Safer injecting for steroid users
Using steroids will always come with risk. If you're injecting steroids, these tips can help you reduce harm.
What are steroids?
Anabolic steroids are man-made versions of testosterone, the hormone that helps build muscle, bone strength, and body hair. They're sometimes called anabolic-androgenic steroids or "gear," "juice," or "roids."
Doctors sometimes prescribe steroids for medical reasons, such as hormone replacement or certain illnesses.
People also use steroids without a prescription to build muscle, improve performance in sports, recover from injury, or change how they look and feel. Some people use them for confidence or to deal with body image worries. But using steroids without a prescription or taking higher doses than prescribed can cause serious side effects.
How do steroids impact your body?
Using steroids can cause:
- Acne
- Liver damage
- Water retention
- Aggression
- Blood-borne viruses (if needles are shared or reused)
- Hair loss
Most steroids purchased illicitly are made in underground labs, which makes it difficult to know what you are taking.
Before you inject
If you're thinking about injecting steroids, take some time to learn about what you're using, the safest way to inject, and how to look after your body while doing it. Remember:
- The steroids you buy are often not what they say on the label. Always check the contents of the vial or amp before you draw up, and if it looks off (e.g. bits in the fluid and it's meant to be clear) do not use it.
- Steroids can vary in strength and purity. If you can, try to find out exactly what's in the vial or amp before injecting. Avoid mixing different types or brands.
- Never share needles, barrels, vials, or other injecting gear, even with friends or partners. Sharing puts you at risk of hepatitis B, hepatitis C, and HIV. We provide free, sterile injecting equipment and safe disposal boxes so you can inject as safely as possible.
- Wash your hands, clean the surface you're using, and make sure everything you need is ready before you start. Never reuse needles, barrels, or swabs.
- Rotate between sites and avoid muscles that feel sore, swollen, or bruised. Injecting in the same spot repeatedly can damage tissue and lead to infection or scarring.
You can always talk to us about it, too - we offer free, confidential advice and clean equipment, no judgement.
Using the right needle and barrel
Different steroids need different needle sizes depending on how thick the liquid is and where you're injecting.
Using the correct needle and barrel helps make injecting safer, cleaner, and less painful. It also reduces the risk of infection, swelling, or damage to your muscles and veins.
The barrel (or syringe) is the part that holds the liquid.
- Always use a new, sterile barrel for every injection
- Don't use barrels bigger than 2ml, as you may draw up too much liquid, which can cause problems like scarring and abscesses (a pus-filled lump under your skin)
Needles come in different lengths and widths (gauges). Using the right one for the injection site helps reduce pain and prevents injecting too shallow or too deep.
- Use a large, wider needle (like a green) for drawing up
- Switch to a fresh, smaller needle (like a blue) to inject
- Never re-use or share needles
Always put used needles and barrels straight into a sharps bin. Never throw them in public bins or household waste.
Injecting into the right place
The most common injection sites are:
- The outer top of the button - imagine that your buttock is divided into four, you need to inject into the upper, outer quarter.
- The outer side of the thigh - halfway between your knee and the top of your leg
- Shoulder - this carries more risk because the muscle is smaller. Make sure you inject into the outer part of the shoulder
These areas are used because they have thick muscle tissue and fewer major nerves or blood vessels, but you still need to be careful.
Never inject into:
- Veins or under the skin
- The chest, neck, or groin
- Muscles that feel hard, lumpy, swollen, or sore
Cleaning your injection site properly
Even small amounts of dirt or bacteria on your skin can cause infections, abscesses, or swelling when injected under the skin. Taking the time to clean your injection site helps protect your health and makes injecting less painful:
- Wash your hands with soap and warm water, and dry them on a clean towel or tissue. If you don't have soap and water, you can use new alcohol swabs or hand sanitiser gel.
- Make sure the area where you're preparing to inject is clean and dry. Avoid dirty surfaces or near sinks where bacteria can spread.
- Use a fresh alcohol swab to clean the skin where you'll inject. Wipe in one direction, not back and forth.
- Let the area dry completely and don't touch it again before injecting. If you do, clean it again with a new swab.
- If you're using a multi-dose vial, use a swab to wipe the top of the vial before you draw up.
- Use new equipment every time. Never reuse needles or barrels.
- After injecting, press gently on the site with a clean tissue or swab. Don't rub.
If you notice:
- redness, swelling, heat, pain, or a lump that doesn't go away
- A feeling like an electric shock when you inject, or any ongoing numbness or tingling
Get medical advice from your GP. These signs could indicate an infection, abscess, or nerve damage.
How to inject into a muscle
- Wash your hands with soap and water. Lay out a new, sterile kit on a clean, dry surface.
- Read the vial/amp label. Don't use anything that's cloudy (unless it's meant to be) or out of date.
- Draw up with a green needle, then switch to a fresh blue for injecting. Don't inject with a needle you used to draw up.
- Relax the muscle and position yourself
- Insert the needle at a 90 degree angle to your body. It needs to go in most of the way.
- Pull the plunger back slightly for 2-3 seconds. If blood enters the barrel, stop, remove the needle, and apply pressure with a clean tissue or cotton wool.
- Push the plunger gently - 10 seconds per 1ml is about right.
- Only inject up to 2ml of fluid into each site - more can raise your risk of infection
- Pull the needle straight out. Press lightly with a clean swab or tissue for a few seconds. Don't rub.
- Put the needle and barrel straight into a sharps bin. Never reuse or share.
After a cycle
Some people follow cycles - periods of using followed by time off. The idea is to reduce side effects, but every cycle still disrupts your natural hormones after a few weeks. Your body needs time to find balance again once you stop.
After a cycle, your body will gradually begin producing its own testosterone again. For most people, hormone levels recover naturally over several weeks or months, depending on how much and how long you've used.
Some people use medicines known as post-cycle therapy (PCT) to try and speed up hormone recovery. They can only be prescribed safely by a doctor, as they can have side effects and aren't always needed. Using them without medical advice carries its own risk. It's best to let your body recover naturally first.
If you notice lasting symptoms such as low mood, tiredness, loss of sex drive or difficulty getting an erection, it could mean your hormones haven't fully recovered. That's the time to seek medical advice.
Time off should equal time on
Avoid starting another cycle too soon. Resting for at least as long as your last cycle gives your body the best chance to heal.
Use this time to focus on nutrition, rest, and lighter training so your muscles and hormones can recover.
Getting support
We are here for anyone affected by drugs or alcohol in Stoke-on-Trent. We offer free injecting equipment, safe disposal bins, BBV testing, and advice on safer injecting.
You don't need an appointment, and you don't have to want to stop. Just reach out for a chat.
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