Boulder Care

Staying safer when you use drugs

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If you're still using, we want you to be as safe as possible while you do. This is sometimes called harm reduction, and it just means taking steps to lower your risk. Here's what helps most.

Key points

  1. Lower your risk of overdose. Use around other people and take turns. Stick to one drug at a time, and start with a small test dose. Keep Narcan (naloxone) nearby.
  2. Lower your risk of infection. Use your own clean needles, syringes, and supplies every single time. Throw them away in a safe container.
  3. Take care of your veins. Use a new needle each time, since used ones do more damage. Move to a different spot so old ones can heal. Skip your hands, feet, neck, and groin when you can. If a spot is red, warm, swollen, painful, lumpy, or draining pus, get medical care right away.

Protecting yourself from overdose

Try not to use alone

If you're with people you trust, they can help if you overdose. If you do use substances alone, tell someone nearby first and leave your door unlocked.

Keep Narcan (naloxone) close

Narcan is a medicine that can reverse an opioid overdose if someone gives it fast enough. Make sure you and the people you use substances with have it and know how to use it. Boulder can prescribe Narcan for you, and there may also be free Narcan in your community. This video shows how to use it.

A few things worth knowing:

  • Narcan can wear off before opioids do, so overdose symptoms can come back. If you use Narcan on someone, call for help. Medical care after an overdose matters.
  • Narcan only works on opioids. If it doesn't seem to be working, other substances may be involved. Call 911 and give rescue breaths if it's safe to do so.

Take turns

If you're using with someone, use at different times. That way if one of you overdoses, the other can give Narcan and call for help.

Start with a test dose

Every batch is different. It can be stronger than the last one, or have other things in it like fentanyl. Even your usual amount can cause an overdose. And if it's been a while since you used, your tolerance is lower than it was. If you're injecting or snorting, try a small amount first and see how your body reacts.

Test for fentanyl when you can

Fentanyl shows up in everything, including methamphetamine, cocaine, and pills. Test strips let you check what you're actually taking. A local syringe exchange or harm reduction group may have them for free, and you can also order strips online.

Mixing is risky

Most overdoses happen when opioids get mixed with something else, like alcohol, benzos, meth, or cocaine.

Safer injection

Don't share or reuse supplies

Use a new syringe, rinse water, cooker, cotton, and tie every time. Some people call these rigs or works. Boulder can help you find places nearby that have new supplies.

If you have to reuse, use bleach

Soak the syringe and needle in bleach for at least 2 minutes. That gives you the best chance of killing HIV (human immunodeficiency virus) and hepatitis viruses.

Throw used syringes away safely

A thick plastic container works well, like an empty laundry detergent bottle. Write "Hazardous" or "Used syringes" on it, and close the lid tight before you throw it out.

Taking care of your veins

Before you inject

Wash your hands with soap and water, or use hand sanitizer. Clean the injection site with soap and water or an alcohol swab.

Use clean water. If the only water around is a toilet, take the lid off the tank and use the water in there, not the water in the bowl.

If you need to break your drug down to inject it, ascorbic acid (vitamin C) is the safest choice. It hurts less and is gentler than lemon juice or vinegar. Use as little as you can, since it can still irritate your veins.

Picking a vein

Arms are safest, then legs. Try to avoid hands and feet. The groin and neck can lead to serious infections, bleeding, and nerve damage.

Move around

Inject at least an inch away from your last spot so the old one can heal.

Watch for infection

You can read more in preventing and treating infections.

An infected spot can look red, swollen, and hot, and it may hurt or drain fluid (here's a photo of what that looks like). You might see or feel a hard bump. Don't try to squeeze the fluid out, since that can make it worse. Infections are serious and can reach your heart.

If you think you have a skin infection, or you feel very sick and feverish, call your primary care provider right away. If it's after hours or you don't have one, go to an urgent care, walk-in clinic, or emergency department.

The main takeaways

Safer injection practices give you real control over your health. Using your own syringe and materials protects you and the people around you from infections. Having Narcan close by, and making sure the people you use with know how to use it, can save a life. If there are harm reduction resources in your area, your care team can help you find them.

What you can do:

  1. If you have signs of a skin infection or you feel feverish, get medical care right away at a primary care office, urgent care, or emergency department.
  2. If you've shared needles or other materials and you're worried about hepatitis C or HIV, talk to your clinician about options for getting tested. No judgment, just a test to have more information.
  3. If you want to talk through anything here, bring it up with your care team. You can also check out the resources below.

Additional resources