injectors experience injection site problems such as abscesses phlebitis and sores and most do not seek appropriate treatment for them unless they become serious.

This results in greater levels of permanent damage, and more intensive and expensive treatment.

Key intervention points
Asking injectors about the state of their injecting sites is a good way of building rapport and reinforcing the idea that you are a source of health advice in the mind of the injector.

When injectors show you injecting sites that look swollen, infected or sore they need to be advised to ‘rest’ that site and not inject near it until the problem has healed.

Bearing in mind that injectors will often choose not to see a doctor, the level of insistence that you attach to advice to seek medical help should be in proportion with the severity of the problem.

It may also be helpful to give advice on the symptoms of worsening infection (and urgent need to seek medical help) including:

• spreading of a previously localised infection; and
   
• running a temperature, sweating and feeling cold.

In terms of injury prevention, the main messages to stress the importance of are:

• hand washing, and keeping injecting sites clean;
   
• not re-using needles (explain that they are only designed for sub-cutaneous injection and quickly barb); and
   
• never go back and inject where there is redness, pain, swelling or infection.

Further reading
Australian IV League. (2000). Safer Injecting. Woden, ACT: AIVL.

Australian IV League. (2000). When there’s no other way... Cleaning Fits. Woden, ACT: AIVL.

Australian IV League. (2001). Handy Hints. Woden, ACT: AIVL.

Derricott, J., Preston, A. & Hunt, N. (1999). The Safer Injecting Briefing: An easy to use comprehensive reference guide to promoting safer injecting. Liverpool: HIT.

Hardacre, P., Preston, A. & Derricott, J. (2003). Vein Care: Maintain Your Veins. London: Exchange Campaigns.

Preston, A., Byrne, J. & Derricott, J. (2000). The Safer Injecting Handbook. Melbourne: Australian Drug Foundation.

Vlahov, D., Sullivan, M., Astemborski, J., et al. (1992). Bacterial infections and skin cleaning prior to injection among intravenous drug users. Public Health Reports, 107(5): 595-7.

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