Whenever I move jobs to a new exchange, or if I’m seeing someone I’ve never worked with before then swabbing is normally the first bit of advice I give. Mainly I do it as a trust builder, if someone’s never met me before then they have no frame of reference on my abilities or knowledge. Plus it seems that anywhere I go, even though this is the most basic of the harm reduction messages I use, that no one seems to have been giving it.

Everyone takes swabs. Heroin, crack, pills, steroids it doesn’t matter what’s being injected. In reality for most people soap and water is a better idea, but there is something wonderfully …. medical… about a swab.

So… when people ask for them I usually ask “When are you swabbing, before or after?”. And you can put money on it that the answer is either “after” or “both”.

Unfortunately the time you should use a swab is BEFORE injecting, ideally about 10 seconds before (to allow the alcohol to evaporate) and with just a single, firm rub on the skin. So why not use it after? Well its because alcohol thins blood, if you put it on an open wound then you will promote rather than stem the bleeding. The more you bleed, the more you bruise. Also the more you bleed the more blood you have to cross contaminate with.

Of course the first thing most people ask then is “well how the hell do I stop the bleeding then?”. If you are lucky enough to have an exchange that gives out any form of stericup there is a small square of absorbent paper, that is for post injection swabbing and not … I repeat …. not, a coaster for putting the used cooker/spoon on to stop soot marks getting on your table.

Why this is important

Obviously it’s important for the health implications. But more than that it’s about building relationships. I could spend ages talking about hepC, or detailing the details of vein structure, but that is all so horribly abstract. Someone you give swabbing advice to is know to know the very next time they inject that you know what you are talking about.

We should be focusing on these basics first, they build trust.