The best way to avoid contracting hepatitis C and other blood borne viruses such as HIV and hepatitis B is not to inject.

Injecting is the single greatest risk factor for contracting hepatitis C. You cannot entirely eliminate the risk of hepatitis C transmission from used syringes. In addition to the risk of contracting hepatitis C, hepatitis B and HIV by injecting with used syringes, there is an increased risk of having a dirty hit, getting an abscess and inflicting more damage on your veins. Even if you have hepatitis C, you can contract another strain of the virus, which adds to the stress on your liver.

If you choose to inject, below is a guide of options, from best to worst:

1. Use sterile injecting equipment every time you inject, including:
• sterile syringes
• sterile water
• new swabs
• clean spoons
• clean tourniquets
• clean filters
• and clean your injecting space and wash your hands.

If you can’t get a sterile syringe you could:

2. choose to wait until you can get a new syringe,
3. try using your drug another way e.g. smoking, snorting, swallowing, or shafting (up your bum),
4. clean a syringe that only you have used before,

or, as a very last resort,

5. clean a syringe that someone else has used.

A guide to cleaning used syringes, including your own

Equipment

Start with a clean safe space and an area with a safe place to dispose of the used fluids such as a sink, drain or toilet.

You will need three separate containers:

1. One container filled with clean cold tap water. If available add a little detergent as this helps loosen the blood particles so they are easier to rinse away. Use water from the cold tap. If the water is too hot or too cold it can cause any blood in the syringe to congeal and stick inside the syringe where it can shed microscopic particles / virus into your mix.
2. One container filled with full strength bleach (at least 5.25% sodium hypochlorite and check the use by date) for soaking / bleaching your syringe.
3. One container filled with clean, cold tap water for rinsing the bleach from your syringe.

Wash your hands in warm soapy water before you start.

Cleaning Process

Remember there are three separate steps to this process: rinsing, bleaching and flushing. They all have to be done for the right amount of time in the right order.

A. Rinsing

• Draw up detergent water or plain water from the first container (A) to fill up the syringe.
• Squirt the water into your sink.
• Repeat at least 5 times.
• Empty the container of used water down your sink.

B. Bleaching

• Take the syringe apart and put it in the second container (B). Make sure it is completely covered by bleach (don’t forget the cap). You may have to put something on top to hold it under the bleach.
• Soak for at least two minutes.
• If you can’t soak it, draw the bleach up into the syringe and shake it for at least 30 seconds. Put the cap on first to prevent bleach getting on clothes or in eyes.
• Count slowly to make sure the bleach has enough contact time with any virus present. Counting “one thousand, two thousand” up to “thirty thousand” is a good way to measure. Try not to rush.
• Squirt this bleach into sink.
• Repeat at least once, and
• Discard used bleach from container down the sink.

C. Flushing

• Draw up fresh water from the third container (C). This should be the only filled container left.
• Squirt the water out into the sink.
• Give the syringe a shake while flushing,
• Repeat this process at least six times.
• Don’t forget to rinse the cap.

Why use detergent in the rinsing process?

Detergent helps clean any residual blood or mix out of the syringe more effectively than just water alone; it helps bind the blood together with the detergent particles and becomes easier to wash out.

Why Bleach?

Other methods of trying to clean used syringes have been researched, e.g. boiling, microwaving, and rinsing with alcohol swabs. None of these has been shown to be useful. Boiling destroys your syringe – it melts. You can’t microwave metal and the process is not effective anyway. Bleach is the best and only real option we have at present.

This article is based on the Guide to Cleaning Used Syringes pamphlet produced by The Australian Injecting and Illicit Drug Users Leage (AIVL) in 2009.

Illustrations by Elisabeth Bischofer

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