A Video Tribute to the Man I Love

I can only pray that since we're capable of feeling love this strong on this terrestrial planet, that Celestial love must be unfathomably more beautiful. I pray that the souls who fought against evil during the first great battle and won the right to our bodies will know a new kind of love to which there is no comparison and no end and that I may feel that love, both for and from, you - Greg.

RIP, My Love, My Life. I wish I was with you.

So as many of you have gathered, I've suffered a great loss recently. My boyfriend of three years was killed in a car crash last Tuesday morning. He was the sole fatality in a single car accident, where speeding was likely the cause. Unfortunately, I watched the video, and there is almost no question he died instantly, which should give me some little relief. I wanted to clear up any misinformation for anyone who suspected overdose. This is without a doubt the most heart-wrenching, indescribably painful, life crushing tragedy I have ever experienced. It's taken me this long to even turn on my computer. Obviously, daily haiku's are put on hold for a while. This Labor Day weekend during the three night Phish run at Dick's Sporting Goods in Commerce, CO would have been our three year anniversary. I still plan on attending, despite how painful it may be. We met on PhantasyTour.com when I sold him a TAB ticket for 4 hits of acid. I was with someone at the time, but little did I know I had found my soul-mate and after about 4 months of friendship and Phish tour, we finally made it official at Dick's 2011. We had three wonderful, loving, kinky, laughter filled, years. We both struggled massively with severe addictions to both heroin and meth, but we had come a long way and he had recently graduated from rehab. NO matter how carefully I tried to compose them, I have no words to describe what a devastating experience this has been and how how utterly and completely destroyed I feel. It's not that I don't want to live life, I would just rather be with him where ever he is. At this point my world is so dark, I seem to have forgotten what light is like and have little faith that I'll experience it again. Although time has shown me that eventually life keeps going after these kinds of tragedies, although I don't know how. I sincerely wish I was in the car with him, or even instead of him. Greg, I cannot express how deeply I loved you. I would give anything in this universe to have you back by my side to share every detail of life with. I'm so unbearably sorry for anything I've ever said or done that would make you doubt that. I would trade my entire life for just one more day with you. Just one more chance to tell you how much I love, to kiss you, to hold you, to just be in your presence. You were there for me when times were darkest and helped me see that light was possible. And now it's all gone again and I have no idea how I'm going to make it through without you. Please be there for me when it's my turn to pass to the other side. Neither of us were perfect. But you were perfect for me. Please forgive me for all my wrongs and remember my love for you. I wish everyone had the chance to know the wonderful, caring, loyal, sweet-hearted, brilliant, creative and truly unique person that you were. You're passion for life was contagious and you brought out the best of me every single day of our lives together. You helped to form a large part of me, a good part that wants to take control of her own life. There will not be a moment of any day that I will not think of you and long for you. I never believed in soul mates, but you are my soul mate. There's nothing more to say. I don't know when the next time I'll have the strength to blog again, but I'm trying to pull my life together. I just don't know how long it will take me. Here's the story if anyone cares to read it. Just a short blurb that ended my entire life. http://www.latimes.com/local/lanow/la-me-ln-crash-fire-110-freeway-downtown-20140729-story.html

Ask a Junky: So Your Friends a Junky

The first post for Ask a Junky is in response to a non-user who asked how she could help her heroin-using friend. This is probably a question everyone who's ever loved a heroin user has asked. I thought it was an important one and deserved to be addressed first :)

So you've found out your friend uses heroin. Maybe in the spirit of friendship they disclosed this information to you. Maybe you found out through a friend of a friend. Maybe they got into some trouble with the law and their secret was exposed. Maybe their drug use got the better of them and it became apparent. No matter how you found out, this new piece of information has you concerned. This is a typical response. Whether you have personal experience with drugs like heroin or have never even been exposed to hard drug use, it’s natural to be worried and want to help, especially when the media irresponsibly bombards us with sensationalized stories “exposing” the horrors of heroin addiction and the deadly consequences of its use. The last thing you want is for your loved one to wind up living on the streets, a shell of a person, stealing to support their habit and risking overdose each new day. If you care at all about your friend, you’ll want to do anything you can to prevent them from destroying their lives and replacing the person you love with a new, junky criminal version who cares about nothing but the poppy. Your first instinct might be to put heavy pressure on your friend to stop, appealing to their good sense. You may have even considered staging an intervention - for their own good. But let’s stop for a moment, take a deep breath, exhale, and take a step back. If you seriously want to help your friend, for their own good, not as an activist for the anti-drug crusade, there are a few things you need to know about heroin, its users and your friend. Without a complete understanding of the situation, any help you proffer will be met with resistance and will most likely backfire.

Stigma not only hurts, it kills. Stop the hate.

First, what is your intention? Do you truly want to help your friend have the best life? Or are your instincts a reaction to your political beliefs? If you approach your friend with forceful talk about rehab and NA, spouting media propaganda and textbook anti-drug rhetoric, their defenses will go on red-alert. You will now be considered “one of them”. And you’ll most likely lose their friendship forever. If the bulk of your heroin knowledge comes from news stories or D.A.R.E. presentations, I would suggest performing a complete system re-boot on your brain. In order to look at the big picture subjectively, let’s wipe the slate clean and start from scratch. Pretend you know absolutely nothing about heroin and drop all preconceive notions. Addiction comes with its own stigma. But let’s try to wipe that slate clean as well. Just for this exercise, let’s remove the substance or behavior of choice out of the equation, in this case – heroin. If your friend was addicted to coffee, would you try to send him to rehab? Would you stage an intervention for your girlfriend with too many shoes? I know what you’re thinking, “No, of course not. But a shoe or coffee addiction isn’t damaging to anybody.” You’re right. But at this point, we don’t know what your friends drug use looks like. We don’t know if it’s damaging to them or not. Until we get some more facts, we are in no position to make any assumptions. There are two main questions you need to ask before trying to help.

1. What type of heroin user is my friend? (There are three types, which I will clarify in a moment.)
2. What are my ultimate intentions for my friend?

I’ll address these questions in order The first thing you need to understand, and this may seem basic, but it’s crucial, is that not all heroin users are created equal. The way I see it, there are three types of heroin users.

Type 1: Use heroin sparingly, saving it for weekends and special occasions. They do not use enough to develop a physical addiction and use it solely for recreational purposes.

Type 2: Use heroin daily and are physically addicted. However, they are functional users. They use within their means, are successful in their careers, do not let it interfere with their families or personal life, avoid trouble with the law. In short, they do not allow it to complete control life, despite the fact that they are addicted.

Type 3: Also use heroin daily and are physically dependent. But they are unable to control their use and subsequently use beyond their means, exposing themselves to unnecessary risk and allowing it to control every aspect of their existence. This type of user has potentially been in and out of addiction treatment, been in trouble with the law and often turns to crime as a means to support their habit. Heroin related health problems like AIDS and Hepatitis C are most common for this type, although not exclusive. The worst cases may find themselves living on the streets.

One’s preferred route of administration does not necessarily reflect the category they fall into. If you’re on the west coast, 98% of heroin users inject, simply because black tar is extremely wasteful any other way, unless you've really master Chasing the Dragon. On the east coast many Type 3 addicts choice never to inject. (Route of Administration is another topic I will cover in Ask a Junky shortly.)

It might seem logical to base the severity of your friend’s problem on the quantity of heroin they use. But this alone is not is not enough information. One person could be using 3 grams of heroin a day, but has a successful career, the means to support his habit, maintains his health and keep social engagements. While his neighbor who use three grams of heroin a day had to mortgage his house, lost his family and got fired from his job. They are both chemically addicted to the drug. They will both go through equally painful withdraws. But one is able to function within the normal parameters of society, while the other has sacrificed his life and relationships for the drug.

You may be able to deduce the seriousness of your friend’s problem simply by observing their life. Are they employed? Do they follow through with their social commitments? Have they been trying to borrow money? Have they been arrested? Supposing you are still on good terms and haven’t tried to shove them into a rehab yet, other questions you can learn by asking. Are they physically addicted? How often do they use? Do they have any diseases? How do they support their habit? When digging for information, it’s important to never come off as being pushy, judgmental, pitying or parental. Unless you demonstrate otherwise, all user assume non-users know absolutely nothing about heroin. They assume you've been brainwashed along with the rest of country. Approaching the subject with open-minded curiosity can go a long way towards showing you haven’t bought into the media hype and are willing to get it straight from the source. If you can do this, most users will be happy to talk with you about their habit.  Once you get answers for most of these questions, you’ll have a good idea of what type of user they are.

Once you've determined what type of heroin user your friend is, you need to ask yourself what your intentions are. If complete and total abstinence from heroin is the only acceptable outcome for you, despite what category your friend falls into or what his goals are for himself, then the only advice I can offer is, be prepared to end the friendship. It doesn't matter what type of user he is or how good your intentions are, no user wants to be scolded, threatened, bullied or forced into anything they don’t want to do, especially from someone who has no real understanding of heroin or addiction. Down the line, they may choose for themselves to quit, but if you try to push the issue before they’re ready, you will most likely lose them.

It could be that you’d rather lose a friend than be friends with a junky. You have you that right, the same way your friend has the right to use heroin. If this is the case, my advice is to say your piece and end it cleanly. I've had friends who have said it to my face and friends who simply refused to return my phone calls. I respect the ones who had the guts to try one more time to get me to quit and tell me to my face why they could no longer be friends with me.

If you don’t want to lose your friendship, then this is most important advice I can give. There is nothing that your heroin user friend will appreciate more than being treated the same as always. I don’t mean ignore the fact that they now use and once didn't. If you want to talk about it, talk about it. The same as you would any other issue you've dealt with. But realize that you are dealing with the same person. Most of the time, when people find out that someone uses heroin, the whole dynamic of the relationship changes. Most interaction are laced with pity, disgust or any number of other undesirable reactions. I can count on less than 5 fingers the number of friends I have who have been able to look past the fact that I’m a user. They don’t avoid the topic, sometimes it comes up frequently, sometimes rarely. They realize that it’s part of my life, but it doesn't define who I am. And if the time comes when your friend wants to quit and get help, you will be the one they will turn to as a trusted friend. If your dynamic changes, you will eventually lose them. We pick up on these things and don’t want to be around people who can’t see past our use. So whether you want it or not, that friendship is eventually doomed.

The next thing I would suggest, no matter what type of user they are, is to have a conversation and get to know the reasons why they use and how their use affects their life. Every drug user uses drugs for a reason. It could be as simple as “It makes me feel good”, or a heavy as “I’m trying to forget an abusive past.” The user is getting some benefit from heroin. Once you know what the benefit is, you can suggest healthier, more productive ways to achieve the same thing. My psychologist does this with me all the time and it’s wonderful because it demonstrates that heroin is not the Alpha and the Omega. Be clear that you’re not trying to take heroin away, just supplementing it with healthier activities. It helps train the brain to not be so dependent.

In addition to finding out why your friend uses, it’s important to find out what their goals are. Do they want to quit somewhere down the line? Are they ready for rehab now, but don’t know where to start? Do they ever want to give up heroin? This is where approaching the conversation with an open-mind and without judgment really becomes critical. Heroin users know that 99% of non-users and even many users believe that ultimately, to achieve long term happiness, they will have to give up heroin at some point. It may be all fun and games right now, but eventually, it’s going to have to come to an end. Whether the user believes it themselves or not, most of the time when talking to someone who does believe it, they will blow smoke up your ass and tell you want you want to hear just to placate you and avoid being judged as the ultimate failure. Hear them out. Make it clear you want their honest answer. Don’t try to add your two cents. Don’t try to poke holes in their junky logic. Don’t try to gently steer their thought process towards more rational thinking. At this point in time, you are building your foundation as someone who can be trusted. There will be plenty of time to speak your mind down the road. You might be pleasantly surprised by what you hear or your might be heartbroken. But at least you’ll know their true intentions as of that moment (chances are they are going to change their mind at some point in time, so don’t think that whatever they tell you is set in stone.) But for now at least, you’ll know what you’re dealing with and two of you will be on the same page.

If your ultimate goal is to make sure your friend is using as safe as possible and limiting risk, try to get a couple more details, like how they buys heroin and how they administer it. That will tell you how much risk they are exposed to. Do they buy from a dealer or on the street? Do they inject? If so, do they share needles? How do they support their habit? Do they have a good doctor they can talk to about heroin related health concerns? If you see that they are exposing themselves to unnecessary risk in any of these areas, work with your friend and try to come up with ways to limit or eliminate these risks. Encourage them, or even help them, find a good doctor who is sympathetic to drug users.

Openly talking with your friend on a regular basis about harm reduction is always a good idea. If they assure you they diligently practice harm reduction 100% of the time, they will have no problem with you checking in every once to confirm they’re still being diligent. They’ll probably be happy that you care so much to talk about it, rather than avoiding the issue as though it didn't exist. If they try to blow you off or give you the run around and act like harm reductions is not that big a deal, that’s a problem. Harm reduction is a huge deal and it needs to be taken seriously. It doesn't matter if they use six times a year or six times a day. If they use with other people, some are probably much heavier users. It’s never okay to share needles, even with long term friends. You just never know.

My advice to anyone who suspects their friend or loved one is not practicing harm reduction religiously is to do the research for him. Find out the location of the closest needle exchange. If there isn't one close by, find out how and where he can procure clean needles. Most harm reduction centers offer free Narcan, the overdose prevention drug. Narcan should be in the most of every heroin user, especially Type 1 users who haven’t built up a tolerance. Sit him down and have a harm reduction intervention. This is the only time I advocate forceful intervention with a heroin user. It won’t work if you are trying to get someone to quit who isn't ready. But harm reduction should be taken seriously by every drug users who values life. If you really want what is best for your friend and aren't simply trying to control his life, then knowing that he’s virtually eliminated all risk of disease and drug-related health problems should make you extremely happy.

 

Part of harm reduction is drug education. Make sure your friend is not mixing alcohol and heroin or benzos and heroin and knows the risks associated with these deadly combinations. Almost every single overdose is due to either benzos or alcohol, mixed with heroin. If you refrain from spouting nonsense about how heroin kills everyone eventually, and addressing legitimate concerns like dangerous drug combinations, you can prove to your friend that you are putting his safety above all else. You aren't acting as a soldier for the anti-drug crusade, you just want to make sure he is being a safe and responsible user. It will also help give you peace of mind.

If your friend is a Type 1 user, the only other thing I would suggest is to monitor his use. I don’t mean grill him every time you talk about how much heroin he did on the weekend and constantly try to keep him in check. But keep your eyes open for warning signs of a developing problem. If the answers to any of your preliminary questions change, it could mean that his use is escalating and he’s changing categories.

If your friend is a Type 2 user, keep them in check. If you see that heroin is beginning to interfere in a certain area of their life, let them know. If you see they are in denial anywhere, point it out. Don’t be aggressive or condescending, they’re still heroin addicts. But call them out on their bullshit. Make sure that if they are slipping into a Type 3 user, they do it with their eyes open. Not so that you can say “I told you so” but so they have the option to take control and turn things around before it’s too late.

If your friend is a Type 3 user, you will need to look out for yourself as well. These are the stories you hear about on the news, the broken families and shattered lives. It may seem the person you were friends with is gone, but that same person is still there. Heroin has a way of making you believe it’s the only source of true happiness and anyone who isn’t actively shoving it up your arm is out to take happiness away from you. This is where rock bottom happens. I've been there, and it’s not a fun place. It may seem that forced rehab is the only way to save a Type 3, but I would still council against it. A heroin user has to be ready to quit for any long term success. But many Type 3’s do wind up in jail or get fed up with their lives and decide to make a change themselves. You don’t have to be a part of their daily life. But let them know you’ll always be there when they want help. It may seem hard, but try to remember they are the same person they were and always will be and try to treat them that way. They deal with the worst kind of discrimination from every corner of society. You could be the only person who treats them like a human being and they will love you for it.

No matter what type of user your friend is, there is going to be little you can do to stop them from using if they aren't ready to quit. Reducing their exposure to law enforcement, ensuring they practice diligent harm reduction, making sure they have access to proper medical care and, most importantly, extending your unconditional friendship are the best things you can do. But I do have some good news for those who want complete and total abstinence. Most heroin users do decide to quit at some point. Unfortunately, many have to hit rock bottom before that happens, but everybody’s rock bottom is different. With your support, it might not be that bad.

The last thing I have to say is, many addicts who decided to clean up opt for a maintenance program. It may seem to some that they are just replacing one drug with another. While technically that might be true, the mindset is completely different. It takes just as much guts and willpower and determination and courage to be on a maintenance program as it does to quit outright. Different things work for different people. Trying to encourage early termination of a maintenance program could have catastrophic results. Let them take the time to recover anyway they choice. I can promise you, whether on Suboxone or Methadone, they aren't getting high. It takes long time to reprogram the brain and body to not crave heroin. They’ll probably want to wean themselves off the maintenance program eventually. But in the meantime, realize that this isn't a recreational substitute, they don’t expose themselves to legal or heath risk and they are being extremely courageous taking this step.

I know it’s not easy to love a junky. Some have it harder than others, but no one has it easy. Deciding to remain friends with a heroin user also takes guts and courage. It would be much easier to write your friend off and avoid any heartache. You could justify it ten ways till Tuesday. But thank you for choosing the road less traveled and sticking it through. I appreciate it on behalf of all heroin users, and I know your friend will appreciate it more than you’ll probably even know.

Peace, Love & Rock 'n Roll D_D

Ask a Junky!

Over the past few months I've received quite a few emails from people, both junky and non-junky alike, asking a variety of questions about heroin and its use. Questions like:

"I just moved and don't know where to any get heroin. Can you help me score?" (or more commonly, "Can you mail me some?" ::eye roll::)

"My friend is a heroin addict and I don't know how to help them. Do heroin addicts ever "get better"? (my quotes, not theirs.)

"I'm a user too, but I'm not very good at cooking up. If I mail you some will you cook it up for me and send it back in the syringe?" (No, I'm not kidding, that was an actual question.)

"I'm new to {insert name of area here} and don't have any friends. I met some people and they offered me heroin. I've been addicted to meth in the past, so I think I could handle it. Do you think I should do it?"

"Do you know where I can get any syringes? I don't live near a needle exchange and my dealer charges too much for them."

"I woke up and had this hole in my arm which is freaking me out. I have read some of your blogs and I think you' re the only one who might know what to do without getting myself into trouble." (he's talking about an abscess)

"I quit heroin a few years ago, but I've recently started using on occasion again. Unfortunately, my veins don't seem to have recovered. It's almost impossible for me to find a vein. I heard IMing causes abscesses, but I know you've mentioned it before. Is it safe to IM black tar?"

Obviously I would never reveal the names of the people who contact me with personal questions. But I thought it would be a good idea to address these topics publicly so that those who have similar questions can benefit as well. If you have any questions regarding heroin, especially if you think others could benefit from it as well, send them to me privately and I'll be happy to answer them - omitting your name of course. If you don't want your question answered publicly, just let me know and be happy to keep your discretion.

I'll be addressing each question individually and archiving them for easy access. So stay tuned! I'll have the first one up in a short while. :)

☮ ❤ & ♪♫ ♪

D_D

 

 

Ask a Junky: Needle Exchanges

Question:  "Do you know where I can get any syringes? I can get them through my dealer, but he charges too much for them."

Answer: This is such an important question because it’s critical for IV drug users to use a fresh needle each time they inject. The best resource for needles is your local needle exchange. Don’t be afraid to go! It won’t be all creeps and low-life junky scum. Well, they'll mostly be junkies, but definitely not all scum! Most Needle Exchanges usually have lots of extra resources that I would highly recommend taking advantage of. The one closest to me prints out a schedule every month and includes activities like yoga, acupuncture, overdose prevention courses, safe shooting courses and a slew of groups for people interested in recovery, as well as Suboxone and Methadone treatment programs - all free to IV drug users! The user who directly asked me this question did live close to a needle exchange but didn't think she could get any without turning some in. Most needle exchange will offer anyone who comes in at least a few needles for free. Mine gives 10 needles - including all the supplies you could need to inject – to anyone who walks in the door, whether you exchange some or not. Most usually have special deal days as well. Like turn in 10, get 15, or even double exchange days - 2-for-1! I started by turning in a few needles at a time, now I turn in 700 at a time. (I don’t take advantage of the special deal days anymore. I figure I have enough).

I know that unfortunately many people don't live close to a needle exchange. And in some places merely being in possession of syringes is a crime that can get you locked up. It’s a sin, if you ask me, but it’s the way the world is. So instead of sticking it to the man and risk getting locked up by openly trading syringes, I would suggest using a more discrete method like mail order. If you buy in bulk, I've seen them as cheap as .17 cents online. Here are a couple of cheap places that I found.

Affordable Diabetes

Bulk Syringes

Vitality Medical 

Many states allow anyone to purchase syringes as well. It's up to the local pharmacies to decide whether or not to sell to the public. In California, Walgreens is only magor pharmacy that sells them.  It is $3.19 out the door for a pack of ten. Even though it's illegal to be in possession of syringes for drug purposes in New York, I personally know that Duane Reade also sells syringes to the public, I've bought them there before. It's more costly than a Needle Exchange or even online in bulk, but in a pinch these pharmacies can be a life saver. Do some research on your home state and see if any pharmacy sells syringes without question!

Using clean needles is so important. It’s literally a life or death matter. If my readers get nothing out of my blog but this, I'd be happy. I use clean syringes all time, I slipped up a couple of times, only with my bf and now I have Hepatitis C. Years of safe shooting practice wasted by my one little indiscretion. I’m being proactive about it and it’s something that can be cured these days, but what a terrible thing to put your body through just for a quick high. If it means putting off getting high until you get home, or even until the next day, wait! It will always be worth it! Even Hepatitis C is a lot better than other diseases you could contract, like AIDS.

Communicable diseases are only one of the reasons to use a fresh needle every time. Using dirty syringes can lead to abscesses or other type of infections. In addition, the damage you do to your body by injecting with dull needles is sizable. It takes me a while to hit a vein. So, it’s not uncommon for me to go through four or five syringes during the course of one injection. When one gets too dull after trying a few different spots, then I swap it out for a fresh one. Keeping your veins fresh isn't just important so that you can keep shooting for years to come (if you choose to). It’s also important for medical situations. I've often thought about what would happen if I was in some kind of accident and needed an IV drip or blood. Where would they go? Not to mention that phlebotomists have only been successful one out of the last eight times I've tried to get blood drawn. When I needed to get my Hep C results, it took over a month and a half. And I always use a fresh needle and always have. This is just wear and tear after years of injecting. It will happen a lot sooner to you if you don’t take safe shooting practices seriously. Don't let these types of medical situations arise. Keep your veins in good shape by using a fresh needle each time.

So show society wrong and be a smart drug user. Just because you use junk doesn't mean you have to treat your body like junk!

Routes of Administration Pt. 2: Blowing, Smoking and Plugging

In the first section of Routes of Administration we covered the different ways to administer heroin with a syringe. In this section we’ll talk about ways to take heroin that do not involve a syringe. Namely, smoking, insufflating and rectal. Most heroin users start out by either smoking or blowing heroin, depending on what coast you live on. There are many advantages to sticking with one of these routes of administration. The two most important in my opinion are that you limit many of the health risks associated with IV drug use and you’ll avoid track marks which can have a serious impact on your relationships and social responsibilities, not to mention your career.

So, let’s dive right into it.

Insufflation 

If you’ve ever done cocaine, you’re probably already familiar with insufflation (or blowing, snorting, tooting, there are many names for it). With this method, the drug is inhaled through the nose and up to the sinus cavity and absorb into the bloodstream. It’s got a pretty good bioavailability for a non-injection method, about 44-60%. One of the biggest advantages to insufflation is its ease. It requires no special tools and can be done somewhat discretely, allowing users to partake just about anywhere, anytime. A major drawback is that it’s the easy non-needle route of administration to overdose on. You’re four times more likely to OD by insufflation than by smoking. There are a few reasons for this. One being that the user usually inhales an entire does at once. Another is that many users do not accurately weigh their dose before taking it. Maybe they don’t have an accurate scale, or they don’t want to take the time to do it properly, or they just get cocky and think they can eyeball accurately. We’ve all thought that way, but it can be extremely dangerous. Especially if you’re developing a tolerance and keep increasing your dose to try to achieve the same high (it ain't ever going to happen, fyi). To limit your risk of OD, always weigh out your doses. You can even pre-weigh a whole bunch at once if you want to save time late. A safe dose for someone with no tolerance is typically between 5-25 mg. For someone with a tolerance it can be anywhere between 20-40 mgs. What dose you take is determined by the quality. The fluctuation of heroin’s quality is another reason users overdose. For this reason, it’s always important to do a small test bump to determine the quality before deciding on your dose. You never really know if the heroin you’re getting one day is from the same batch as the heroin you got on another day. So be safe and do a test a bump. You can always take more, but you can’t take back a potentially fatal dose. Always error on the side of caution. That being said, re-dosing is another very common reason people OD when blowing. Compared to most other methods, the effects come on relatively slowly. First onset is felt in 10-120 seconds, but peak isn’t achieved until 10-30 minutes. So one might assume that their dose wasn’t strong enough before peak is achieved and take more to try to feel the effects. To be completely safe, always wait 30 minutes before taking your next dose. A less serious drawback is that it does have the shortest half-life, about 3-4 hours.

The process of insufflation is incredibly simple. The substance, which is usually a powder, is typically cut into lines or formed into bumps. The user either inhales the powder directly by bringing his nose as close as possible to the powder and inhaling deeply, or enlists the use of a straw or other hollow straw-like tool (like a rolled up dollar bill). One end is inserted into his nose, the other end is as close to the powder as possible, so that when he inhales the powder is channeled through the small opening and directly into the sinus cavity, leaving less room for error. My currently dealer gets black tar and brown powder. And she blows the brown powder the same way you would white powder. So while it might be tricky with black tar, it’s not exclusive to white powder.

This is not the only way to insufflate heroin however. If you only have access to black tar and still want to insufflate, it is possible, but a bit more complicated. The process is called water-lining and entails dissolving the heroin in water and squirting it up the nasal passage, the same way you would Afrin. In the spirit of full disclosure, I use to carry a little Afrin bottle around my old office and subtly take heroin all day long in-front of my coworkers and boss in this manner. Although I would never do that now, and I would certainly never recommend that anyone else do it either! This method requires the same cooking process as any of the injection routes (because some of the chemicals in black tar are not activated until cooked). To start, place the heroin and a small amount of water in a metal cooking device like a spoon. Heat it with a flame until the tar is completely dissolved in the water. With syringe or pipette, transfer the liquid to the container you’ll be using – being careful to only use a sanitized bottle! Once it’s cooled, tilt your head back and squirt the water as far up your nasal passage as possible. Keep your head tilted back for a while to make sure none of it drains back out. It has a very strong taste that most people would find unpleasant at first. But once your used to it, you’ll probably start craving it (that is to say, once your addicted, you’ll definitely start craving it ;-).

Smoking

Smoking is almost exclusively a black tar route of administration since it has a much lower burn rate than white powder. In fact, it was designed specifically to give west coast users an alternative to injection. It is also possible to smoke white powder heroin, but the process takes a little more preparation. The bioavailability of smoking is widely debated. It has been reported to be as low as 26% and as high as 75%. One of the reasons for this is that effectiveness of smoking is completely dependent on the skill of the user. The process, called Chasing the Dragon, requires quite a bit of skill and finesse to perform properly. When done by someone without skill or experience, it can be extremely wasteful and may produce little to no effect at all. When done by an expert, it can get you extremely high, arguably higher than any other non-needle methods, and waste is kept to a bare minimum. In fact, smoking is the only route of administration that produces a rush similar to an IV injection. Out of all the routes of administration we’ve talked about so far, smoking as the longest half-life, about 6 hours.

Another benefit to smoking is that it’s relatively safe. In fact, it’s almost impossible to OD when smoking. There are a couple reasons for this. For one, smoking (as any cigarette smoker can attest) has the fastest onset of any route of administration, including IV injection, just 10-20 seconds. So you immediately feel the effects of smoking. It might seem logical that insufflation would be just has fast since your nose is so close to your brain and it seems to give you a rush. But in reality, you are only feeling the first onset, not the actual peak and it has to be absorb through your mucus membrane, travel through your bloodstream and then reach your brain. The other reason is that it’s very hard to smoke enough heroin at once to OD. You will almost definitely pass out before a fatal dose can be taken.

Many drug users form deep attachments to the ritual around their drug use. From scoring to prepping to administering and being high. There is a ceremony that many users perform religiously and can sometimes grow just as attached to as the drug itself. All injection methods have some ritual, but smoking has a specific and enjoyable ritual. For hundreds of years lovers of the poppy have been fine-tuning and perfect the art of Chasing the Dragon. In a way, it is the most time honored of all the administration rituals. It can be an extremely social event, where I find injecting to be a very solitary experience (and I don’t think I’m alone here, no pun intended), even when done in the company of others. Although, I suppose if someone else injects you it would be a much more communal experience. So for some, the whole ritualistic experience of Chasing the Dragon can also be a benefit of this method.

There is one health risk that is unique to smoking heroin, (on top of the given hazards inherent with all heroin use: addiction, social stigma, the danger that comes with buying, using and funding a habit (both legal and social), that is unique to smoking heroin. On top of all the other inherit health risks that come with smoking anything, heroin smokers are susceptible to Leukoencephalopathy. Leukoencephalopathy is a disease of the white matter of the brain and affects your motor, sensory, and visual systems and disrupts your cognitive and emotional function. While cases of Leukoencephalopathy among heroin smokers aren't staggeringly high, it is common enough to have drawn the attention of the medical industry and needs to be taken seriously. Next to genetic disorders, is one of the more common ways to contract it, along with, cerebrovascular disease, AIDS and toxic exposure. None of this sounds good does it? Medical researchers have concluded that it is not actually related to the heroin, but an adulterant in the heroin, although which adulterant has not yet been determined. The good thing is, whatever adulterate is responsible is much rarer in black tar, which is the most commonly smoked form of heroin. There is really nothing you can do to limit your risk, other than not smoking heroin. But each time a junky sticks a spike in his vein, Chases the Dragon or does a line (or a water-line, as the case may be) he exposes himself to health risk. It’s your job to weigh the pros and cons and make a (hopefully) educated decision and calculated risk. The good news is, it’s much less common then Sudden Death associated with injecting. Notice I didn’t say overdose, as these are two very separate things, which I will go into in more detail in the next section: Health Risks associated with each Route of Administration, as I will with Leukoencephalopathy as well. But, I don’t meant to cause a panic, Rest assured, smoking is still the safest way to administer heroin.

It’s easy for me to tell you the steps of how to smoke heroin. It might sound easy, but trust me, it’s not as easy as it seems. But I encourage you try it, hone it, tweak it, and become a master. It’s an art that’s dying out as more and more people don’t want to take the time to master it and would rather just jab a needle in themselves. But I respect those who have mastered this art form and would put down the needle to smoke with them any day of the week. Because I know I’ll still get high. But have patience. Don’t give up. Become a guru of Chasing the Dragon, and then invite me over J because in truth, I’m quite rusty these days. I waste too much and can barely get high. But there was a time I was much more skilled.

Smoking with a partner makes the process infinitely easier. But since most people probably use alone, or will at least have to at some point during their heroin years, I’ll cover this one first. You’ll need a few tools, but luckily none of them are illegal like so much other drug paraphernalia like syringes or crack pipes, even opium pipes. Which if you had one – you wouldn’t need to learn the whole Chasing the Dragon process. And it would be pretty fucking sweet to break out your opium pipe, both as a conversation starter and to smoke out of. But anyway, the tools you’ll need are a flame, a tube for inhaling the smoke and the most important tool, a surface to smoke off of. It needs to have a low heat capacity, or something that will heat up very quickly and cool down just as quickly. It also needs to be sturdy enough to resist burning itself. The ideal surface would be one that when you applied heat below it to boil the heroin, it would cook it very quickly, allowing you inhale a large hit all at once, and then cool down the second you remove the flame, so that the heroin didn’t continue to burn and release extra smoke that you’re no longer in a position to use. The best surface we have today that is easily accessible to just about anyone is heavy duty aluminum foil. And it works very, very well. Although I’m sure there are more scenically advanced surfaces out there. They just haven’t been made available to the general heroin population (stupid junky-hating scientists ;-) The tube is also important. It may seem easy to use a straw because you can hold it in your mouth while your hands are busy holding the foil and flame. But a straw has such a small opening that is allows for a lot of heroin to simply go up in smoke and never make it to your lungs. The best solution I’ve seen is a toilet paper roll. The mouth is wide enough to catch almost all the precious, valuable smoke and funnel it into your lungs. But you have to hold a tube that big. The solution? Get a Zippo. With a stationary flame you hold the foil with one hand and the tube in the other. The other solution is to use something that keeps the foil in place while you control the tube and lighter. This would take some creativity to figure out what you have on hand that can serve this purpose. But if you’re dedicated, there are all sorts of things you can find in craft store or home improvement store that will do the trick nicely. I think this is the better of the two because trying to maneuver the aluminum in your hand while using the tube can be tricky when the boiling heroin begins to move slide along the crease in the foil.

Smoking with a partner makes it much less complicated because the other person can hold the foil for you.

Okay, before I get any further, let me give you the steps, one by one, so you can visualize what I’m talking about.

1. Gather all of your supplies and set your environment. You’ll want to be comfortable once you are high.
2. Weigh out your heroin. A common dose for someone with a low tolerance is 15 - 30 mg, for a high tolerance 20 - 50 mg.
3. Take a piece of aluminum foil and make a crease down the center lengthwise, keeping the shiny side up. Place the heroin on end that is closest to you.
4. Get your tube in place and position the flame so that it is directly under the heroin. Start to gently heat the flame, starting from the far end of the foil. It’s very important not to overheat the heroin. This could result in too much waste, burning the heroin or smoking more than is safe at one time.
5. As the heroin begins to boil and the smoke starts to rise, start to inhale the vapor immediately.
6. You want the heroin to start to slide or trail on the foil. If it blobs up in one place, much of it won’t be smoke-able. The smaller the trail the better, so that the entire trail is smoke-able.
7. Once you've filled your lungs to a comfortable level, immediately remove the heat and stop inhaling.
8. Once you've exhaled and ready for another, reheat again and take another hit.

Both black tar and brown powder can be smoked in this manner. The process for white powder is identical, with one extra step. You’ll need to make a 1:1 ratio mixture of heroin and caffeine powder. This can simply be done in a small bowl, no special perpetration is required. Try to get the actual powder and not just a crushed up caffeine pill. Other substances will work, so long as they have a low boiling rate, but caffeine is the only one I’ve actually heard of people using and it supposedly works very well.

You will find that that heroin begins to move as it becomes liquid and boils. Be careful not to tip the foil in either direction too much so that it doesn’t run off the foil. You will have to reposition your lighter several times as the heroin moves around the foil to ensure you’re inhaling from the right place. It can be difficult to chase the vapor and ensure you’re inhaling it all without letting it go up in smoke. That’s why it’s called Chasing the Dragon! But don’t fret. Keep practicing and you will be one of the few in the world who has mastered this most complicated route of administration.

Side Note: Smoking heroin out of a tip of a cigarette is another way to smoke it. It makes smoking white powder much easier. The process is identical for both. Just remove a little tobacco from the cigarette and add some heroin in its place. Then smoke it like a regular cigarette. My old dealer would always give me a little to smoke in a cig while I waited on his front porch for him to come back outside with my goods. But I’ve never found this to be effective at all and it only pissed me off because I was wasting the heroin. Of course, it was a free bump, so I did was I was told and never complained ;-)

Rectal

Also known as plugging, boofing, booty bumping and a number of other colorful nicknames, it's probably the least commonly used route of administration of the three mentioned in this article is rectal suppository. This category would more appropriately called just suppository because it also includes vaginal as well as rectal. Although that method is less used than rectal. First, let me dispel a myth. Sticking drugs up your butt will not make you gay. I give you my 100% word, cross my heart and hope to die, you will not turn gay. Nor does it mean that you were ever secretly gay and just didn’t know it. You can rest assured that if you do empty this method, your sexuality will not be in jeopardy and you will still like sticking your dick in women. You can even have one lined up immediately afterwards for a quickie, just in case you want to ensure your masculinity is still in tact.

This is actually my favorite route of administration next to IV and IM injections. It works the same way as insufflation, except your using the mucus membranes in your anal glands rather than your sinus cavity. It’s very safe. Its’ got a bioavailability of about 50%-70%, which is really excellent. Some claim it’s as high as 90%, but I have a hard time believing that. Some people claim that they rush they experience is equivalent to an IV injection. I don’t personally agree with that, but for those with less of a tolerance, maybe it’s conceivable. Other claim it has no effect at all. This would only happen if it was not administered correctly.

A syringe with the tip cut off for easy administration.

Basically, you’ll need three supplies: 1.) A syringe. It can be an oral or infant syringe (you can buy them at any pharmacy without any weird looks ;) or an insulin syringe with the tip removed and the nib cut off, leaving a small hole at the top. Make sure it’s as smooth as possible to prevent any scrapes or tears when it’s inserted. 2.) Some water and 3.) Your heroin. A typical dose should be about 50 mg. If you’re really opiate naïve, maybe start a little lower, like 30 mg. Any type of heroin will do, it doesn’t matter what kind.

1. Prepare the heroin by dissolving it in a little bit of water, some say the more diluted the better, but I don’t see any reason for this unless it’s to cut down on potential burning. I would say the less diluted the better, so that your body can absorb it as fast as possible. If it’s powder, just dissolving it is fine. With black tar or brown powder, cook it first, the same was as mentioned above.
2. Draw the liquid up with your clean and sterile syringe.
3. Some find Vaseline or other lubricant makes the process more comfortable, although I’ve never really had a problem sticking anything up my ass, so I’ve never even tried this step, lol.
4. (For obvious reasons, it’s a good idea to clean out your bowels before this point. An enema isn’t really necessary, but just make sure they are empty). Lie on your side on the bathroom floor with your pants removed (or at least lowered to your ankles. Find a position where you can easily reach your, um…. asshole J Some people need to raise their high leg to achieve this, or if your limber, you may be able to simply reach behind.
5. Once you’ve located the entry (yes in this case it is an entry ;-) gently push the syringe into your anus until it is inserted all the way to the base. Don’t worry, there syringes are skinny and fairly short.
6. Press the plunger all the way day and hold it there for several moments. Sing Happy Birthday two times like your washing your hands or something. Then gently remove the syringe.
7. Stay on your side for about 10 minutes, depending on the amount of water you use, you may want to stay there up to 20 minutes.
8. Once you feel fairly confident that all of the liquid has been absorbed, you can get up and for God sakes put your pants back on.

You should start to feel the effects in about 10 minutes. Full peak takes between 20-30 minutes. But then it last a considerably longer time than blowing or even injecting, up to six hours. By far the most common reason that rectal administration doesn't work is that the syringe wasn't inserted far enough. Make sure you don't waste your heroin by pussing out and not getting it all the way up there ;-) A vaginal suppository is done in the exact same manner.

Converts to rectal administration swear by this methods. The general consensus among devotees is that it’s equal, if not superior to an IM injection. While IV is hard to give up, if I had to, this would definitely be my go to method. Many drugs are extremely effect this way. I’ll be straight with you guys, I’ve put just about every drug you can find up my ass, including my birth control pills :)

Bonus Tip: Acetyl L-Carnitine is said to be an extremely potent potentiator for rectal heroin use. Simply perform the same procedure 20 minutes before you insert the heroin. It’s said to increase the high by up to 2x the normal potency!

These aren’t the only routes of administration. There are a few others, like oral or vaporizing, but the six I've mentioned in part 1 and 2 of this series are tried and true methods that seem to produce the best results.

Hopfully that was informative for some of your guys and will help you make a well informed decision on which route of administration is right for you. If you’re used to one method, maybe try another to change things up a bit! In the next section I’ll be discussing health risks associated with each method and how to limit your risks!

☮ ❤ & ♫♪♫

D_D

Routes of Administration, Pt. 1: Injecting

"I quit heroin a few years ago, but I've recently started using on occasion again. Unfortunately, my veins don't seem to have recovered. It's almost impossible for me to find a vein. I heard IMing causes abscesses, but I know you've mentioned it before. Is it safe to IM black tar?"

When talking about heroin, one of the topics that comes up all the time, among users, potential users and non-users alike, is routes of administration. There is usually a generally accepted preferred route of administration (or RoA) associated with each drug that most users stick to. Pot is smoked (although it can be consumed orally). Cocaine is insufflated (although it can be injected or smoked), LSD is typically dissolved on the tongue (although it can be taken sublingually, injected, consumed or absorbed through the skin) and so forth. Heroin on the other hand can be taken any number of ways and each user has their own method. The most common routes of administration include, insufflation, plugging (rectal administration), smoking, oral, skin popping, IV injection and IM injection. While heroin is most closely associated with IV injection, a recent study claims the majority of users in American insufflate heroin. But depending on your region, the statistics will vary greatly. On the east coast heroin comes as a powder, making it easy to blow. The same study showed that the vast majority of west coast heroin users inject. That’s because black tar does not lend itself to insufflation (although it can be water-lined with very nice effects, a process I’ll cover later). On the other hand, unlike white power, it can be smoked. In fact, black tar was actually created in response to users on the west who wanted an alternative to injecting. It’s got a good burn rate and when done by a skilled user, can produce and effect similar to the rush experienced with injection, a process called Chasing the Dragon. The downside is that it does require skill and experience, otherwise it can be quite wasteful and hardly worth the time.

Before choosing to use heroin, each person has to ask themselves what routes of administration they are willing to use. Many people have a strict no-needle policy. And in truth, there are a lot of benefits to avoiding the needle, both in terms of your health and socio-culture consequences. Multiple studies, both in the US and the UK, have reported a general trend away from injecting, even while heroin use appears to be on the rise. On the flip side, there are some drug users who are drawn to heroin, and IV drug use in general, because of injecting's taboo reputation. It’s considered the ultimate conquest, the final frontier of drug use. And some will be intent on trying it as a means to achieving status among the drug using elite. Unfortunately, many of these people aren’t prepared for the full spectrum of negative consequences that come with being an injecting drug user. I know that it’s very unlikely I’ll be able to talk anyone out of it if they are set on feeding their ego. But I would still strongly encourage everybody to carefully weigh the pros and cons before making the decision to inject. The wider your eyes are open, the better prepared you’ll be to handle the realities. Because it’s not all pretty.

Each route of administration comes with its own sets of pros and cons. Which one you choose use is a very personal decision. I would never attempt to tell you which one is right for you and neither should anyone else who has your best interest in mind. Just like sex, never do anything with your body that makes you feel vulnerable or uncomfortable. Whether it’s the drug itself or the route of administration, make the choice ahead of time so that you are one hundred percent sure that it’s something you want to do.  My goal is simply to provide you with as much information as possible so that you can make an informed and educated decision.

There is so much important information on routes of administration that I decided to break this up into three separate posts. The first and second parts will be in-depth breakdowns of those RoA’s. For our purposes we’ll break them up into two major categories: Those that use a syringe, namely Intravenous Injection, intramuscular injection and skin popping, and those that don’t, including smoking, insufflation and rectal. The third will be health concerns associated with each RoA.

The intention is to address many questions that I've been asked over the years about RoA’s in one fell swoop, as well as to clear up any misunderstandings and set the ground work for future posts addressing questions on how to care for RoA related health problems that I've been asked. So if you’re considering using heroin, or considering changing up your current RoA, hopefully this post will give you plenty of information to make an educated decision.

Subcutaneous (Or Skin Popping):

I used to think that skin popping was a thing of the past. I’d never seen or even heard of anyone I know doing it, until a few years ago and then suddenly like four or five people I know owned up to skin popping all around the same time, even my then heroin dealer. So I guess the tradition lives on. Basically, skin popping is a subcutaneous injection or injecting the heroin directly into the skin tissue, just under the surface of the skin. Many people like it because it’s a lot easier to skin pop than inject intravenously and while there isn't the rush experienced with IV, the high lasts longer, supposedly hours longer. It’s also much easier to hide your use because it doesn't produce track marks, although bruising can occur around the injected site. When skin popping, small doses are wasteful, so you want to gauge your tolerance closely. Start out with a lower dose and work your way up, because overdose is still a risk, although less of one than with an IV injection. But for the max benefits, dose on the higher end of your tolerance. Because it takes between 5-15 minutes to completely absorb, it can cause infections like abscesses, just like missing an IV injection. So it’s important to change injection site frequently and limit the number of daily injections.

The process goes like this:

1. Cook the heroin in a clean metal container, like a spoon or cooker from a needle exchange, by dissolve it in water over a

   

   Cooking Up Heroin

   flame. This helps cook out any impurities, and with black tar actually activate some chemicals as well.
2. Drop a small piece of cotton into the dissolved heroin.
3. Press the tip of a clean syringe into the cotton and suck up the liquid into the chamber by pulling up on the plunger.
4. To practice strict harm reduction, back-fill a new syringe with the heroin and tap out all visible air bubbles.

*Quick note on air bubbles. Somehow a rumor started that air bubbles can kill you. This is not the case. You can inject up to 4 cc’s of air before any damage will occur. That’s 4 full syringes of air. So don’t stress or worry about a few tiny air bubbles you can’t see.

5. Locate a spot on your arm or thigh to inject and clean it with alcohol.
6. Remove the cap carefully, so as not to make contact with the syringe tip.

   

   Sucking up Heroin

7. Inject the needle just under the skin. If you start to bleed in excess, stop and apply pressure; you might have hit something. But once you are just under the skin, very shallow, simply push the plunger down and allow the fluid to collect under the skin. A large bubble will develop. That’s okay. The skin is very elastic and the bubble will go away as the heroin is absorb. The bubble can be a bit alarming at first, but you’ll get used to it.
8. Once all the heroin has been injected, simply remove the syringe and in 5-15 minutes, you’ll be high.

You may experience slight discomfort, but it shouldn’t be too unbearable. The main things to consider when choosing to skin pop are the likelihood of infection, and to make sure never go to deep. It’s got a lower bioavailability than IV or IM, but it produce a longer lasting high.

Back-Filling the Syringe

Intramuscular Injection:

Intramuscular is my go-to route of administration if I can’t IV for some reason (usually do to lack of usable veins). It’s a got the second highest bioavailability at 86% and is extremely easy to do. However, it can be extremely painful, especially with black tar and it does leave lumps around the area of injection, but almost no bruising whatsoever. So if you’re looking for a good way to inject without leaving any trace, IMing is the way to go. As long as you administer the shot slowly, the pain can be significantly reduced to almost zero. I like it because while it doesn’t have the same intense rush as an IV injection, there still is a slight, yet noticeable rush that comes on about 3-5 minutes after the shot. You definitely know you’ve taken it; you’ll even get the same taste in your mouth, although slightly less intense. If you’re squeamish about IV or just don’t have any veins left, you’ll be most satisfied with an IM injection, in my opinion. The chance of infection is much lower than both IV or subcutaneous, as long as you go deep enough into the muscle. In all of my years of IMing, I’ve never had an infection and I’ve only IM’d black tar. But if you do get an infection, it will probably be very deep, so you’ll need to get medical attention right away,

Blood Filling the Syringe

before it can make its way to the bone.

The process is simple.

1. Prepare the shot by following steps 1-4 under skin popping.
2. Locate a spot on your upper arm or buttock, thigh is acceptable as well, but hurts like the Dickens, so I would avoid it, and clean it will alcohol.
3. Insert the syringe until the entire tip is deep within the muscle.
4. Push down slowly on the plunger until all the heroin has been injected. The high will come on in about 3-5 minutes. So sit back, relax and enjoy

If the pain is too intense, you can also choose to rotate spots part way through the injection, or pause and take breaks. The pain will only last during the injection. Although you may feel some tenderness around the area for a couple of days. And honestly, I’m just preparing you for the worst here. It’s honestly not that bad at all. It’s only when I've used the same injection site for a while that I ever experience any notable pain. One more word of caution; it may be very tempting to want to IM after you’ve been struggling to IV for a while but can’t locate a usable spot. I’ve done it a lot, lots of junkies have done it a lot, especially when you’re feeling sick and just need relief. It won’t kill you, but it will greatly increase your risk of infection. Your body doesn't know how to handle its own blood when inserted into a place it shouldn't be, like your muscle. So if your needle is filled with blood from trying to IV, it’s best to avoid IMing if you can. But I won’t judge you. We've all been there. Also, like skin popping, it’s a good idea to rotate spots, to avoid painful lumps on top of each other.

Injecting Heroin

Intravenous Injection:

Intravenous injection comes with the best payoffs and the worst downfalls. It has 100% bioavailability, so it’s by far the least wasteful. It produces the greatest rush, which many junkies are just as addicted to as the high. But it comes with many physical problems, including collapsed veins, bad infections from missed shots, thrombosis, endocarditis, the risk of infectious diseases like Hepatitis C and Aids, cirrhosis of the liver, just to name a few (health risks associated with heroin use is another topic I will cover shortly). It also leaves permanent scarring from multiple injections. Unfortunately, the scaring also comes with its own social stigma. It’s almost impossible to hide track marks, making it easy to point out an IV drug user. Many people will use this knowledge to discriminate against you. This should hold equal weight as any of the physical side effects of IVing when choosing which route of administration to use because in reality, it will have the biggest negative impact on your life. It does take a little more skill to administer an IV injection, but after a bit of practice, it’s not that hard.

The process goes as follows:

1. Follow steps 1-4, as above.
2. Locate a usable vein and clean the area with alcohol.
3. Take your tourniquet and tie off the area you plan on injecting, the same way they do when drawing blood. Sit down and make yourself comfortable, supporting the area you plan on injecting.
4. Hold the syringe like you would a pencil. It should be at about a 45 degree angle. You want to point the syringe with the flow of blood, towards you heart. Insert the needle into the vein.
5. When you think you’re in the vein, pull up slowly on the plunger. If you’re in the vein, a plume of blood will fill the syringe. If you don’t see blood trying readjusting the needle slightly until blood fills the chamber. But don’t poke around in your vein too much. If it doesn’t happen, pull out and try another area.
6. Once you’ve got a good flow of blood into the chamber, proper protocol says to untie the tourniquet. If you’ve got good veins, this shouldn’t be a problem. Your syringe will stay in place.
7. Once the tourniquet has been removed, simply push down on the plunger and inject the heroin.
8. Slowly remove the syringe from the vein. You can put a cotton ball on it if you want to stop the bleeding. Or just apply pressure. I typically swab the area with alcohol again. But many people choose not to because alcohol can increase bleeding and can be slightly painful. You should feel the rush within 5 seconds.

I’ve already covered many of the questions you may have regarding which veins to use and how to make veins accessible in a prior post. To read all about it, please visit Making Veins Pop.

As I mentioned before, IV drug use comes with many health risks. And while every route of administration causes addiction, IV injection poses a much greater risk of addiction than other RoAs. Some say 200% more. In fact, even the act of injecting drugs can be addicting – extremely addicting. I often say I’m equally as addicted to the needle as I am to the drug. It’s very, very hard to stop after you start and it should not be taken lightly. There are so many negative consequences associated with injecting drugs, I couldn’t even begin to list them all. I would be a hypocrite if I told everybody not to do it, since it’s a daily part of my life. But I would strongly council anyone who is considering it to try another method of injection first. IMing is much less dangerous and eliminates the social stigma you’ll face.

In the next installment, I’ll cover the routes of administration that do not require a needle. Following that, I’ll discuss health risks associated with heroin use. In the meantime, let me know if you have any questions regarding this topic, or any other heroin related topic.