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Preparing Pills for Intravenous Injection

It is common practice for intravenous opioid users to inject pills that have been crushed and dissolved into a solution. The reasons that an user would prepare and inject a pill are varying: some may do this primarily for the rush associated with intravenous injection, while others may do it because they think that they are getting higher than they would if they were to take the pill orally or intranasally. Injecting pills can be hazardous to the user's health. Despite this knowledge [and years of constant admonitions by Heroin Helper —Dr. H], many people still choose to continue injecting pills. It is my goal to make pill injection safer by giving instruction on the safest possible preparation method for injecting pills.

I think it first necessary to state that the pills are designed for oral administration. That being the case, there have traditionally been no doctors or scientists studying and producing the safest and most efficient methods to inject pills; drug users have had to experiment and find the best ways to do this themselves. Because of this, many unsafe preparation methods, rumors, and bad information have been propagated. Fortunately, there are a few scientists in the world who are studying the most commonly used preparation methods, and trying to determine the safest methods possible.[1]

To Cook or Not to Cook

One popular method of preparation is to boil the solution before extraction. It is a contentious and often debated issue among users of whether to cook the solution or "cold shoot" it—to extract the target drug with cold water. It seems, however, that those advocating cold water extraction were right, at least in part. A group of scientists working in Australia determined that heating the solution causes no higher solution concentration of the drug. In fact, adding heat to the mixture actually increases the amount of particulate matter in the solution by causing melted wax to pass through the filter, which produces particles when it cools and solidifies within the syringe.

This image shows the differences between heated and unheated unfiltered solutions of Oxycontin and MSContin.

MScontin and OxyContin unfiltered solution

The reasons that users boil their solutions are varying: some think that by doing so they will kill any bacteria or viruses contained within the mixture, others think that they are getting more of the drug to dissolve into the mix. However, the study cited above found that heating the mixture causes no more drug to be extracted than would be if extracted with cold water. The most commonly injected drugs found in pills (i.e. oxycodone, hydromorphone, morphine, oxymorphone[2]) are water soluble and it takes no heat to get them to dissolve into the water. In fact, some of the modern pills contain abuse deterrent mechanisms in which the solution will turn into a gel when heat is added.[3]

Many people think it is necessary to boil the solution to kill bacteria and viruses. While this is an admirable goal, the cause is hopeless. Users would need to apply heat for much longer than is conventional, and much of the water, if not all of it, would be boiled off by the time most of the germs were killed. The best that can be done is to use a .22 μm (micro-meter) sterile syringe filter, as described below.

Preparing the Solution

An online search will reveal varying and often contradictory information on preparing pills for injection. The best way to prepare pills for injection is through cold water extraction (see below).

Cotton Filters

I am only covering this type of filter because it is the most commonly used; many users may not have access to better kinds of filters, such as wheel filters. According to the study above, cotton filters reduce particulate matter by about 60%. Thus, many particles still make it through these filters and can cause great damage to the veins and the rest of the body.

  1. Crush your pill(s) as finely as possible. A good method is to take a hose clamp, which can be commonly found in hardware stores, and rub your pill back and forth on it. This will shave it into a fine dust. Also, remember to sterilize your hose clamp first by hitting it with a clean flame or by applying isopropyl alcohol to it.

  2. Add the powder to your "cooker," or whatever device you use to mix your solutions. A good tool to use is a table spoon used for measuring volume for cooking. They are deep and commonly hold 15mL (milliliters).

  3. Next you will need to add water to the solution, and then stir thoroughly.

    The amount of water to add depends on the size of the dose that you are preparing. The most oxycodone that can dissolve into 1 ml of water is 160mg. Note that this is a substantial dose—even for a regular user; remember that oxycodone is about as potent as heroin. Gauge the amount of water properly for whatever dose you are taking. For example, if you are taking 80 mg of oxycodone, you will need at least 0.5 ml of water to extract the full amount (80mg).

    This being said, I would recommend adding more water than the bare minimum necessary for the extraction process. For example, if you are preparing 80 mg of oxycodone, I would recommend adding 1mL of water. If you are preparing 40mg, I would recommend using 0.5mL, and so on.

    Morphine is less soluble than oxycodone. The most that 1 ml of water can hold is 60 mg of morphine. Check on the solubility of whatever drug you are going to inject so that you can determine the proper amount of water to use.

    It may be hard to use micron/wheel filters with insulin syringes. You may need to buy a a larger syringe with a removable needle. They can be found for sale online. These syringes make the preparation process much easier.

  4. After you have completed this process, some amount of drug will be left over. To get this, repeat the process to get what you have missed.

By using this method and rinsing twice, you should be able to get 90-95% of the drug extracted from the pill.

.22 μm Wheel Filters

The use of wheel filters should be common practice for injection drug users, regardless of the drug that they will be injecting. Wheel filters reduce 95-99% of particulate matter in a given mixture, thus greatly reducing harm caused by injecting anything. The following image shows the differences between an unfiltered mixture and a mixture prepared using the following method.

Wheel filtering compared to no filtering

In order to use a filter, you must first filter normally using cotton or cigarette filters, otherwise the wheel filters may become clogged. Thus, follow Steps 1, 2, and three above. Then do the following:
  1. Next, filter using your .22μm wheel filter, and then you are ready to inject.

  2. Now you can perform a rinse in much the same way as described above, but filtering with a wheel filter. As with all filtering materials, you should not reuse your wheel filters.

Conclusion

Remember, pills are meant to be swallowed, and there are no current filtering techniques that create a particle-free solution. Exercise extreme caution if you are going to inject pills, and be as clean as you possibly can when you do. Wash your hands first, sterilize your equipment, and most of all, take your time! I know it can be hard not to rush while you are suffering from withdrawal, but the effort will payoff in the long run as you will have little to no medical consequences.

Notes

[1] Some of the information used for this article came from McLean et al. in Harm Reduction Journal.

[2] Common brand names for these drugs are as follows:

[3] I am aware that there are pills with abuse deterrent mechanisms that cause them to gel in any type of water, heated or not. The pills described in this article are standard Oxycontin and MSContin (not the new formulations) as well as any instant release tablets that contain the drugs listed in the second note [2]. It is all but impossible to quickly separate the drug from this type of pill because the drug is bound within the matrix of the pill. Crushing the pill will not subvert the time-release mechanism, as it does with traditional formulations of OxyContin and MSContin. I will be searching for methods to safely inject the pills with these abuse deterrent mechanisms, and writing an article about it in the near future.

by Jay Mack © 2012


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