Author: Don Stader, M.D Educational Pearls: It is important for providers to know how to use IV drugs properly so that they can instruct their patients on how to avoid injury. Heroin use is increasing. Hepatitis, HIV and infection are possible complications of improper IV drug use The first step of heroin use is to dissolve the solid heroin in water using heat - a spoon and lighter are often used for this step. Next, the heroin is drawn into the syringe through a filter (cotton is often used). Heroin concentration often varies widely - counsel patients to test their heroin first. Sterility of the needle, water, cooker, cotton and syringe is paramount. Refer patients to a needle exchange program where they can get clean supplies. Hepatitis C can live outside the body for 4 days - NEVER share ANY supplies. Sterile procedure is important - needles should not be licked. References: http://drugsense.org/flyers/10_tips_for_safer_use.pdf