Filters

[bogumil]

What kind of filters do your SWIYS use? I mean, not cig filters, but the 0.45 - 1mym ... Like, does anyone have a favourite brand, does SWIY use them at all?

[candy]

Hey there,
In the Q&A forum there are some great posts regarding SWIM's question. If SWIM were going to use a filter, a small tip of a cotton swab works great and is better than a cig filter or tampons.
SWIM would avoid cig filters due to harmful contents in them and tampons, even the smallest of pieces can lead to toxic shock syndrome.

[insaneike]

Yeah cotton swabs are what someone always uses.

later

[bogumil]

Ok, thanks. Here, I found another kind of filters, extra made for putting them on a syringe. They are 0.2 mym, and filter out even bacteria.

Those would be the best in my opinion, although I know of course, that most users dont have the time and money to use them.

http://www.wpiinc.com/WPI_Web/Glass-Holders/SYRINGE-FILTERS.jpg

http://www.morvay.ch/optifl1.jpg

The picute is big, sorry. Thats how they work.
Here some sellers. Some of them are sterile, some not, but all are more sterile than any other common filter used, I think.

European
http://www.sartorius.de/index.php/Spritzenvorsatzfilter/224/0/
http://www.fisher.at/newsletter/dezember/default.htm#fisherbrand
http://www.morvay.ch/optiflow.html
http://www.milian.com/catalog/chaps/18/0414-01.de.shtml

US
http://sterlitech.com/products/filterHolders/syringe/syringemain.htm
http://www.whatman.com/products/?pageID=7.26.10.40
http://www.sartorius.com/index.php?id=197
http://www.emsdiasum.com/microscopy/products/preparation/syringes.aspx?mm=8
http://www.wpiinc.com/WPI_Web/Glass-Holders/Syringe%20Filters.html

[steelheadwayne]

wow......cool filters. i must be in the dark ages man i have only ever used cig. filters.
.........PEACE.................Wayne.............. ....<{{{><...............

[steelheadwayne]

opps.....i mean i heard of them

[bogumil]

Sorry ... double post

[bogumil]

Check it out:

- cig.- and cotton filters remove between 79% and 90% of particulate matter. Syringe filters 95%.

- cig.-filters and cotton filters hold back 20% of the diamorphine! Syringe filters only 2.8%.

Wouldnt that compensate for the higher price?



http://www.brugerforeningen.dk/bfny.nsf/0/ce7bfd939210381fc125686600487122?OpenDocument&K=Science&S=UK&Click=


Jennifer Scott, BSc (Hon), MRPharmS, Research Pharmacist, Emily J Kennedy, BSc (Hon), MRPharmS , PhD, Boots Teacher Practitioner, Arthur J Winfield, BPharm, MRPharmS, PhD, Head of Pharmacy Practice. The Robert Gordon University, School of Pharmacy, Aberdeen and Christine Bond, BPharm, MRPharmS, MEd, PhD, Chief Administrative Pharmaceutical Officer, Grampian Health Board and Deputy Head of Department of General Practice and Primary Care, University of Aberdeen.

Abstract: People who inject street drugs can suffer health problems caused by insoluble particles which damage veins and internal organs. Drug users try to reduce the risks by using makeshift filters in an attempt to remove the particles. No previous study has investigated the effectiveness of different filters, so agencies who provide other injecting equipment cannot distribute them or advise on use on the basis of scientific evidence. This study investigated the effectiveness of filters using injections made with street heroin. Injections were analysed in the laboratory for particles (using the Coulter Multisizer) and concentration of drug (using Capillary Zone Electrophoresis). Filtered and unfiltered injections were compared. The conclusions presented will show the effectiveness of various filters used to prepare injections and discuss some of the potential implications for their distribution including user acceptability, cost and the reduction of drug related harm.

Introduction: There are several medical complications associated with injecting street drugs, some of which are attributed to the presence of insoluble particles in the injections. Examples include inflammation of the veins due to particle build up behind valves, sterile abscesses, blocked blood vessels (which can lead to thrombosis, ulcers and in extreme cases gangrene) and inflammation of the heart (endocarditis) caused by the build up of particles behind heart valves. (ANSWER, 1996; Posner and Guill, 1985; Haverkos and Lange, 1990; Scott and Bruce, 1997, Stein, 1990).
Injecting drug users (IDUs) are familiar with these risks and use makeshift filters to attempt to remove the particles prior to injection. Previous to this study, such filters had not been tested in the laboratory setting to investigate their effectiveness at removing particles. It is an important consideration when giving harm reduction advice to drug users, that the filter recommended must not only remove particles, but must also not hold back extensive amounts of the drug in solution otherwise the drug user will not want to use the filter. This study aimed to investigate three makeshift filters and one commercially available syringe filter for effectiveness at removing particles and effect on drug concentration.

Method: Permission was sought and granted from the Crown Office through the Procurator Fiscal for Grampian Region, to obtain street heroin for the purpose of this research project. Samples of street heroin from closed cases were supplied from Grampian Police after inspection of the premises and approval of the project by the Home Office. Semi structured interviews were carried out with 20 current or ex injecting drug users, to establish the methods they used to prepare their injections. Harm reduction leaflets were consulted to ensure that the preparation technique used followed the best practice advice given ( Exeter Drugs Project, 2nd Ed; HIT, 1995). From this, the laboratory method was established.

250mg of street heroin was weighed accurately. This quantity was chosen because most drug users reported injecting a 'quarter gram bag' or preparing a 'quarter gram hit' and sharing it with a partner. Citric acid was stated as the preferred additive and the quantity used described as a 'small pinch'. Ten 'small pinches' of citric acid were weighed and the average weight taken (14mg). Therefore 14mg of citric acid BP. was weighed accurately and added to the heroin. This was then transferred onto a clean metal tea spoon and 0.8ml water freshly boiled and cooled from the kettle was added. This quantity was used because 80 units (the measure on an insulin syringe equivalent to 0.8ml) was the quantity most commonly reported as used. This was then stirred with the sheathed end of an insulin syringe and heated over a flame. The point where the solid mass appeared to sink to the bottom of the spoon and the top liquid appeared clear and began to bubble was taken to be the end point of heating, as described during the interviews.

The three make shift filters were investigated: (1) A quarter of a cigarette filter, prepared by removing the outer paper, tearing in half then cutting in half again. This was stated to be the most popular filter used by those interviewed. (2) A hand rolling filter (Rizla 7mm acetate filter), no preparation necessary. This type of filter is distributed by some needle exchanges in the UK. (3) A tip from a cotton bud, removed by pulling gently with the fingers and rolling the end fibres into a thread (perceived to reduce fibre shedding). This was stated to be used by some of those interviewed, if no cigarette filter was available. The commercial syringe filter investigated was the 5 micron Acrodisk, made by Gelman Sciences. This filter is specifically designed for use by medical and scientific staff to remove particles from injections. The particles were detected using the Coulter MultisizerÒ. The size range of particles selected for analysis was between 2 to 60 microns, to ensure those of interest were detecteda. Controls were analysed using injections made with water only, both boiled and cooled from the kettle and water for injection. These were done to confirm that the heroin is the major source of particles and not the water and preparation procedure. Unfiltered and filtered injections were analysed. Each experiment was repeated three times and the average result taken. Change in concentration of diamorphine was measured using Capillary Zone Electrophoresis (Hewlett Packard), using a method developed for a separate research project (Mrs Ann Low, personal communication). The concentrations before and after filtration were compared. Each sample was assayed twice and the average result was taken. Street heroin is made up of many opiates, diamorphine usually being the principle one. Therefore it is important to note that further work is necessary to measure all opiates in the sample to gain a complete understanding of how the filtration process may affect the psychoactive effects of injections made from street heroin.

Results: Table 1 below shows the percentage of the total number of particles that were removed by the filtration process.

Table 1: percentage of the total number of particles that were removed by the filtration process. Percentage of particles removed by filtration

Cigarette filter ---79.4

Rizla filter ------- 90.4


Cotton Bud ------ 89.4

Syringe Filter ---- 95.1



Table 2 below shows the effect that the various filters had on the concentration of diamorphine detected in the injections. This is shown as the percentage reduction in concentration measured after filtration.


Table 2:Percentage reduction in diamorphine concentration caused by filtration

Cigarette filter ----- 19.7

Rizla filter ---------- 21.3


Cotton Bud ..------- 21.0


Syringe Filter .------ 2.8


Discussion: As expected the commercially produced syringe filter appears to be the most efficient at removing particles from the injections, showing an average reduction of 95.1%. The Rizla filter and cotton bud are similar in the amount of particles they remove, 90.4% and 89.4% respectively. However, the Rizla filter requires minimal handling compared to the cotton bud and is less fibrous, so less likely to shed fibres that could potentially get into injections and consequently veins.



This makes it more favourable than the cotton bud. The cigarette filter removes the least amount of particles, showing an average reduction of 79.4%. The contribution to particle count from sources other than the heroin (e.g preparation process and water) was not sound to be significant. All three of the makeshift filters had very similar effects on the reduction of the amount of diamorphine in the injections, causing an approximate reduction of 20%. The syringe filter caused a much smaller reduction of 2.8%. This considerably smaller effect of the syringe filter on the concentration of diamorphine in the injections means care would have to be exercised if drug users were changing from make shift filters to syringe filters to avoid overdose. Also, the syringe filter requires skill in use, to avoid losing any of the prepared injection. Users would need to be given clear instructions and possible demonstration on its use to avoid losing drug on first attempt, causing an unwillingness to continue use and damaging trust in the drugs worker. The syringe filter cannot be used with insulin syringes, as it has to be attached onto the end of the syringe barrel.
The bigger the barrel the easier it is to draw the liquid through. Detachable needles have to therefore be used or the filtered injection transferred into an insulin syringe. This obviously has implications for changing practice, and in so doing ensuring it is done safely to avoid reuse of equipment or sharing. There are therefore cost implications providing a syringe barrel and insulin syringe to make one hit. Also, compared to the makeshift filters, the syringe filter is relatively expensive.

From the makeshift filters, the Rizla filter appears to be the most effective overall. It removes approximately 90% of the particles in the injections, but is less fibrous and requires minimal handing before use, unlike the cotton bud filter, which has to be removed from the plastic shaft of the cotton bud and loose fibres rolled tightly at one end. All makeshift filters have a similar effect on concentration of the diamorphine. The cigarette filter was reported to be most popular amongst the IDUs interviewed for this study, possibly because they are readily available and their use has been learned from others, in concordance with other preparation techniques. Consideration has to be given to education methods chosen when trying to introduce new injection preparation techniques to the injecting drug using population. Also, in the UK many needle exchanges do not distribute filters to IDUs because this is forbidden under section 9A of the Misuse of Drugs Act (1971). Therefore, the drug users would have to be encouraged to buy the Rizla filters, rather than receive them with their sterile injecting equipment unless a change in the law occurs.

Further work has to be done to assess the syringe filters and Rizla filters for user acceptability. Also, the likelihood of reuse of such filters and implications of this have to be considered. A method has to be developed to look at the effects of filtration on the concentration of all opiates contained in injections made with street heroin to allow final conclusions to be drawn. Therefore, this work is ongoing and not complete.

References:




1. ANSWER (AIDS News Supplement to the Weekly Report) , Scottish Centre for Infection and Environmental Health, 1996, No. 3.
2. Exeter Drugs Project, ''What Works?', 2nd ed.
3. Haverkos H and Lange R. Serious Infections Other Than Immunodeficiency Virus Among Intravenous Drug Abusers. The Journal Of Infectious Diseases: 1990: 161: 894-902
4. HIT, 'A Safer Injecting Guide' Liverpool, 1995.
5. Posner D and Guill A. Cutaneous Foreign Body Granulomas Associated with Intravenous Drug Abuse. Journal of American Academy of Dermatology: 1985: 13: 869-72.
6. Scott J and Bruce L. Practical Advice on Medical Complications of Intravenous Drug Misuse. 1997. Pharmaceutical Journal In Press.
7. Stein M. Clinical Review: Medical Complications of Intravenous Drug Use. Journal of General Internal Medicine 1990:5 (3): 249-255.

http://www.drugtext.org/library/articles/scott01.htm : This is on injection of pills. I post only some parts.

...
Results

The total number of particles can be determined but is of little value because there will be a large variation in numbers depending on volume of water used to make injections, how finely the drug is crushed etc. Particle size analysis was performed on 0.5m1 sample from the injection. Changes in trends seen in particle size and number before and after filtration were looked for. Before filtration can take place, the drug has to be mixed with water on the spoon. Therefore the number of particles in the unfiltered sample prepared in this way was taken to be 100% and the effects of filtration shown as the percentage reduction in the total number of particles. This is shown in table 1 below. The Physeptone solutions were thick and did not pass through the filters quickly or easily. Several filters had to be used as they clogged and it took longer than was deemed acceptable to the IDU. Since this does not fit with the definition of an effective filter given earlier, it was decided not to continue with the Physeptone filtration investigations

http://www.drugtext.org/library/articles/scott01.jpg

...
Of the makeshift filters, the Rizla gives the best overall performance for both drugs. The cotton bud showed a good reduction in particle count with Temgesic injections, but was not as effective with Diconal. The cotton bud also has loose fibres which could enter the injections after filtering. Because the Multisizer sizes particles as spheres, a long thin fibre passing through the orifice may be counted as several smaller spheres.
Tables 2a, 2b and 2c show that all filters cause a shift in size range to the smaller end of the scale for the drugs tested. Again, the Acrodisk shows the greatest reduction in size range with the majority of particles in the filtered solution being smaller than the capillaries in the body. Of the makeshift filters, the reduction in size range appears to be greatest with the cotton bud filter. Splitting and shaking the tablets in the syringe also gives more particles in the smaller size ranges. Thus if no filter was used, this would be preferable to crushing the tablets to a fine powder first. ...

[poppy]

Oh my God, well that pretty much clears up any questions any of us had regarding filters..........Thanks

[Coddfish]

That's why I like this site. Good shit Bogumil. I wish I had seen this years ago. i will say that it used to be one of my little pleasures to 'rinse' my cottons into a nice healthy shot, so I think the % of diam. I lost was significantly less than 21%. Still, I doubt it was as low as 2.8! Steelhead....Don't use cig filters, brother. If you haven't gotten sick from them you will eventually, and it ain't fun. a few hours of hell when you are expecting to feel like Jesus.

[poppy]

Bogumil I've just re read my post and it sounds really abrupt and sarcastic,:o which I honestly didn't mean it to. Really! I was just amazed at the mass of information which you provided. I know the importance of providing information in terms of helping with harm reduction issues, also to some extent I take it for granted that here in the UK, we are currently provided with much more information regarding safer injecting methods. Sorry, I'll try and think before I post!! :o Laters Poppyx

PS, I am really glad I found this site where it is possible to 'talk' with likeminded people be they addicts like me who are still using and want to stop, addicts who are happy where they are at or 'weekend warriors' (quote Mokelly) an apt description of those with the strength to be part-timers!. I hope one day that will be me!!:)

[GMorris]

Wow, I didn't find it to be abrupt or sarcastic or condescending or anything like that. I mean, you DID say "Thanks" at the end. It really is a good post about filters, and taken from a good source at that. I hope it does help someone, even if they are a SWIM!

Although I could never be a "weekend warrior", I have respect for them as I do for ALL users of substances (at least those who can contain themselves and not put others in harm's way). Even so, I just don't see how anyone does it. If I'm gonna get drunk on the weekend, I'm most likely gonna do it all week; same with getting stoned on weed; same with getting high on the Opies. Seems like it's always been like that with me. Once I discover how good one buzz is, I'm a-chasin' it until....

[bogumil]

Bogumil I've just re read my post and it sounds really abrupt and sarcastic,:o which I honestly didn't mean it to. Really!Well, actually I didnt think it was sarcastic ... But now that you say it ... I'll remeber your name... Just kidding :D I really wasnt offended.

Did I say the filters are expensive?!

http://cgi.ebay.de/ws/eBayISAPI.dll?ViewItem&item=7577440563&rd=1&sspagename=STRK%3AMEWA%3AIT&rd=1

Tell your SWIYS. Question for a product creates offers! (Or something like this)
Still more expensive than cig.filters, but way cheaper than if one buys them at chem.- / medic-stores. The ones on the link are even the 0.2 ym, which filter out bacteria! The ones in the test had bigger pores. This ones should make a 100% clean shot and free of bacteria.