This page is ONLY for people who use needles to inject drugs. The information herein is graphic and not intended for those who are opposed to Harm Reduction measures.

Vein Care & Safe Injection Pages


Valves & Tourniquets

Veins- All the veins in your body have valves. You can find the valves by running your finger slowly along a vein. In the picture the valve is located where the blood stops. A valve allows blood to flow in one direction only. When shooting up, locate the valve and inject either above it or below it, never into it. Injecting into the valve can lead to permanent vein damage or collapse.
When you lift your finger, the valve will open and that's when you know you found a valve.
Here are four kind of tourniquets. Moving from left to right, you have the best to the worst represented. The rubber tourniquet on the left is best because it is soft wide and elastic. It is easily released prior to injection and will cause least vein damage. Basically you want the gentlest tourniquet available to avoid crushing your veins.

Injection Sites

Tie your tourniquet near the veins you will be injecting into. When using veins in your upper forearm tie off just above your elbow.

When shooting in veins lower down on your arm move the tourniquet below your elbow.
And even lower when shooting into veins just above your wrist.
When injecting into veins in your hand place the tourniquet just above your wrist. Wherever you tie off with a soft rubber tourniquet, DO NOT TIE A KNOT in the tourniquet, just tuck the rubber underneath itself in a comfortably snug position, so it can be easily released after the needle is in the vein but before you press the plunger down.

The veins in your hand are more fragile and smaller then the other veins in your arm. Try to use smaller gauge needle and inject much more slowly than you would in a a big honkin' arm vein. The reason for that is that you inject too fast, you put too much pressure on your delicate vein which can burst.

You always want to inject in the direction of your blood flow. Trying to inject against the flow will increase the chance of blowing out a valve, doing damage to your vein or wasting drugs.

Site Preparation

It is very important to clean your injection site as well as possible. Anti-bacterial soaps are really great and you can get them anywhere. It's good to wipe thoroughly with an alcohol pad BEFORE injecting, not after. This will help prevent track marks, infections or abscesses, because when you get rid of dirt and germs on your skin you don't jam them into your body.
Wash your hands if you can before touching your injection site, needle, cooker/spoon, cotton, and your drugs. Even though there may be unknown stuff in your drug, you still want to be as clean as possible and reduce any harm to yourself.
Wash your injection site thoroughly before you shoot.

Injection Preparation

All filters are not created equal. Dental cotton is the best because it is made of very long, flexible, clean fibers, that will not break off and get injected into your vein. It also has a little hole in the center that helps protect the point of the needle. Dental cottons are also best because they are already rolled into a ball and you don't have to handle them much, so there is less chance of breaking fibers or getting other stuff in your mix. Other filters, cotton balls, cigarette filters and Q-Tips may contain short, sharp, brittle fibers that can easily break off and be injected along with your drug which can cause all kinds of bad stuff, like infections, abscesses and clogged veins.

Syringe exchanges provide dental cotton in convenient little plastic bags, which makes them easy to carry and keeps them clean. This way you don't have to fool around with other types of filters. Some people say dental cotton is too small and put two or three of them together into the cooker. Although this is better than using other filters, just one works better then two or three, if you place the needle directly into the little hole in the cotton.

These are ampules of pharmaceutical drugs from England. In some European countries these drugs are regulated through various types of programs which provide safe, pure drugs for intravenous drug users.
Sterile water is perfect for dissolving your mix, because it doesn't have any junk in it to gunk up your veins or bacteria that can make you sick. If you're going to use tap water, its best to boil it first, to kill the bacteria. Then mix it up, draw it up into your syringe. Put the cap back on the syringe and wait for it to cool before shooting. Don't inject anything hot, you will cook your veins.
Cooking your mix does not sterilize anything, it just helps to dissolve the drug.
After your mix is ready draw it up into the syringe through the cotton filter, making sure the point of the syringe is well into the cotton. Drawing up slowly helps eliminate formation of air bubbles.
Hold your syringe point up and tap on it to make any bubbles rise to the top. Then depress the plunger just a little bit to push any bubbles out.
Let it cool, before you inject, by resting the syringe on something so that the needle is not touching anything else.
While your syringe is cooling, put your tourniquet in place near the vein you're going to use and wipe the area thoroughly with an alcohol pad.
Wiping after injecting will sting and make it hard for the wound to heal.


There are many kinds and sizes of syringe to choose from. The smaller the needle the better for maintaining healthy veins.
Shown here are two types of syringes.
Syringes were designed to be used once and thrown away. After just one use they are already dull enough that further use causes damage as it punctures the vein. Instead of making a sharp clean entry, the point may tear or rip the vein, which makes the wound harder to heal and more likely to be open to infection and scarring. Blood and other bits of things may remain in the syringe after use which can clog the needle, making it harder to depress the plunger and possibly forcing dangerous debris into your bloodstream.

Using a syringe once and only once is the best way to be safe if you are injecting drugs. When you don't share your works, you don't run the risk of either passing on or contracting any diseases.


Injection & Aftercare

Wrap the tourniquet around your arm and tuck it into itself. Make sure that it's not too tight or you may damage your vein. Insert the point of the needle at a 45 degree angle into the vein, remembering to inject with the flow of the blood. Injecting against the flow can cause turbulence which screws with the proper pressure that veins are made to take. Not only could this damage the vein but also possibly the valves.

When you think you've got the needle in the vein, test to see by pulling up on the plunger a little. If blood enters the barrel, you are ready to go. Before you press the plunger down, release the tourniquet.

It's important to release the tourniquet before injecting because otherwise you place way to much pressure on the vein, which is like a delicate hose. If you close off the hose and then increase the pressure by putting more liquid inside it, you can make it burst, which causes leakage, waste of drug, and bruising. If you let the tourniquet go first then you are working better with the way your body works naturally, and will cause less damage to yourself.
Here is a variety of things you could use to put pressure on your wound after you finish the injection and withdraw the syringe. The best thing to use is the cleanest thing so that you avoid getting dirt on it. Given a choice between a rag or towel that has been sitting around and a roll of toilet paper, the toilet paper is probably going to be cleaner.
Apply pressure to the site cleanly and steadily, if possible raising it above the level of your heart. The combination of the pressure and the elevation greatly reduces bruising and helps the bleeding to stop sooner.
After all this, you have a hole in your body, which like any wound, heals better if you care for it. There are some products which may help the healing process, like vitamin E oil and antibiotic creams. Others products, like aloe vera or skin creams, may help promote healthy skin in a more general way. If you apply skin creams to the area around an injection, either wait till the wound has closed or try and use products that are free of colors and fragrances that may sting.

Copyright 1998, Safe Work AIDS Project, Incorporated All Rights Reserved.
Photos by: Hillary Issacs
Permission for the reproduction of graphic images granted from the Safe Works AIDS Project, Inc.