Drugs
This page is mostly about self-harm, but Erowid is what I use for drug-related stuff. There's also the Bluelight Forums and the website for the Nation Harm Reduction Coalition.
Also, go to a needle exchange if you can help it. Needle exchanges are, in my experience, free and confidential, and do not allow drug use on the premises (that would be a safe injection site). I called ahead to check if they had my desired gauge. They welcomed me in, I sat in a waiting room for two seconds, and then they called me back to a private room. I gave them demographic information and told them whether I used druge or not--but the person working there told me I was free to lie. They gave me a card with a code on it, with which I could return the needles. Will report back once I return them!
I also got naloxone training. There's the nasal type, which comes in 4mg and 3mg concentrations. The 3mg is gaining more use, as it causes less-severe withdrawals and is a more humane option. There is also intramuscular naloxone, which is faster. I got injection training, which I elaborate more on here as it applies to injecting HRT. They also taught me about rescue breaths. Rescue breaths are commonly associated with CPR, but in the event of an overdose, pumping the chest isn't necessary, as their heart hasn't stopped yet. They involve pinching the nose, placing a rescue-breath bag on the person's face (if you're worried about putting your mouth against another person's), and breathing into their mouth, one exhalation at a normal rate every 5 seconds. You don't need to breathe as hard as you can.
Needles are remarkably difficult to disinfect, adequately, probably because you have to clean the inside of a very small tube that goes very deep in the skin. From the CDC's Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008 (latest update June 2024): "Full-strength bleach has been recommended for self-disinfection of needles and syringes used for illicit-drug injection when needle-exchange programs are not available."
This guide is going to get a LOT of use on this page, and if I assert something without a linked source, it's probably from the guide.
Self-Harm
Step 1. Do not ignore it.
I'm a chronically ill bitch and a big proponent of "if you ignore it, it'll go away." However, I have found this doesn't work as well with wounds. So, here's what I use to keep myself as safe as I can. With the addition
of my footer from my helth page.
I am not a doctor, nor am I your doctor. This is civillian-to-civillian communication.
Now, for all of these shoulders I'm standing on.
Cuts, Scratches and Tears
Here's some stuff I grabbed from the Merck Manual about lacerations, a.k.a cuts or tears. Stop bleeding by elevating the area if possible, then apply direct pressure with clean cloth, gauze, or fingers for "at least 5
minutes." I'm using a mix of the consumer and professional versions here. Consumer version says to apply pressure,
professional says to wash the wound. I have no idea what to make of this, but I usually go with stopping the bleeding, as I'm not a professional and it's uncouth to bleed all over the carpet on the way to the bathroom.
Speaking of, wash with mild soap and water. Tap water is okay. Professionals would use saline, but obv most people don'thave access to that at hand.
"There is no need to use hydrogen peroxide or alcohol for cleaning." The concern appears to be that strong agents would kill healthy cells.
Your local needle exchange may have wound care packages with water, saline, benalkonium chloride wipes, antibiotic ointment, gauze, and bandaids. If you can, it doesn't hurt to keep these items or similar in a little kit.
Bites
Pretty much the same deal as cuts, scratches and tears. We're dealing with human bites here, of course, which are typically non-serious. However bites to the clenched fist are more likely to become infected, so it's good to be vigilant. Flood the wound with saline or regular tap water, wash with soap, and monitor for infection or foreign objects in the wound. A finger-tendon injury often results in difficulty moving the finger in one direction. Infected bites become very painful, red, and swollen."
Hitting and Bruises
For those that hit themselves or others--I find my kink and self-harm research tend to overlap--there's this chart intended to be used by police officers.
It goes without saying that this is intended for escalation. However, we can use it to point out the areas least likely to do serious harm when hitting ourselves with hands or tools.
Obviously try to use new blades if you can. I see surgical scalpels thrown around since you can buy them in bulk. This is also true of disposable razors. If you don't take them out, it keeps you from cutting yourself too deep, and the handle allows for better control.
For those who cannot buy new, there are ways to make tools safer and they mostly involve cleaning and proper storage. Before we go over possible sterilants/disinfectants, here's a couple important notes from the 2008 guide above:
"Liquid chemical sterilants reliably produce sterility only if cleaning precedes treatment and if proper guidelines are followed regarding concentration, contact time, temperature, and pH."
There's also differences between cleaning, sanitizing, disinfecting, and sterilization. Thankfully, someone official has done it for me. This is also from the CDC. Cleaning removes physical stuff like dirt, sanitizing reduces germs (a.k.a. bacteria, viruses and fungi). According to this graphic, disinfection kills remaining germs, but other sources say that the level of germ-killing depends on the level of disinfection. According to the 2008 guide, a low-level disinfectant is an "agent that destroys all vegetative bacteria (except tubercle bacilli), lipid viruses, some nonlipid viruses, and some fungi, but not bacterial spores" An intermediate-level disinfectant is an "agent that destroys all vegetative bacteria, including tubercle bacilli, lipid and some nonlipid viruses, and fungi, but not bacterial spores," and a high-level disinfectant is an "agent capable of killing bacterial spores when used in sufficient concentration under suitable conditions. It therefore is expected to kill all other microorganisms." Sterilization kills (functionally) all microorgasnisms.
For our purposes, the higher the disinfection level, better. The highest would be cleaning followed by steam sterilization via autoclave. If you have a friend who's got one and you can go to them about this stuff, I would use that.
"In general, sterilization of critical items is not practical in homes but theoretically could be accomplished by chemical sterilants or boiling." This matches up with what's in Cutting the Risk: "The need for use of clean implements (including hands) cannot be overstressed. Even if sterile blades are not your usual choice, much can be done improvisationally. Needles, pins, pieces of glass, whatever is used, can be boiled in a pan of water for 20 minutes before using. This time lag and need for consideration may even act as a distraction, and might delay or reduce incidence of self-harming" I've also seen boiling attested to on the above @self-harm-harm-reduction blog. It seems like the most accessible option, but there is also the referenced liquid chemical sterilants.
This post warns against using hydrogen peroxide for blades, as it's corrosive. Corroborated here. The 2008 guide also calls 7.5% hydrogen peroxide corrosive to copper, brass, and zinc. Unsure about steel, However, if you use glass, it would probably be okay, as there's no warning for incompatibilities with glass here.
Same deal with household bleach. It corrodes stainless steel, iron, copper and nickle. Bleach is commonly used to disinfect glass jars, so using it on glass blades should be fine.
Ethyl/isopropyl alcohol at 60-90% concentration can be used! "Their cidal activity drops sharply when diluted below 50% concentration, and the optimum bactericidal concentration is 60%–90% solutions in water (volume/volume)" Hand sanitizers can fall into this concentration. Especially high-proof liquors can as well.
