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Hierarchy of Water Sources for Injecting Drug Users

babylonboy

babylonboy

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Joined
Oct 30, 2012
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The water used to dissolve drugs for injection can be a source of blood borne virus transmission, and bacterial infections. The water risks poster is designed to inform drug users attending needle and syringe programmes about the relative risks of different sources of water, and to present them in a clear hierarchy of risk.



Below is a detailed description of why the sources of water are listed in the order that they are.

Unopened ampoule
The 'gold standard' for safety, an ampoule of water for injections means that the water used for dissolving the drugs isn't going to be the source of viral or bacterial infection.

Boiled water
Boiling water in a kettle will kill virtually all organisms, and using boiled water from a kettle is the advice to injectors who do not have an ampoule of water for injections.
Although it is true that to guarantee that even the most resistant pathogens are killed the water should be boiled for several minutes, in practice the additional benefits are few and advice to boil water in a pan is problematic because:


  • the water takes time to cool, and could become contaminated during cooling;


  • the pan or lid used to boil the water could be contaminated; and


  • the advice is unlikely to be followed, and there is a risk that injectors will take the view that if they can't follow the advice, then they might as well not bother doing anything because they are taking a risk anyway.


Kitchen tap - cold water
The reason the poster differentiates the kitchen tap from other taps in the house is that the kitchen tap is usually fed from the rising main which, in the UK, is usually virutually or completely free from bacteria.

Water from bathroom taps may have been stored in a cold water tank in the roof where it can become much more contaminated with bacteria: not a problem if you're drinking it, the acid of the stomach is able to kill low levels of bacteria without a problem, but not so good if the water is being injected.

Bottled water
The constant advertising and marketing of bottled water has created a strong perception in the public psyche of it as a pure, safe source of water that is better than tap water.

Certainly in the UK it is open to debate whether this is true in terms of drinking water – the UK has a very good safety record for our drinking water which is pure and free from contamination. But for use as a liquid for dissolving drugs for injection, there is no debate: tap water is almost always better than bottled water because the bacteria count will be lower. The bacteria count in bottled water is much higher than in tap water, and varies according to the temperature at which it is stored, and can be very high if someone has drunk the water from the bottle.

This is not to say that the bacteria in bottled water are harmful if drunk – the acid in your stomach is perfectly well able to kill bacteria at these levels, however when injected intravenously, they can cause infections.

Distilled water
Distilled water is boiled and then condensed to ensure it is free of all minerals, and people could be excused for thinking that it might be sterile. However, the end use of distilled water is in machinary and there is no requirement for the water to be clean in terms of bacteria count. Indeed the condensing plates and bottling plants are often low tech, and dirty.

Hot water from a tap
The water in a domestic hot water tank is not hot enough to kill all bacteria. If the tank has been warmed and cooled, the bacteria count can grow.

Toilet water
It could be argued that pointing out the dangers of drawing water out of a toilet is stating the obvious, but having it there – and not at the bottom of the list – makes the point that the other sources of water below it are really dangerous.

There was some debate in the drafting process about whether the harm reduction advice to take water from the cistern rather than the bowl, but we didn't for two reasons:

  • firstly, most public toilets have the cisterns secured and inaccesable; and


  • where people can access cisterns they can usually access a tap.


Puddle water
As with toilet water this is on the poster to highlight the serious nature of the risks associated with water that could be contaminated with blood.

The advice to catch rain water instead was suggested by homeless drug users, who described it as a harm reduction strategy they had developed.

Part-used ampoule
Many injecting drug users underestimate the risks of sharing the source of water that they use for preparing their drugs for injection.
Because ampoules of water for injections 'feel' medical, safe and sterile, injectors will sometimes choose to take water from a part used ampoule. Clearly this carries a very high risk, and this is highlighted by the position of the opened ampoule below water from toilets and puddles.

Shared cup
Too often when there is a group of injectors together in a room, the source of water used for preparing drugs for injection, is a single cup of water.

Sometimes this same cup is used to draw water to clean injecting equipment, and to repeatadly draw water to prepare drugs for injection.

This presents a significant risk of blood borne virus transmission, and one of the key functions of the poster is to highlight this risk and danger - which many injectors are not aware of, or underestimate.

There was some debate during the peer review process as to whether the ampoule was higher risk than the cup, but as the ampoule has a limited volume it is unlikely that it could have been contaminated by more than one person, whereas the cup could have been contaminated by many – hence it's position at the bottom of the table.
Click to expand...
Not my work, but seemed like someone did a good job here. Can't link to source, take no credit or responsibility, but there it is.
 
Interesting reading, thanks. If it was a quiz to put them in order of safety I wouldn't have put them that way, but the way it is explained makes sense.
 
I'm only an occasional IV user, and one who swore never to deviate from HR best practice, and yet I've already used sterile water from an amp, boiled water, bottled water and cold tap water. I wonder what a hardened addict may have used.

Interesting stuff.
 
I'll hold my hand up to having used toilet water. Oh yes I did. It was a very clean toilet and I took it from the cistern though. First thiing I thought of when this came up was me sat on a train station toilet floor feeling both grubby and desperate but also rather impressed with the cleaning staff at this particular station. Back when I was a more mobile, somewhat between homes, kinda Shambles with a monkey on his back and a train to catch. Needs must and all that.

Ramble aside, I've been tested for all the blood-borne stuffs at regular intervals since me teens and all clear. Very much luck rather than judgement, unfortunately. Never ceases to amaze me how very deeply dodgy yet dodged I've been. HR info wasn't always as easily accessible as it is in this whizzy interwebz age and lawdy have I dodged a few bullets :\
 
Injecting with puddle water. 8o Yeah i saw that on the documentary about the heroin users in Swansea. Fucks sake the things that stuff can make people do.

I would imagine blood contamination would be the least likely concern in puddle water, unless it happens to be in a spot IV users habitually use, far more likely to be contaminated with shit from pigeons, dogs, cats etc and absolutely teeming with bacteria. I wouldnt even drink puddle water if i was extremely thirsty let alone inject it. (Of course Bear Grylls has demonstrated techniques for making water sources purer and safer, but thats for drinking purposes, not for injecting directly into your veins)
 
MDB, I'm only a dabbler whe it comes to IV use.

What I can say without a doubt is that your standards plummet as soon as you start craving that feeling. You don't even notice it either.
 
Right what happened to the 63°C rule that Swarm applies when he's heating up roadkill (and which I'm now applying for my roadkill)? Water must be boiled for injection but roadkill just needs warmed up? Oh he's not injecting roadkill. Sorry, I'll shut up.

Is there bacteria in shit? Do I need to use boiled water for plugging? If not, why not? Do bacteria not cross the blood/ring barrier?
 
I think the point it's trying to make is just that Hep C & the like could easily infect every user who shares water. Try to get the cleanest water you can but - above all - don't be sharing the same water just in case. Keep your own works and water and every lil thing you need to get a dig for yourself is all. We all haz our individual lurgies of one kind or t'other - no need to mix em up.
 
^This is exactly right, it's trying to demonstrate exactly how important it is to avoid contamination with blood. You're better using water from the shitter or the dirty ground than risking using anything that anyone else's rig might have gone anywhere near. Anyway, it's not what I would have guessed, thought it was worth a share.
 
knock said:
Right what happened to the 63°C rule that Swarm applies when he's heating up roadkill (and which I'm now applying for my roadkill)? Water must be boiled for injection but roadkill just needs warmed up? Oh he's not injecting roadkill. Sorry, I'll shut up.

Is there bacteria in shit? Do I need to use boiled water for plugging? If not, why not? Do bacteria not cross the blood/ring barrier?
Click to expand...

you can safely give yourself an enema with blood soaked highly bacterially contaminated fluids if you wish. A family stranded on a life raft had to do this, the only fluids they had were rain water that collected on the floor of the raft but it was mixed in with the blood of dead turtles and stuff like that they had been eating to survive. The water was obviously not safe to drink, but a bit of tube up the garry glitter to rehydrate them was fine. Bet you'll never guess where i got this tale of survival from. :\:o
 
mydrugbuddy said:
you can safely give yourself an enema with blood soaked highly bacterially contaminated fluids if you wish. A family stranded on a life raft had to do this, the only fluids they had were rain water that collected on the floor of the raft but it was mixed in with the blood of dead turtles and stuff like that they had been eating to survive. The water was obviously not safe to drink, but a bit of tube up the garry glitter to rehydrate them was fine. Bet you'll never guess where i got this tale of survival from. :\:o
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Ray Mears?

No Bear Grylls?

http://www.youtube.com/watch?v=TtIG4TuVnvg

Plugging really is amazing!
 
The insides of my veins and muscles, they're nice and clean, don't want to be introducing any nasties to those. The inside of my rectum? What could I possibly be putting up there to make it dirtier?

Turtle-blood enema. Definitely the name of an indie band. You can also have yoghurt enemas. The man who invented cornflakes had a fetish for them. True story.
 
Drinking piss, plugging the blood of turtles. Must have been a rugby player.
 
knock said:
Yeah see my edit I posted a link!
Click to expand...

yeah that was the exact clip i was on about. I should have known it would be on youtube. Lie back AND THINK OF ENGLAND !!! lol

(warning, the clip may contain material that may be disturbing to some viewers. Who the fuck wrote that. You'd have to be disturbed in the first place to be disturbed by matters of fact and biology)

1,265,961 views

Jesus Christ. I didnt realise the clip was that famous or "big."
 
Last edited:
yawn. cup of tap water sat on top of a gas fire with flecks of ash, hairs and assorted other crap floating inside. used at least twice daily to inject, flushed the bloody pins back out - changed once a week when too much had evaporated and i risked hitting the pin on the bottom when drawing up. did this for years. if you use fresh bottled water each time - fair play, - but dont tell everyone its necessary. its not.



i do however, draw the line at puddle water. someone i know did that and contracted pneumonia
 
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