Most everyone at some point has learned something about Sexually Transmitted Infections (used to be called Sexually Transmitted Diseases). And depending on where you heard about them, you probably have mostly correct information regarding the sexual nature of the topic (you should probably double check what you remember, especially if you only learned in public schools, and 100% should if it was in the southern US.).

This post isn’t about safe sex practices, abstinence, or any sex-specific anatomy at all. This is about the illnesses that can be transmitted through sexual contact, and how they can also be transmitted through substance use. Most diseases not typically considered"STI’s", such as the flu, can also be transmitted the same ways, and the risks of contracting them can also be minimized using the same practices. To keep this post simple, The majority of this post will:

  • Assume you had a minimum “mediocre” sex-ed course at some point and that you’ve at least heard some terms.
  • Treat all common diseases the same instead of specifying which disease can be carried by which method under which circumstances.

Finally, if you’ve got questions, ask in the comments, or message me.

Comments making fun of anyone’s question/comment will be reported, and everyone will know you’re an asshole.

If you spot a comment you think to be misinformation, act like an adult and vote appropriately, and point out what information is incorrect, and why you think it is. Discussion is part of the process and needed, derailing and just general childish tomfoolery is not.

No matter which specific infection(s) we’re talking about, there are basic “catch-all” rules you can follow to avoid the risks of contracting a disease through substance use. The “Mother-of-All-Rule” for all types of harm reduction concerns: “Practice Good Hygiene” serves as the base, or starting point for reducing the risks infectious disease transmission through substance use. Note: many would describe these as “over cautious” in some aspects, and they may be; however, they’re meant to be broad and simple. Any detailed specifics are at the end, or in the comments.

  1. Don’t share any equipment that is used to get high. Even if you think you can trust them. If you’re only going to pick one rule to follow, then this is the one.
  • Equipment you didn’t get yourself should be assumed to be dirty. Someome else’s needles, straws, pipes, foils etc, all increase your risks of exposure to infectious diseases. Even your friend’s one hitter thats only ever had organic pot in it can have something like herpes. (Dollar Bills too! Even currency fresh from the bank has had hands on it, and is gross no matter how baller you look.)
  • This includes water used to dissolve substances for intravenous/nasal/rectal/oral usage. Ideally, fresh distilled water should be used regardless of method or substance. Rectal and oral methods of substance use need clean water, from a fresh bottle or jug. Tap water, or water that’s been sitting open should never be used for any drug use or method.
  1. Don’t reuse any needles, syringes, or anything that comes into contact with blood (yours, or someone else’s).
  • Sharing of needles is probably the most widely known transmission method of STI’s, especially HIV and Hepatitis. But reusing your own needles carries several serious risks as well.
  1. In group settings, think “Chips n Queso”. Treat a bag of drugs (Queso) and your hands/equipment (Chips) the same way you would if sharing a snack at a table full of strangers.
  • Drugs that have come into contact with someone elses equipment, or god forbid directly with someone’s fluids, can also transmit diseases. For example, a pile of cocaine on a mirror that someone’s dirty fingers got out, and dirty blade chopped up, or had their dirty straw in, can carry diseases with it.
  1. And finally, the most sensible rule for substance use overall, including disease risk reduction: Trust nobody.
  • Equipment should be purchased from a store/website/someone that isn’t your dealer, a fellow user, or a fence of stolen goods. Just because you’re familiar with how someone has been in the past, doesn’t mean you can count on them to be the same today. Rapid life changes and substance use often go hand in hand.
  • Your dealer who’s always been a straight shooter for years could have had to pay a fine for his car being towed yesterday and now they didn’t have enough money to pay back their own plug. Your friend could have been sexually assaulted at a party last week and hasn’t told you yet. Any number of things could have happened since you last saw someone, and things change.

That’s all I have currently in the way of general disease harm reduction. Yes, there is a slight overabundance of caution to some of them, but I’d argue that its only slight. A straw that only you and your boyfriend have used, that hasn’t gone up a nose with a cut, is probably not going to carry a risk of HIV. But that’s specific to your exact situation, and also includes your own risk assessments based on trust and general health. The tips above are meant to be for everyone, and are also meant to be as easy as possible to follow.

If you have something else you think fits, comment below. I’ll try to keep this post updated as more interactions and information is added.

Drug-Specific, Method-of-Use-Specific, and Disease Specific information and details:

  • KillingAndKindessOP
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    9 months ago

    One thing I gather from this is a limited number of backup options, or room for error.

    You’re correct. This bulk of the post is a generalized best practice guide. I did not have the personal experience to offer other levels of harm reduction, as they would become too specific and most would be out of my personal substance use history.

    …many people may have trouble getting new syringes. Walgreens might discriminate against them, they might be too afraid to try, they might not have access to a syringe exchange

    I know of no store policies, restrictions, or laws dictating who is allowed to purchase personal injection supplies within the US. Any discrimination would have to be of an individual nature by the pharmacist/pharmacy technician themselves. Now, I remember some people were nervous about it, but I’ve not personally heard of anyone being turned away (with the exception of someone who pocketed something from the store prior to approaching the counter).

    Do you think that its alright to say that, if someone has access to a place that sells them (or exchange) the more effective method of reducing exposure would be getting new equipment, even if it means working through any anxiety and having persistence on the rare occasion you’re denied sale?

    I would think that, while you may be able to effectively clean your own used syringe, since you’re still going to have to have a new needle for each use, then getting a syringe as well is the best way to go about it. (since disease transmission isn’t the only reason needle reuse can cause illness)

    I don’t mean to be a negative nancy, sorry, I really appreciate your input, truly! Your information though is super useful, as not everyone can, or will, follow best-practices. I’ve added your comment to the post.

    • Beegzoidberg@beehaw.org
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      8 months ago

      Your analysis is spot on, and I really respect that your advice cannot fulfill everyone’s needs since it is, as you said, a high level overview. I didn’t think of what I wrote as an essential addition to your writing, just a helpful comment if people scroll through and say, “I can’t do that!”. Really, I think what you wrote is great! And sticking to your learned experience means you can provide the best information possible.

      For context, i work in harm reduction, and i havent injected before. I end up talking to a lot of people who expect to run out of supplies like syringes, narcan, test strips, etc. As a result, we end up talking about next best options, and the most important one I end up sharing is the syringe sanitization. Some people come in to my workplace for supplies, informing me that the pharmacy has refused to sell them syringes and that is why they are coming to me, so you nailed it with personal discrimination. Without giving my location away, certain states in the US impose large penalties for carrying used or unused syringes without a prescription. I carry naloxone vials and syringes to use them, and i could be charged with a felony if i bring a syringe over state lines.

      Now is it alright to say that you should use a new syringe at every opportunity, and attempt to brave that discrimination? Yes! It is especially ok for you, who I assume has lived experience braving that discrimination in some way. While a sanitized syringe is leagues better than a used one with blood or substance in it, a new syringe is leagues better than a sanitized one. And the reasons you state that a new syringe is best are huge. Less damage, less opportunities for hep-c infection, comfort, and more.

      I’d have all kinds of polite corrections to your post if I thought it was lacking, but I didn’t because I don’t! Your desire to educate people is my vibe as well, and your experience is a meaningful addition to your post. I love doing this stuff, which is why I wrote the comment!

      • KillingAndKindessOP
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        8 months ago

        Side note: whenever you have the freetime, Direct message me if you would.

        I thought your information totally fits the post. I know so many people really would benefit from it, thats why I linked it! I would have been mistaken and suggested isopropyl alcohol for cleaning and sterilization, as that seemed effective for my booty bumping syringe when I didn’t want to run to the store for a new one.

        Question for you as I think I’ve spotted some tunnel vision on my behalf regarding needles, and I’ve only ever bought sharps for my estrogen: are you treating needles and syringes the same (mostly) in your comments?

        • Beegzoidberg@beehaw.org
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          8 months ago

          I appreciate it! And you’re right on booty bumping, as long as it isn’t being shared it can be treated like a sex toy (warm water and soap are fine). I do use syringe and needle interchangeably, unless I’m talking about the actual needle, or a syringe for booty bumping.

          And, I know less about taking estrogen than using drugs so the knowledge may be interchangeable in some cases but I surely have gaps in understanding!

          • KillingAndKindessOP
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            8 months ago

            So, needles themselves are reused as often as syringes are? I thought even after the first use, they become incredibly dull, and exponentially so with each attempt? I know people will put up with pain for a high, but I guess I thought the body’s response to a dull needle can and often makes the entire area essentially uninjectable for a while…

            Wow. I always knew needle exchange to be underrated and underfunded, but holy crap. They’re so much more vital that I’d ever thought

            • Beegzoidberg@beehaw.org
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              8 months ago

              Yep, the needle on diabetic syringes are often attached, and they become dull quickly. There’s pictures like these (sorry for the reddit link) of how dull they become, but they still work. It’s a lot of pain, and the area does become uninjecatble over time. Many people have collapsed veins from prolonged use, but so much of that could be avoided with injection site rotation and new syringes. I’ve only grown in my understanding of their importance since I started working here. Another part of the importance is that people can get instruction on safety, narcan, test strips, and communicable infections while they are here. We also do hep-c and hiv testing, and would care! Lots of free stuff that people deserve, and since affirming care is few and far between, we do our best to do that as well.