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Safer injecting for steroid users

If you’re injecting steroids, these tips will help you stay safe and healthy.

If you're under 21

It’s important to focus on diet and training because taking steroids can affect your growth and development.

Before you inject

  • Check the contents of the vial or amp before you draw up – the steroids you buy are 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.
  • Start small – start low and build up until it feels like you’ve got the right dose for you. Avoid copying someone else’s dose – what's right for them may not be right for you.
  • Rotate which muscles you inject into – this gives your body time to heal between injections. Never inject into skin that is broken, irritated or lumpy.

Always use the right needle and the right barrel

  • Use a new, sterile needle every time – this reduces your risk of injuries and infections.
  • Stick to your own needles, vials and amps – using the same needle or vial as someone else 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 and syringe service (needle exchange).
  • Greens for drawing up, blues for injecting – 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.
  • Don't use barrels bigger than 2ml – 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 glutes, quads and delts.

It’s easier to inject into these bigger muscles but you still need to be careful to avoid blood vessels or nerves.

Glutes – your glutes are 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.

Quads – your quads are the next safest area to inject after the glutes. You need to inject into your outer thigh, half way between your knee and the top of your leg.

Delts – injecting into your delts carries more risk because the muscle is smaller.

Avoid injecting into other muscles – this increases your risk of problems like nerve damage, which can affect your training. Bear in mind that steroids work on your whole body, not just the area you're injecting into.

Visit your local needle and syringe service

Needles and syringe services 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.

Some services have specialists in steroids and other image and performance enhancing drugs (IPEDs). Ask if a specialist is available when you go in.

As well as new needles, barrels, swabs and bins, 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

See what to expect when you visit a needle and syringe service.

When you're ready to inject

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.
  • Wash your injecting site with soap and water too, or clean it with a single wipe of an alcohol 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.

Injecting into a muscle step by step

  1. Draw up with a green needle, then swap to a blue for injecting
  2. Insert the needle at 90 degrees to your body. It needs to go in most of the way
  3. 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 cotton wool
  4. Only inject up to 2ml of fluid into each site – if you inject more it raises your risk of infection
  5. Inject slowly – 10 seconds per 1ml is about right
  6. Remove the needle carefully and apply pressure with a clean tissue or cotton wool
  7. Use a proper sharps bin to dispose of needles. You can get these free from needle and syringe services

When to get medical help

Get some medical advice 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

Your natural hormone production usually stops a few weeks into a cycle.

Some people take post-cycle therapy (PCT) drugs to help kickstart their natural hormones again. These drugs can have side effects and they aren’t always needed – your hormone levels should gradually recover on their own.

In some cases, hormone levels don’t return to normal. If you have signs of steroid crash that aren’t improving, such as lack of sex drive or difficulty getting an erection, get some medical advice.

Remember – time off should equal time on.