One of the ways you can reduce the spread of Hep C and HIV is by taking care to inject safely. This means never reusing someone else’s needles or other drug-use equipment, including those for heroin, crack, steroids or hormones.
Reusing someone else’s equipment can mean different things—sharing, borrowing, lending, buying, selling, taking, passing on, and even using your sex partner’s equipment.
The harm reduction information that follows is offered as a public health service. Its purpose is not to encourage or condone the use or possession of illegal drugs. It is to help people make safer choices in their use of drugs that will reduce the spread of Hep C and HIV.
Location
Try to pick a place where it is safe to use your drugs. Ideally, somewhere inside that is well lit and has running water so you can wash your hands before and after you fix. You’ll need a work area to lay out your stuff while you fix your drugs. If you find yourself using in a place like a back alley, try to figure out if it’s possible to go somewhere safer and cleaner.
Wash up
Wherever or whatever you inject, cleanliness is your best bet for making sure you don’t get dirt or germs in your veins. Think about all the things you touch or use during a fix and then think about how to keep them clean: your equipment, your drug, your work surface, your hands and your veins. Make an imaginary bubble around all these things and let you and your drug in, but keep the germs out.
Wash your hands and the work surface with soap and water. Clean the skin around your vein 
where you’ll inject—use an alcohol swab or BZK wipe (alcohol-free antibacterial wipes) and wipe in one direction. Use as many swabs as necessary until they stay white after wiping. Anything on the skin will get pushed into the skin when the needle is inserted, including germs, bacteria and viruses.
Use brand new equipment every time and don’t let it get contaminated by touching dirty surfaces.
Injecting Equipment
In order to reduce the risk of transmitting or getting infected with Hep C or other diseases, it is important to inject safely. Needle exchange programs give out new, sterile, and free equipment for safer drug use. 
Find a program near you or you can also find most of these items at your local pharmacy.
Supplies given out by needle exchange programs to help reduce infections include:
- alcohol swabs
- cooker
- sterile water
- vitamin C powder
- filters
- tourniquet or tie (made of pliable, easy-to-tie-and-release material)
- sterile/unused syringes (one for each injection you’ll be doing, plus some extra for good measure)
For more information on these supplies, visit OHRDP's Product Information page.
Fixing your drug
Dissolving your drug before you inject it avoids getting tiny chunks or pieces into your body that could mess up your veins and lungs. Some drugs (like cocaine) dissolve really easily in water. Applying heat from a lighter or candle can help the drug dissolve, too. 
Other drugs (like brown heroin or crack) need an acidifier (like vitamin C powder) to help them dissolve. Vitamin C powder is safer than lemon juice or vinegar because these can damage your veins. If you need to use vitamin C, use just enough to dissolve the drug. 
If you’re injecting pills, they have to be crushed before injecting. The finer the powder, the easier it dissolves and the less chance you’ll have of injecting un-dissolved pieces. Some people buy a pill-crusher from the drugstore to help with this. If the pill has a coating on it, the coating has to come off first before crushing and injecting. Any bits left can clog up your syringe and get into your veins and cause damage. Try to use sterile water and a clean piece of paper to rub it off—using your spit or your fingernails puts germs on the pill that can get into your veins when you inject and this can cause infections or abscesses.
Cookers and Spoons
The most frequently shared piece of drug-use equipment is a cooker or spoon.
The concern here is that the spoon is an easy place for Hep C to be transmitted from one person to another. Cookers from the harm reduction kits are safer to use than household spoons because the needle exchange programs will give out enough sterile cookers that you can have your own and not need to share or use someone else’s.
Filters
Once the drug is dissolved in the cooker, a filter is needed when you draw the drug up into the needle. This will keep out some of the bits that didn’t dissolve and help protect you from chalk lung. Remember a used filter is impossible to clean and can easily have germs growing in it or Hep C from someone else who used it.
Vein care
Veins are an entry point for Hep C and other infections such as HIV and hepatitis B. Your veins can also collapse or get damaged if they are not properly taken care of. Decide which vein you want to use for your injection. 
The best sites are on the arm. Veins in the neck or groin are too close to arteries, so if you hit the artery you could lose a lot of blood. Keep changing the spot where you inject on your body (rotate your sites) to give your veins a chance to heal between injections. You can protect your veins from blowing (or bursting) by pushing the plunger slowly when you inject and keeping a bit of space (like six inches or so) between where you tie off and where you insert the needle.
To prevent abscesses, flagging is important so you don’t miss the vein when you inject. The needle is inserted into the vein at a shallow angle (about 35 degrees) with the bevel (opening at the end of the needle) facing up. As soon as the needle disappears into the skin, the person injecting pulls the plunger back until blood rushes into the syringe. This is called flagging and it means that the needle is in the vein. If you miss the vein and inject, there’s a chance you’ll get a skin infection (like an abscess). If you didn’t get the needle into a vein, slowly take it out and loosen the tourniquet. Calm yourself and try again.
Tidy up
All the equipment used in injection drug use has a chance of getting contaminated blood on it that can spread the Hep C virus. Once you are done and the needle is out, put pressure on the injection site to help stop the bleeding. Use a clean tissue to press on the site; don’t wipe with an alcohol swab because this will just make it bleed more—the more blood, the easier it is to get Hep C. Put all your used equipment in a sharps biohazard bin and clean up your work area. If you don’t have a bio-bin you can also dispose of these items in a hard plastic container like a detergent bottle or glass bottle with a lid before taking them back to the needle exchange program. This way, there is less chance of someone else using your stuff or used equipment ending up in public places, like parks or alleys.
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