I looked elsewhere in the HR group but couldn't find anything like this: a repository of practical tips (beyond the basics of safe injecting) for keeping your shit alive and safe while using. As a long term IV user (8-10 years before I stopped) I've been very very lucky: I never once had to be hospitalized for an OD, never once had to be narcan'd, DID have multiple infections but didn't lose limbs or functionality (and only got really serious infections/scarring when I was shooting speedballs, not dope by itself). I shot up with tons of people and had at least 20 people go out in my house. No one ever died when I (or my partner) was in charge of things.
I am not by any means bragging. I only mention it to say this: it can be done, but there are a lot of things I learned along the way about safer using that made it possible. Some were common sense, some were taught to me, and some I learned by trial and error.
I thought it would be a good idea to post some of them, and ask other long time users to do the same, especially for all the n00bs out there.
So here we go:
1. Always have a bottle of narcan and a few clean syringes around. Tell everyone who you use with where they are.
2. Never use alone. Always have someone with you who a) knows how to use narcan b) knows protocol for calling 911 c) cares enough about your fucking life to do both, even if it means putting themselves at some risk.
3. If you MUST use alone, have a friend on the phone with you (speakerphone is fine) who knows your location. Keep them on the phone for the whole shooting up process, and at least 10-15 mins after your shot. Have an agreement with them that if at any time you are unresponsive, or you get disconnected, they are to hang up and call you right back (make sure your ringer is on). If you dont answer or call back within a short amount of time (say 1-2 mins) they will call 911 and give them your address. I did this many times when I was traveling in a new city, and away from my using partner; even if I was with other people (because I didn't know them that well and didn't trust them to help me if I went out).
4. Always have a surplus of clean needles around, more than you think you'll need. I kept at least 20-30 10 bags around at all times, and would exchange them when I got down to a few bags worth.
5. Know, or have posted somewhere, the hours and days of your local exchanges and user clinics. Also know the address and route to the closest 24/7 emergency room.
6. Whenever you miss or IM a shot, or if you have any pain upon injecting, hot soak that shit right away for 5 mins with a damp washcloth. This prevented many likely infections from developing.
7. Know the signs of common user ailments like cellulitis, abscesses, MRSA, endocarditis, cotton fever, etc. If you even think you have one of these, go to the clinic right away. Better safe than sorry.
8. Clean/Sterile IV technique always. Take the extra 1-2 mins to do it, without fail, even when you're sick.
9. Handwashing. Lots of it.
10. If at all possible keep a surplus of methadone, lope, pills, or some other preferably long acting opiate around for emergencies: whenever you are flush for cash, buy a little more. That way you wont be "forced" to make really bad decisions when you're sick, like buying from untrustworthy sources, using dirty rigs, etc.
11. Find a reliable phone connect, even if you just chip, and keep them. Find at least one backup too, and buy from them every once in awhile to keep them fresh. The higher up the chain, the better. This way you are less likely to get dope of widely varying quality, and/or dope that is full of flesh eating bacteria and other nasties, and/or mugged/shot/whatever copping from random people on the street.
12. Dont do stupid risky shit to prove your commitment to yourself while first kicking, like throwing your clean needles away, throwing your numbers away, etc. Maybe store that shit somewhere that takes awhile to get to, like a lockbox or a friend's house, but don't trash it entirely. If you are really ready to stop or take a break, you will regardless of how easy it is for you to cop and use: on the other hand if you're not, doing that stuff could put you in a predicament of having decided to use and not being able to do it safely. If you've been maybe a couple months without using, THEN you can think about throwing that shit out. Even so, its been 7 years and I still have a pack of cleans and a bottle of narcan in my house, just in case.
13. Always start with a small tester shot, especially when copping a new batch or from a new dealer, or starting a new run. If veins are very hard to come by you can cook up the size you think you'll want and just inject half, wait for it to hit you *and finish hitting you* (very imp: sometimes there can be a prolonged rush), and then slooooowly inject the rest, in increments. I would still err on the smaller side though when you're first starting out that batch/run.
13a. If you do a tester shot make sure to let it kick in all the way before you do the additonal shot(s). My using partner used to OD aaaallll the freaking time in the beginning because he would do a small shot, then forget he did that and do another one, and sometimes a third, all within a short period of time. The 2nd shot would hit him just as the 1st one was cresting, and out he'd go. I think he had a death wish honestly, because he was able to stop doing this once he because really aware of the pattern, but it took 5 full on ODs in one year for that to happen.
14. If you are a tar user and you inject, understand that you WILL lose your veins eventually. How long that takes depends on how your veins are to begin with, how well you take care of them and rotate them, and how often you inject. It took me a year of injecting (not every day) before I lost most of my easily accessible veins: the ones in the elbow crease, wrists, and tops of breasts. Another year or two and there went the ones in my hands, my forearms, my upper arms, and the rest of my chest. My leg veins were never any good either, so by the end of year 2 I was spending 45-90 mins hunting for each shot. Look into various methods of purifying and filtering tar posted elsewhere on the 'phile and think seriously about adding them to your repertoire.
That's all I can think of for now, please add your own and if I think of more I'll add them too.