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Muscling and skin poppingMuscling and
Skin Popping
Information for injection drug users

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Click here for current Needle Exchange Schedule.
En español: haga click aquí para "Intramusclar y pinchandose"

What is muscling?

Muscling is when you inject into muscle instead of a vein. Most people muscle in the upper arms or legs.

What is skin-popping?

Skin-popping is when you inject between skin and fat layers. Also called "subcutaneous" or "sub-Q," it is injecting the drug just underneath the skin.

Why do people muscle or skin-pop?

Lots of reasons. Some people just don?t like to inject right into a vein. Others have a hard time hitting their veins. For some, trying to hit a vein gets so frustrating that they just give up and shoot anywhere they can. Some do it because drugs absorb more slowly this way. Muscling and skin-popping give you less of a "rush," but the effects of the drug may last longer. Some folks don?t care about the rush. They?re just trying to keep from getting dope sick. Finally, some people muscle or skin pop to reduce their risk for overdosing.

Use new clean equipment!

Use clean equipment!

What are the harms of muscling and skin-popping?

All injectors are at risk for infections related to using needles. Muscling and skin-popping allow germs to "sit" inside muscle and fat tissue or under the skin. These are great places for abscesses and other infections to brew. Infections in these a reas can be very serious. They can also spread to the blood, bones, heart and other places in the body. Some of the worst infections include wound botulism, tetanus (also called "lockjaw") and necrotizing fasciitis ("flesh eating disease"). If not treated quickly, these and other infections can become life-threatening and result in death.

Is shooting into a vein safer than muscling or skin-popping?

No. All three have serious risks. All three put you at g reat risk for blood-borne infections like HIV and Hepatitis B and C. Although muscling and skin-popping may cause more abscesses and skin infections, shooting into a vein may be more likely to cause serious long-term illnesses like endocarditis. This is an infection of the heart valves. It can do permanent damage to your heart. It can also kill you. Injecting into a vein also increases your risk of dying from an overdose. This is because the dope gets to your heart, brain and other organs much quicker than if you muscle or skin-pop.

Wash your hands and skin!

Use plenty of hot soapy water! Follow up with alcohol pads!

If you skin-pop:

  • Do so in your upper arms or thighs.
  • Don't inject more than 1/2 cc in one spot.
  • Do not skin-pop speed or cocaine.

If you muscle:

  • Relax your muscle before you inject. It will be less painful.
  • Pull back on the plunger to make sure you haven?t hit a blood vessel. If you hit blood, pull out and try again in another area. Remember to clean the new area before you try to hit again.
  • Hit big fleshy areas such as the outside of your upper arm, the top of your thigh, or your butt.
  • Avoid the bony areas below your elbow or knee -- especially around your wrist.

How to clean the injection site

Step One: Take an alcohol pad and wipe back and forth where you plan to inject. (This will probably be your arm.) You want to press kind of hard this time. Use as many pads as you need to get the dirt off your skin. But don't stop here! You're not done! That's why wipes come two to a pack.
Step Two: Now grab a new pad, and press down over the spot where you're going to inject. This time, wipe in a circle. Start with small circles and make bigger circles as you go. This pushes any leftover dirt and bacteria on your skin outward from the spot where you're going to shoot.

How to reduce your risk

Whether you inject into muscle, a vein, or under the skin, it is always important to use sterile equipment. If you don't have sterile equipment, use bleach to clean all of your works before you use them again. Muscling and skin-popping do not lower your risk of infection. But here are 8 ways to reduce your risks:

  1. Always use a brand new sterile syringe every time you inject.
  2. Wash your hands and the injection site well. Use plenty of hot soapy water. Getting bacteria into the muscle, fat tissue or under the skin is a leading cause of abscesses.
  3. Use an alcohol pad to clean the injection site. See the box for directions on how to use alcohol pads.
  4. Use a clean cooker and fresh clean water to cook your hit.
  5. Filter the hit well. Use a brand new cotton every time you draw up a hit.
  6. Rotate injection sites. This will reduce abscess formation. It will also give your skin and muscle a chance to heal.
  7. Get a tetanus booster. If you inject, it is a good idea to get one every five years. You can get a booster at the downtown needle exchange medical clinic.
  8. Don?t muscle or skin-pop speed or cocaine. It may be painful and is more likely to cause an abscess.

Hard-to-hit veins? Abscesses?

Talk to our abscess and vein care specialist at the needle exchange. Get expert advice and helpful hints to reduce your risk of getting nasty abscesses and life-threatening infections. Ask Needle Exchange staff for times and locations. Or visit the new medical clinic at the downtown needle exchange. The clinic is open Monday through Friday from 1:30 pm to 4:30 pm. Walk-ins welcome. Click here for the current Needle Exchange schedule.

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All information is general in nature and is not intended to be used as a substitute for appropriate professional advice. For more information please call (206) 296-4600 (voice/TDD).

Updated: Tuesday, April 23, 2002 at 02:57 PM PDT

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