INJECTING YOUR DOSE: STORIES AND TIPS FROM PEERS AND PROFESSIONALS
In an issue which focuses on the OTP, we thought it was important to hear from people who inject their doses. There are a lot of reasons people might choose to do this – to avoid the nausea that comes with oral dosing, because they like using needles, or just simply because they prefer the faster come up. Here are 3 stories from people who choose to inject methadone or buprenorphine, focusing on why they do it and how to do it safely.
I started using heroin on and off in my late teens, and I’m in my 50s now. In the earlier days I was a poly-drug user, but given a choice of drugs, it’s always been heroin. The first time I went on methadone was back in the early 1990s, and I must admit, I didn’t like being on the program and went off it after a while. I’ve recently returned to the methadone program and have been on it for about three years now.
There are a couple of reasons why I inject methadone. First, I find it comes on a lot stronger. When I inject methadone, I think its effects don’t last as long as when I drink it, but I get a more euphoric feeling from injecting. The other reason I do it is I suffer from really bad migraines, and taking the syrup orally is something that really sets off my nausea – sometimes I just can’t keep my dose down. I’ve been in the clinic before, taken my dose, and have thrown it straight back up. For me, injecting is sometimes the best way to dose.
Methadone in Australia mostly comes in a pretty thick syrup. Not only is syrup painful to inject, it damages your veins, so most people dilute it with water. Diluting it means there’s a lot more liquid to inject, so it’s important to use a large-barrel syringe or butterfly infusion set so you don’t have to keep changing your fit. The syrup is filled with colours and dyes and isn’t sterile, so you need to filter it before you inject to remove all that. I use a wheel filter.
After I left the program, I was buying methadone diverted by people on the program. I thought it was better than using street heroin. It’s not a big market though – most people aren’t diverting methadone to make a profit. There are a lot of different reasons why people divert. Perhaps someone they’re close with can’t get on the program, so they divert a bit so their partner or friend won’t be sick. People often divert just to pay for their own treatment – they’re willing to be being sick for one day if it means they’re alright the rest of the week. If you’re not working, treatment costs can take a big chunk of your money. Most people would prefer not to divert, but sometimes the reality is you have to pay the bills.
Simply being on the program carries stigma, whether or not you inject your doses. On one occasion, my partner ended up in emergency and I told the nurses he was on methadone – next minute, they were all double gloved. You become very wary of what you share. Of course, any injecting marks you have, no matter what you’re injecting, carries stigma with it. I was once at a local medical centre, and the GP grabbed me and tried to pull my jumper up, exclaiming “what have you got on your arm!?” Having a doctor grab your arm because they see track marks is a very uncomfortable experience. Injecting has such a bad reputation that you just have to hide it. You know that through sharing that information in a medical setting, you’re not necessarily going to be helping yourself. Because you can’t talk about it anywhere else, talking about injecting methadone with your peers is important. How else can you share safety tips? No doctor will help you with it.
Having said that, there’s no social element to my actual injecting. While I know other people who inject methadone, it’s a solo thing for me. Maybe that’s partly my age – things were different when I was younger and buying diverted methadone. Injecting methadone is not something I do with other people. It’s simply something you do just to feel normal sometimes.
I’ve been a methadone injector for almost 25 years and it’s been one of the better choices I’ve made around my drug use. Ideally, like most people, if heroin was freely available that would be my drug of choice. If we had a hydromorphone program here, I’d be on it. Without these options, I’ve found a way to make injecting methadone work for me.
Injecting methadone has helped me to stop using heroin, so much so that these days I don’t even have a heroin dealer. I have a job, a stable long-term relationship and even a mortgage. Having to maintain a heroin habit taught me how to budget, how to be tight with money and how to live on close to nothing. When my partner and I stopped using heroin, we continued that lifestyle of living tight and saving money. Pretty quickly we ended up having five grand in the bank and we thought “Wow! How did that happen? Maybe we can save for a house deposit!”. If we’d been spending all our money on gear that never would have happened.
Don’t get me wrong, I do have days where my drug use can affect my work attendance. Sometimes I have a dirty shot, and that affects me. I’m getting older, I’m 49, so I’m not bouncing back like I used to. I imagine my immune system isn’t as good as it used to be. Some days I have to go without a dose and I think that makes me more prone to sickness and catching colds. Sometimes I don’t sleep that well.
Some years back I switched from methadone to Biodone. It has less additives and isn’t as thick so it’s safer to inject and it won’t screw your veins up as much. However, both carry risk of contamination — if any part of the dispensing equipment is dirty, your dose can be contaminated and make you sick. Because of this you need to use a blue bacteria wheel filter. I’ve had dirty hits and I’ve had what I call a ‘grimy’. It’s like a mild dirty hit: you get a slight headache and you feel a bit grimy.
I worry about sounding like a poster girl for shooting methadone, but it’s mostly been positive for me. Not being able to pay bills and rent, really freaking about getting evicted; those worries have been taken away from me because I’ve been injecting methadone rather than heroin. When you’re worried about housing, you’ve got no food and you’re living on porridge, it’s not a very happy life.
I’m at the point now where my veins are getting quite damaged. I have to make a decision about injecting into my groin or neck. That’s always been a no-go for me, and I still think that it’s a line that I don’t want to cross. My partner’s not in the same place, men generally have better veins, but he’s not far behind me. It’s causing tension in the home, stress about where to go from here.
Even though I’m about to run out of veins and it’s probably going to finish soon, I’m glad I’ve made the choice to inject methadone. I know that’s a pretty controversial thing to say. It’s not perfect but it’s helped make things work for me while waiting for an injectable pharmacotherapy to become available.
I injected Suboxone for quite some time, eventually coming off the program. But by the time that happened, I was getting 100% takeaways… of which 100% were injected.
I had about five friends OD and die in the Cabramatta heroin glut in the late 1990s, but I was a stimulant user. I didn’t start using opiates until I got a badly infected tooth when I was about 30. Neither the doctor or the dentist gave me antibiotics and painkillers, and it was just getting worse and worse. My friends were still using opiates, so I just tapped into it. I could get a pack of MS Contin (morphine) for $15, and my partner could access acetic acid through his job. We started making our own homebake (heroin).
By the time the doctors realised I had gangrene in my infected jaw, I had a physical dependency on opioids. I’d started injecting it at that point – I just tried it myself one day and thought ‘I can work this out’. I did, it was easy, and I liked it. That’s the start of my dance with steel.
We had good jobs and, for a while, good money. We racked up about $80,000 in debt on credit cards, and then one day it all dried up. We couldn’t even take our stuff to the hock shop – it was the weekend and it was closed. I just remember being so sick. The following Monday I went to a private clinic and started on methadone, eventually swapping over to Suboxone.
I was well-behaved for quite some time on the program, but I still thought about wanting to inject a lot, and my ex-partner read online about safely injecting Suboxone. After trying it, it became the way I would always take it. It never gave me a high or a rush though. I just did it because I like the needle.
I started escalating my injecting behaviour around Suboxone, although I wasn’t taking more of it. I just increased the number of needles I stuck in myself each day by having smaller shots more often, up to 10 a day. I became an expert in how to do it safely.
If you’re going to be injecting bupe, it’s important you look after yourself. Make sure you filter your mix, preferably through both a red and a blue wheel filter to get all the gunk out. You could also use Sterifilts, cotton wool, or even cigarette filters. Anything is better than nothing when it comes to filtering.
I moved from the city to deep suburbia, so I had to transfer to a new private clinic – this place was my only option because the public clinic had a huge waiting list. It was here I found that private doctors can do what they like. For example, we were made to sign a Medicare form saying he saw us for a 20-minute consultation – you were seen for a minute at most if you were lucky. Once, I had codeine in my system that I took for migraines. When I tested positive for it, the doctor threatened to kick me out and said I would be put on daily dosing if it was found again. He told me that it was more important for my wellbeing that my dose was monitored daily, rather than me holding down a full-time job and being able to pay for my mortgage. I came off the program because of the way that I was treated by this doctor.
All I can say is that injecting my doses made it a bitch to detox from. I’ve heard from so many people that Suboxone was easy to get off, but that was absolutely not the case for me – I was experiencing detox symptoms for about 12 weeks after my last dose.
If somebody thinks you’re a user, it can be a ticket for them to treat you like shit – this is definitely true in medical and clinical settings. People can have a lot of power of you if you’re dependent on drugs, and some people love that. As long as drug users are viewed as Other, or as less than people, then that imbalance of power will always be an issue.