How do you properly clean shared needles?

Dear Worried and Wondering, 

Your boyfriend is fortunate to have someone like you who’s looking out for his health and safety. Sharing needles can certainly be risky because it increases the chance of contracting blood-borne pathogens—many of which cannot be cured—including human immunodeficiency virus (HIV), hepatitis B (HBV), and hepatitis C (HCV). Additionally, continual reuse of a needle can cause the point to dull over time increasing the probability of creating abscesses and contracting both infectious and non-infectious skin conditions. The most effective way to avoid contamination when it comes to injection drug use is to use a new, sterile needle for every injection. That said, if clean needles aren’t accessible, there’s a suggested way of rinsing them that may reduce, but not eliminate, contamination and transmission of viruses. 

Ideally, your boyfriend would use a new needle each time he injects. However, if purchasing new needles isn’t possible, you might suggest that he try checking if there are Syringe Service Programs (SSPs) or safe injection—also known as supervised consumption—services available in your area or through the local health department. These sites serve as a free and safe place for people to both dispose of used syringes and obtain new, clean syringes. They can also serve as a pathway to ensuring safer consumption of drugs, accessing other helpful services such as vaccinations, referrals for treatment, and the distribution of potentially lifesaving medications. 

Should the option to obtain new needles be unavailable or inaccessible, the following steps are suggested when rinsing syringes: 

Step 1: Fill the syringe with bottled or cold tap water. Tap the syringe. Squirt out the water and repeat this at least three times. 

Step 2: Fill the syringe with bleach. Tap the syringe. Squirt out the bleach and repeat this at least three times. 

Step 3: Repeat step 1. 

Note: If you do not have bleach, completing step 1 is still recommended. Rinsing with water is safer than not rinsing at all. 

List adapted from the New York City Department of Health 

While bleach is the recommended disinfectant when it comes to do-it-yourself needle rinsing, it should also be mentioned that it has the potential to dull the point of needles and break down the rubber in the syringe over time. If bleach is unavailable, other options such as peroxide, dishwashing liquid and water, or rubbing alcohol—while not as effective—can be substituted. If all else fails, high-proof drinking alcohol such as vodka or rum can be used as a last resort. 

That said, while rinsing needles may lower your boyfriend’s risk of contamination, both HIV and HCV can survive on surfaces for up to four weeks. Take caution of the fact that this process only rinses contaminants from the syringe and doesn’t completely clean or sterilize the needle. Research suggests that the cleanliness of other items used during injection should also be taken into account. Tools such as cookers used to prepare the drug as well as any filters that are being used (e.g. cotton balls, cloth, etc.) should all be discarded and exchanged for new materials—if possible—or rinsed as an alternative. 

You mentioned your boyfriend’s choice to inject cocaine is fairly recent. If you’re concerned about his use overall or sharing of needles, it may be an opportunity to communicate your concern. Have you ever brought this up to him directly? Do you know how you would support your boyfriend if he asked for your help? Have you considered how his injection drug use may affect you and your health? 

It could be a good idea for the two of you to have a conversation about how his injection drug use affects you both. While sharing syringes increases the risk of a number of injections for him, it could also have implications for your own physical and emotional health as his partner, especially if you two have a sexual relationship. You may also consider talking with a health care provider about the risk for blood-borne infections, preventive care (such as getting the HBV vaccine and starting PrEP), and getting tested for sexually transmitted infections. If you aren’t already, you might also consider using a barrier method of contraception, such as condoms, during sex to help reduce your own risk. If you’re unsure about how to start this conversation, it might be helpful to talk with a health promotion specialist who can help you decide the best way to approach the topic. 

Hope this will help you and your partner take action to support each other’s health!