Non-medical use:

Notes on use by drug users for the injection of illicit drugs
These notes are written for needle and syringe programme staff buying, and advising drug users on the use of 21G 40mm 1½ inch green needles for distribution through a needle and syringe programme.

They will also be of interest to injecting drug users.

Cautions / Harm Reduction Advice For Injectors of Anabolic Steroids
21G green needles are well suited to the drawing up of anabolic steroids from ampoules, although in doing so the needle can be blunted and damaged so it should not be used for injecting.

Even if it isn't blunted, people who inject anabolic steroids intramuscularly should not need to use a 21G green needle for the actual injection – a 23G blue needle or 22G black needle would be more suitable and less damaging. So after drawing up with this needle, it should be safely disposed of and replaced with a 23G blue needle or 22G black needle – both of which we always stock at exchangesupplies.org.

Cautions / Harm Reduction Advice For Femoral Injectors
21G 1½ inch green needles are also regularly used by groin injectors who have very deep veins which are highly scarred. This practice is highly damaging and speeds up damage to the site, and the vein. In part, the use of this needle for the groin has often been due to lack of alternatives. Encouragement to use a finer needle – such as the 23G blue needle or 22G black needle needle could reduce harm.

Injecting in the femoral vein is always a high risk activity – workers should always encourage, support and explore other, less risky alternatives such as route changes, and identifying other sites.

For those who are opiate dependent, entering drug treatment and getting a prescription for methadone or buprenorphine can significantly reduce injecting and the associated harm.

A 21G 1½ inch green needle should not be the needle of choice for femoral injectors: a finer gauge needle will almost always be preferable from a harm reduction point of view. By using the smallest needle that reaches the vein, damage to the femoral vein can be reduced but not prevented.

Care of the site, including regular washing, pre-injection cleaning, and resting of the vein will help reduce damage and promote healing.