This is Part One in a series of "Sticky" threads called "Safer Injecting". These threads are designed to promote harm reduction and the use of safe injection techniques in the hopes of keeping Opiophiles safe by providing them with information that is easily accessible to them at all times.
The information in this thread is about Filters. It will cover everything about Filters that you ever needed or wanted to know.
Let's start with the basics, what filtering does to protect you from serious medical problems. Filtering helps to remove most of the insoluble particles that can cause damage if injected. Some materials and techniques used for filtering drugs can greatly reduce the chance of bacterial and fungal infections. Remember that no filter can remove a virus. The only way to reduce the chance of introducing a virus into your body is to understand blood-borne pathogen prevention and to use that knowledge.
So why filter your shots? Illicit, injectable drugs are not produced, stored or consumed in sterile or clinical environments. They can be full of germs and insoluble particles. This is especially true for users that inject prescription pills such as opiate/opioid painkillers, benzodiazepines, amphetamines and stimulants. These drugs are dispensed in the form of tablets and capsules that are made for oral consumption. They contain ingredients, also called binders, that do not break down in water and may cause serious damage if injected. Drugs made for oral use contain insoluble particles can block small blood vessels, cutting off the oxygen supply to tissues in the body. Cells deprived of proper blood flow will die from lack of oxygen. The insoluble particles in drugs for oral use can also result in harmful deposits in the larger blood vessels, eyes, lungs and other organs.
When preparing these drugs for injection, bacteria and viruses from the surface of the tablets and/or capsules, from the air, or from the hands or other surfaces can get into the solution and then are introduced into the bloodstream via injection. Of course bacteria and viruses are too small to be seen with the naked eye, but they are present and their numbers can reach into the millions. They can cause very serious infections when injected via a contaminated drug solutions.
Filtering helps to remove most of the insoluble particles that can cause damage if injected. Some materials and techniques used for filtering drugs can greatly reduce the chance of bacterial and fungal infections. Remember that no filter can remove viruses. The only way to reduce the chance of introducing a virus into your body is to understand blood-borne pathogen prevention and to use these strategies when preparing drugs for injection.
There are many different types of filters, from the basic homemade filters made from common household items up to sterile medical grade micron filters and everything in between. Homemade filters are the most often used because they are made from common items that are easily obtained, inexpensive, and easy to use. The most common items used for filtering are Cotton, Q-tips, tampons, cigarette filters and alcohol swabs. These types of materials provide a basic level of filtering. They will remove many of the larger insoluble particles but nothing more. They are also useful in drawing up solutions from spoons and are helpful in preserving a sharp needle point. Homemade filters made from the materials and items above have their limitations. Below is a list of the problems with filters made from these products.
- Because these types of filters are manipulated by a user's hand, it is possible that traces of blood from the fingers are transferred to the filter; increasing the chance of bacterial contamination and the transmission of viruses.
- Cotton filters are often kept and re-used because they hold residual quantities of drugs after first use. There is a higher potential for transmission of blood-borne viruses if used filters are passed from one person to another for re-use.
- Filters that are kept for re-use can contain dangerous amounts of bacteria and fungi that can grow on them during storage.
- Filters made from these materials are not efficient in removing large amounts of insoluble material, as with crushed tablets.
Swabs (Alcohol swabs, wipes)
When used correctly, Isopropyl Alcohol Swabs are very useful in cleaning your fingers and injecting sites, the alcohol in these swabs will not sterilize or clean injectable solutions. These swabs are not a very effective material to use as a filter, the Isopropyl Alcohol contained in these swabs is not suitable for internal use and serious health risks are associated with the injection of this product over time. The swabs are also very thin and do not protect needle tips very effectively; blunted needles cause serious vein damage.
Cigarette filters contain harmful chemicals and small fibers that can break off and be injected into the body along with the drug.
Cotton and Cotton Swabs (Q-tips)
Cotton has been associated with "cotton fever", a bacterial infection. Most Cotton and Cotton Swabs (Q-tips) are not produced, treated or packaged for clinical use, they are not sterile and may contain bacteria even when they are not re-used. Some Cotton is sterile in the package (Tampons, certain Cotton Balls), but only until it is opened; once opened they are just as likely to become contaminated as other non-sterile cotton.
Wheel Filters and Single Use Sterile Micron Filters
Filters that come in individual, sterile packages are the safest and most effective type of filters that can be used. These filters are made so the user doesn't have to use the hands or fingers to manipulate them, eliminating the need to touch the filter membrane reduces the risk of contamination that can cause infections. These types of filters are also much more effective in filtering out the smaller particles that homemade filters miss. These filters come in a range of different sizes.
Different size filters will filter drugs to different degrees. The smaller the filter pores, the greater the filtration. Filter pores are measured in microns (Āµ) (one thousandth of a millimeter). Remember, no filter can remove a virus. The only filters able to remove all bacteria are 0.22 micron and smaller. Almost all common bacteria are larger than 0.22 micron, so to filter bacteria effectively be sure to use this size filter or smaller. Filters larger than 0.22 micron are used to remove particles like dirt, dust, and binders from oral pharmaceuticals. Needle exchange programs often stock several different size filters, the largest filter usually stocked is 5 micron and the smallest is often 0.22 micron. Please check with your local exchange to see what is stocked.
Sometimes pre-filtering with a larger-sized filter maybe necessary, especially when the solution being filtered contains oral pharmaceuticals. Large quantities of talc, starch, or chalk from crushed tablets or capsules will block a 0.22 micron bacteria filter, in this case you will want to pre-filter with a 5 micron Wheel filter or SterifiltĀ® (this is a brand of micron filter) filter to remove the larger particles before using the smaller filter to remove bacteria.
Filters should never be re-used. Any filter (especially wheel filters, where the filter membrane is enclosed in a plastic casing) can grow bacteria, mold, and fungi after being used. Cotton, cigarette filters, tampons, Q-tips, and alcohol swabs will be damp after use, making the perfect place for bacteria, mold, and fungi to grow. Re-using these filters increases the chances of getting infections.
A guide to filter types will be posted in this thread also. It will contain filter types and sizes along with the information on what filters to use with certain drugs.