Not all acids are created equal, but they do all have risks.
'Brown' heroin (ie Afghan heroin sold in Europe) and crack cocaine both require the user to 'cook down' their drug with an acidifier if they are going to be injected. But which are the best options and what's the advice that we should be giving along with them?
Firstly there are some acids that should always be avoided outright like vinegar and lemon juice. Not only are these non-sterile to start with, but they are also able of growing a fungus that can lead to both blindness and endocarditis. OK, so lemon juice is out. What, historically have people used? I've put some of the usual suspects here along with their risk factors:
- Brewers/Cooking Citric
This is non-sterile, food grade citric.So while the amount of bacteria is fine for ingesting it isn't anything you'd want to put in your veins. This kind of citric is also made up of large, course grains which increases the chances of adding in too much to your solution.
- Kettle De-scaler
Another common form of citric, however this isn't even at a food grade so may contain even more impurities than cooking citric. The grains are also usually very large.
- Citric/VitC sold in tubs
OK things are getting better, at least we've reduced the grain size and have a product that's sterile. Well.... its sterile until its opened. Once opened this is only slightly better than the food grade, and may even cause extra problems by making people think it's safer than it is. Bacterial from the air, peoples breath, or dirty fingers taking pinches can increase the bacterial load.
- Other things
Some people have used a wide range of different acids for cooking up, personally the strangest I've heard of was the coating of 'fizzy cola bottle' sweets. As Jim Morrison said 'people are strange'.
Right that covers the bad acids, so what do we want people to use?
Both citric acid and VitC (ascorbic acid) are now legally (in the UK) available in single use sachets from a number of different companies. So great risk free, just give it to them and off they run right? Nope.
In reality any acid added to an injecting solution is likely to cause vein damage.
Most of the sachets available contain more powder than is needed for a standard £10 bag. While this may seem a strange thing to do there is a good reason for it. the general idea is that you're giving people enough acid to cook down the gear for a single shot, even if the person injecting is having more than one bag at a time. So, we have to make sure that injectors know to only use as little as they can to 'cook down' their shot, and then THROW THE REST AWAY, after all its no longer sterile.
Using too much acid will increase the risk of vein damage as well as possibly damaging some of the drug being taken. Now I don't know about you, but I'm constantly having long conversations with people insisting that they even need a couple of sachets for just a single £10 bag. One company (Exchange Supplies ) have done something to help, if you order your citric or VitC via them they will supply you with free DVD's or videos that explain the science behind acidifiers, including the effect the acid had on the quantity of the drug. The best bit is they will give you enough of these DVDs for each needle exchange visitor to have one each for free. In our exchange these have not only proved very popular, but they have also helped change the injecting habits of a number of out visitors.
Acidifiers Advice (Part 2): differences between citric and VitC and go into more detail on the risks of using too much acid.
Nigel Brunsdon is the owner of Injecting Advice.com. He's been working in harm reduction since the 1990's, although he's previously a frontline needle programme worker he now spends most of his time developing online resources for drugs workers and users.