movement and return rates of syringes. This method does not provide specific information about participants, though some information may be approximated, such as gender, race/ethnicity, age, etc. Of course, the unreliability of any approximated data will severely limit its value and legitimacy. Aside from the limited usefulness of solely tracking syringe movement, the procedure of marking syringes can threaten the sterility of the syringe and can also be very time-consuming.
SU P P LIES In addition to syringes, there are a wide variety of other supplies that are important for SAPs to stock and distribute in order to offer a true comprehensive approach for preventing infectious disease and promoting safer injection. Blood-borne infections such as HCV can be transmitted through sharing any piece of injection equipment that may have blood on it. In addition, not all syringes are the same. Needles and syringe barrels are available in a wide variety of sizes, and injection drug users may have very particular habits when it comes to preparing and injecting drugs. Injection equipment may also vary depending on the drug being injected. Ideally, SAPs will offer needle and syringe sets in a variety of sizes. If an SAP does not offer the preferred size and brand of syringe a user prefers, s/he may be less likely to access the program. It is important to consult drug users to learn about their injection preferences. Open dialogues about current injection equipment and practices may also provide an opening for guidance around equipment that may promote better vein care and safer injection. Needles and Syringes Consider the following when making needle and syringe selection: Needle Gauge: Refers to the size of the bore or hole in the needle. With needles, the higher the gauge (G), the thinner the needle. Standard insulin sets, often popular with injection drug users, typically have a 27 gauge (27G) or 28G needle. Standard tuberculin sets come with a 25G needle. 1 Safer Injection Tip: The smaller the needle gauge (= higher number), the smaller the puncture wound and therefore, less bleeding, less damage to the vein and less opportunity for infection; it will also be easier to find smaller veins. Intramuscular injections – required for steroids and other hormones – require a larger gauge needle (typically 21G or 23G). People injecting methadone and/or certain drugs that are cut with a lot of impurities that may clog the syringe may also prefer needles with a higher gauge (smaller number). Needle Length: Insulin needles are typically 1/2 inch in length and tuberculin needles are typically 5/8 inch in length – these are usually preferable for intravenous drug injectors. Longer needles are typically needed for intramuscular injections. 1 Safer Injection Tip: A needle that is too short may miss the vein, and one that is too long may go through the vein or be difficult to position. Syringe Barrel Size: Standard insulin and tuberculin syringes are typically 1 cc or 1/2 cc in size and calibrated by .10 ccs along the barrel of the syringe. Most intravenous drug users will prefer either 1 cc or 1/2 cc syringes. People injecting cocaine and other drugs that may require more dilute may prefer 1 cc syringes. Methadone and/or steroid or hormone injectors may request 3 cc syringes. Brand: Different manufacturers create needles and syringes with varying quality. Some brands are more comfortable to inject with than others, and the plungers on some brands of syringes are easier to manipulate than others. Many -35-
