Safer injecting for steroid users
If you’re injecting steroids, these tips will help you stay safe and healthy.
If you are under 21
It’s important not to inject steroids as it can harm your growth and development. Focus on diet and training instead.
Before you inject
- Check the contents of the vial or amp before you draw up – the steroids you buy may look legit but most of them are fake. They’re often not what they say on the label. If you see bits in the fluid and it’s meant to be clear, for example, do not use it.
- Know your dose – use smaller test doses until you get to the right dose for you.
- Rotate which muscles you inject into – ideally don’t inject into the same muscle more than once every two weeks. This gives your body time to heal between injections. Never inject into skin that is an odd colour, broken, irritated or lumpy.
- Avoid injecting steroids into smaller muscles – bear in mind that steroids work on your whole body, not just the area you're injecting into. Injecting into smaller muscles also increases your risk of problems like nerve damage.
Always use the right needle and the right barrel
- Use a new, sterile needle every time – this reduces your risk of injuries or infections.
- Never share needles, vials or amps – doing this increases your risk of blood-borne viruses like hepatitis C and HIV. You can get as many needles and barrels as you need for your cycle free from your local needle exchange.
- Always use the thinnest, shortest needle you can – for injecting steroids, you need to use a green needle to draw up then swap it for a blue needle to inject. A blue needle is long enough to get the fluid into your muscle without hitting a bone.
- Use a 2ml barrel – if you use bigger barrels you may draw up too much liquid. Injecting too much liquid can cause problems like scarring and abscesses (a pus-filled lump under your skin).
Make sure you’re injecting in the right place
The best places to inject are your buttock, thigh and shoulder muscles.
It’s easier to inject into these bigger muscles but you still need to be careful to avoid any blood vessels or nerves.
Buttock – Your buttock is the safest place to inject. If you imagine that your buttock is divided into four, you need to inject into the upper, outer quarter (see diagram). This is so you don’t hit the sciatic nerve, which runs down the centre of your buttock.
Thigh – Your thigh is the next safest area to inject after your buttock. You need to inject into your outer thigh, half way between your knee and the top of your leg.
Shoulder – Injecting into your shoulder carries more risk because the muscle is smaller. Make sure you inject into the outer part of the shoulder.
Visit your local needle exchange
Needles exchanges are free services where steroid users are welcome.
They’re completely confidential. Staff won’t tell anyone that you’ve been there, including your work or GP.
As well as new needles, barrels, swabs and bins, needle exchange staff can help with:
- safer injecting advice
- advice on sore or infected injecting sites
- testing for hepatitis C and HIV
- hepatitis B vaccinations
- free condoms and sexual health advice
- disposal bins
Clean your injecting site properly
Cleaning your injecting site correctly helps to prevent infections.
- Always wash your hands with soap and water before you inject.
- Clean the injection site with a single wipe of a swab. Scrubbing at your skin with the swab will just spread bacteria around.
- Allow your skin about a minute to dry before you inject.
- If you’re using a multi-dose vial, use a swab to wipe the top of the vial before you draw up.
How to inject safely
- Insert the needle at 90 degrees to your body.
- You don’t need to push it in all the way – you should still be able to see a bit of the needle.
- Draw the plunger back slightly to check you haven’t hit a vein or artery. If you have you’ll see blood in the barrel. If this happens remove the needle and apply pressure with a clean tissue or cloth.
- Only inject up to 2ml of fluid into each site – if you inject more it will just sit in your muscle, raising your risk of infection.
- Inject slowly – 10 seconds per 1ml is about right.
- Remove the needle carefully and apply pressure with a clean tissue or cloth.
- Use a proper sharps bin to dispose of needles. You can get these free from needle exchanges.
When to get medical help
See your GP if you have:
- any redness, pain, warmth, swelling or blistering at your injection site, or you get a fever – you could have an infection or abscess
- a feeling like an electric shock when you inject, or any ongoing numbness or tingling – these are signs of nerve damage
After your cycle
For every 6-12 week cycle you do it’s recommended you have 6-12 weeks off to let your body recover.
Your natural testosterone production usually stops a few weeks into a cycle.
Some people take post-cycle therapy (PCT) drugs to help kickstart their natural testosterone again. But this isn’t always needed – your testosterone levels should gradually recover on their own.
In some cases, testosterone levels don’t return to normal. If you have signs of steroid crash that aren’t improving, such as lack of sex drive, difficulty getting an erection or enlarged breasts, see your GP.