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Intramuscularly (IM)

Intramuscular injections deliver medication into well-perfused muscle, providing rapid systemic action and absorbing relatively large doses. The choice of site should take into account the general physical status and age, and amount of drug to be given.

Like IV methods, IM can be very potent way of taking drugs.  The needle is injected in to the upper arm, thigh or buttock.  The speed at which the drug gets to work will vary. This is not as difficult as IV but you should still know what you are doing before attempting this route. Sterile equipment is still required - ask your local harm reduction service for additional advice.

Harm Reduction Messages

IM can give veins a rest from the daily grind, but this method will cause irritation to the tissue and skin around the site. The level of irritation will depend on the drug you are using. The long-term outcome will often look like cellulite.

The proposed site for injection should be inspected for signs of inflammation, swelling, and infection and any skin lesions should be avoided. If injections are repeated frequently, the sites should be rotated evenly. IM injections should be given at a 90-degree angle. The needle is inserted and injection given. Allow 10 seconds before removing the needle to allow the substance diffuse into the muscle. With anabolic steroid use the person should be injecting into their upper, outer quadrant and should avoid contact with the sciatic nerve. Potential complications of IM injections are nerve injury, septic abscesses, necrosis, gangrene and intramuscular haemorrhage.

Aspiration (the process of drawing back the syringe) should be practised in IM injectors as if a needle is mistakenly placed in a blood vessel, the drug may be given intravenously by mistake and could cause an embolism as a result of the chemical components of the drug. Inject at a rate of 1ml every ten seconds.

Change the needle after preparation of the drug and before administration to ensure that it is clean, sharp, dry and the correct length.

Anabolic steroid users should apply pressure to the site and massage the muscle to help the substance absorb. This is NOT the case with other substances.