4. Avoiding infection from bacteria
Bacteria are everywhere: in the air, on our skin and on surfaces. Many of them could live and breed inside us, but for the most part they don’t because our skin protects us and keeps them out. Injecting provides a direct route for bacteria to travel from the outside into the body.

It is important to reduce the number of bacteria that can get into your system. The fewer there are the greater the chance that your system will be to able fight them.

Sterile means 'no bacteria'. The only sterile (i.e. no bacteria at all) things in the injecting process are the needle and syringe before you take them out of the pack and, if you can get it, the sterile water in the ampoule before you open it.

Everything else may be contaminated by bacteria. There are bacteria in the air and on the:

• Skin
• Powder
• Spoon
• Cup
• Filter

and in the

• Water (unless you can get water amps from your needle and syringe program).

It makes sense to wash the injection site with soap and water before you start and after you’ve injected: this will reduce the number of bacteria on your skin.

If you use a swab just rub it gently over the site once or twice before you inject. Every time the needle goes through your skin it picks up bacteria. If you have difficulty finding veins and often can’t get a vein on the first attempt, it would be worth getting syringes with detachable needles so that you can change the needle between attempts to find a vein.

There isn’t much you can do about the bacteria (or chemicals) in illicit drugs: it is a risk of injecting things that aren’t manufactured in sterile conditions.

Non-sterile water contains bacteria. The boiling of the liquid in the spoon will not sterilize it.

All the water that you buy from shops labelled ‘distilled’ or ‘spring water’ or ‘pure water’ is not sterile - it will probably contain more bacteria than tap water.

The best water to inject with is a newly opened ampoule of sterile water for injection. All unused water from an ampoule should be thrown away because as soon as the lid is off, bacteria from the air can get in and start to multiply.

You can sterilize water by boiling it in a clean pan for 5 minutes, covering it and letting it cool before use.

Next best is water that has been recently boiled in a kettle - this will kill 99.9% of bacteria.

Keeping drug filters is asking for trouble: the amount of drug left in them is small but the number of bacteria that grow in them can be huge! They can also be a hepatitis and HIV risk too - especially if they've been kept warm and damp in a plastic bag.

Licking the needle during the process of injecting transfers millions of bugs onto the needle - which then get injected into you.

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