Harm reduction advice for people with infective endocarditis who inject drugs

This table lists some ways drugs can be used more safely to prevent infection. Some other things to make drug use safer are not using substances when alone and, if using opiates (eg heroin, morphine), always carrying naloxone.

Free confidential information, support and practical help is available 24 hours a day, 7 days a week anywhere in Australia.

For any drug concerns, call the national Alcohol and Drug Information Service on 1800 250 015 or go to https://www.counsellingonline.org.au.

To learn more about injecting drugs safely, go to the Touchbase website at touchbase.org.au/drugs/methods-of-use/.

• Find out about the nearest needle and syringe programs (go to https://aivl.org.au/nsp-directory/) and safe-injecting rooms.
• Do not share your injecting equipment with others.
• Always use a new sterile syringe and needle to draw up and inject the drugs. Use them once and dispose of them in a sharps container.
• Regularly clean your re-usable injecting equipment (such as spoons and tourniquets).
• Use a water filter to prevent damage to veins and vital organs.
• Wash your hands and the injection site with soap and water before getting the drug ready to inject. Clean the injection site with alcohol wipes before injection, if possible.
• Use sterile water from an ampoule of ‘water for injection’ that has not been opened or used before, available through needle and syringe programs. If sterile water is not available, then use (in order of preference):
  • cooled boiled water
  • clean flowing cold mains tap water (do not use tap water connected to a rainwater tank or dam because it is often more contaminated than domestic mains water).
• Infection and other complications are more likely if you use other sources of water, such as water from a hot tap or previously opened bottled water.
• Inject into a part of the body that is less likely to become infected. It is safest to inject into the hands or arms, and then feet or lower legs (in that order). Do not inject into the neck and groin area.
• Do not lick needles or injection sites.
• If using ‘brown’ heroin, do not use lemon juice to dissolve the drug because this can cause serious fungal bloodstream infections.
• If using ‘ice’ (crystal meth, metamfetamine, methamphetamine), inhale (smoke) or swallow it rather than injecting it.

• Wash your hands with soap and water before and after rolling or smoking a cigarette or joint.
• If using a smoking device with a water reservoir (eg a bong), change the water after each use so you don’t inhale dirty water, which can cause serious lung infections.
• Regularly clean bongs with warm soapy water and allow to air dry.
• Do not share cigarettes, joints, smoking devices or bongs.