WHAT

WORKS?
A comprehensive guide to safer needle
and syringe selection for injecting drug users.

tools for harm reduction

What works? (product code: A299)
Written by: Andrew Preston, Jon Derricott, and Kevin Flemen

© 2011 Exchange Supplies

What works? will be regularly updated – if you have

any comments or suggestions, please send them to
andrew@exchangesupplies.org, or call on 01305 262244

Other titles
If you like ‘What works?’ other titles we stock
that might be of interest include:

Safer injecting handbook (product code: P303)

Needle poster (product code: A300)

Full details, and online ordering at exchangesupplies.org

All the needles and

syringes in this book 12 mm [ 1/2 inch ]
are available online at Product code: A210
exchangesupplies.org
– our product code is listed underneath the
needle length at the top left of every page.
What works?
A comprehensive guide to safer
needle and syringe selection for
injecting drug users.
This booklet is written for people injecting
illicit drugs such as heroin, cocaine, crack,
and amphetamine. It does not cover the
use of equipment for injecting steroids.
Use it to look up the needle you’re using,
and see if there are any safer alternatives.

3
 Important note for all injectors!
Injecting is dangerous, and there is no way
to completely remove its risk. We’d urge
you to consider smoking or sniffing the
drugs you take instead.
If you are opiate dependent, getting into opiate
substitution treatment – such as methadone
prescribing – can really help you stop or reduce
injecting, and reduce your overdose risk.

If you are going to inject, this guide is designed

to help you choose the needle that will cause
you least damage.

There are a lot of other things you can do to

reduce the risk of injecting, and we also publish
a book called ‘the safer injecting handbook’
which covers everything from injecting site
hygiene to injection technique.

4
Which needle?
If you are injecting, the best needle
to use is the shortest, thinnest one that
will reach the site, and enable you to
inject without it breaking.
You can reduce the risk of
the needle breaking by:
■ not letting go of the syringe once the needle
has gone through the skin;
■ reducing bending of the needle to a minimum;

■ changing needles if finding a vein doesn’t

happen first time; and
■ keeping steady while you inject.

5
 How to use this book
Using the ‘alternatives’ table
By each needle there is a table with a colour coded guide
to the alternatives. The aim of the alternatives listing is
to give an at a glance guide to other needles that you
could use. The best needle is the shortest, thinnest
needle that can reach the vein, and is strong enough
to do so without breaking.

We suggest that you start by looking up the needle

you’re using now, and seeing what the safer alternatives
might be.

Alternatives

12 mm Nevershare 30G

12 mm Yellow 30G

12 mm Insulin 29G

12 mm Grey 27G

12 mm Brown 26G

16 mm Grey 27G

16 mm Orange 25G

16 mm Blue 23G

20 mm Grey 27G

Alternative table for the 16 mm orange (page 24)

6
The needle size ‘traffic light’ system
We have colour coded the alternative needles according
to the level of risk.

Green: a shorter and/or thinner needle.

Light amber: a needle used for injecting in the groin

that is shorter or thinner so may cause less damage,
but it’s still always dangerous.

Amber: a thicker needle that is the same length, or

a longer needle that is the same thickness: both will
cause more damage to the vein and injecting site.

Red: a big step up in risk terms because the needle is

significantly thicker and/or longer. It is a needle that
people moving to more dangerous injecting sites use.
If you are thinking about changing to a needle that
is red, please consider stopping injecting.

On the inside back cover is

a flap that lists all of the
available needles in order
of length (then gauge)
– if you have this open
when reading the book you
can see exactly where you are in terms of risk.

7
 Needle length, gauge and bore
Needle length
The stated length of the needle can either be the visible
length, or the total length of the needle from end to end
– including the portion of the needle that is in the plastic.
This means that the actual needle length can vary, and
may be slightly shorter than the measurement stated.
Needles are measured in both inches and millimetres,
because fractions of an inch can be confusing, we have
used millimetres.

Luer slip
The exact angles inside the hub of needles that allow them
to grip onto the syringe with friction alone are known as
a ‘Luer slip’ fitting. Syringes made for detachable needles
are called ‘Luer slip syringes’.

Luer slip

8
Needle gauge (the needle diameter / thickness)
Confusingly, the bigger the number the thinner the needle.

On the labelling and boxes for needles, where the gauge

number is given, the word gauge is always shortened to
just the letter ‘G’.

The gauges used for needles range from 30G (the thinnest)
to 21G (the thickest). Each gauge is allocated a colour
so that people can tell which is which.

30G 27G 26G 25G 23G 22G 21G

Yellow Grey Brown Orange Blue Black Green

Needle bore (the hole down the middle)

The gauge only describes the outer diameter, not the
hole down the middle (the bore) which can vary.

In general the thicker the needle, the larger the bore but
some of the thinner needles – such as the nevershare –
have a smaller bore so that the wall thickness, and strength,
can be maintained.

9
 High dead space syringes
What is dead space?
The dead space is the space beyond the plunger that is
filled with blood after the injection. Luer slip syringes made
for detachable needles have a large dead space that holds
more blood, which makes them more dangerous when shared.

1 ml and 2 ml Luer slip

Good for small volume injections for people who can’t
find veins easily, and might need to change needles
midway through the process. But there is increased risk
of blood-borne virus transmission.

The dead space between the plunger and tip stores more
blood than an all-in-one syringe, so makes sharing more risky.
The fine dosage 1 ml syringe offers a safer alternative.

Dead space

10
Low dead space syringes
Insulin type fixed needle syringes
Good for: being less fiddly, having a thin needle attached,
having low dead space for blood to collect after injection and
therefore lower HIV, and hepatitis B and C transmission risk.

Not so good for: people who can’t get a vein quickly,

and people injecting larger volumes of liquid.

The nevershare syringe comes with plungers in a range

of colours to help prevent accidental sharing.

Fine dosage syringe

A low dead space syringe for detachable needles.
The plunger has an extension that fits down into the
dead space to ensure all the fluid is expelled.

11
12 mm [ 1/2 inch ] Nevershare [ 30G ]
Product code: S140

Main use
The nevershare needle is designed
30 GAUGE
[ NEEDLE THICKNESS ] for injecting into surface veins.

Being thin, the 30G needle is the

50
best for injecting into small veins,
and many injectors have been able
40 to stop injecting in the groin, and
use it to inject into very small veins.
30

20
Plungers in a range
of colours to prevent
accidental sharing.
10

LENGTH
[ 12 mm / 1/2 inch ]

12
 Alternatives

Notes 12 mm Nevershare 30G

All thin needles should be used 12 mm Yellow 30G

with care – don’t let go of the 12 mm Insulin 29G
syringe once the needle has gone
12 mm Grey 27G
through the skin, and keep steady
during the injection. If you can’t find 12 mm Brown 26G
a vein straight away, change the 16 mm Grey 27G
syringe before the needle gets blunt.
16 mm Orange 25G
The nevershare is as strong as 16 mm Blue 23G
the yellow detachable Luer slip
20 mm Grey 27G
needles, and other insulin type
syringes. 25 mm Brown 26G

25 mm Orange 25G
The nevershare and Luer slip yellow
needles are the least dangerous to 25 mm Blue 23G

use for injection into surface veins. 30 mm Blue 23G

The other needles used for surface 30 mm Black 22G

vein injection are shown under 40 mm Orange 25G
‘alternatives’ on the right.
40 mm Black 22G

40 mm Green 21G

50 mm Green 21G

13
12 mm [ 1/2 inch ] Yellow [ 30G ]
Product code: A210

Main use
The yellow needle is designed for
30 GAUGE
[ NEEDLE THICKNESS ] injecting into surface veins.

Being thin, the 30G needle is the

50
best for injecting into small veins.

Many groin injectors have been

40
able to use it to find and use very
small veins.
30
If you’re changing from a thicker
needle to a thinner one, you may
20 need to pull back more carefully,
pause to see if you’re in the vein,
10 and inject more slowly. It’s worth
being patient – it’s causing less
damage to your veins.
0

LENGTH
[ 12 mm / 1/2 inch ]

14
 Alternatives

Notes 12 mm Nevershare 30G

All thin needles should be used 12 mm Yellow 30G

with care – don’t let go of the 12 mm Insulin 29G
syringe once the needle is through
12 mm Grey 27G
the skin, and keep steady until
you’ve finished injecting. 12 mm Brown 26G

16 mm Grey 27G
The advantage of a ‘detachable’
needle is that if you can’t find a vein 16 mm Orange 25G
straight away, you can change the 16 mm Blue 23G
needle before it becomes blunt.
20 mm Grey 27G

25 mm Brown 26G

25 mm Orange 25G

25 mm Blue 23G

30 mm Blue 23G

30 mm Black 22G

40 mm Orange 25G

40 mm Black 22G

40 mm Green 21G

50 mm Green 21G

15
12 mm [ 1/2 inch ] Insulin [ 29G ]
Product code: A257

Main use
Insulin syringes are widely used for
29 GAUGE
[ NEEDLE THICKNESS ] injecting into the small veins of the
arms, hands, legs and feet.
50
Some insulin syringes have
an orange cap but they don’t
40 have an orange needle:
orange needles are thicker.

30

20

10

LENGTH
[ 12 mm / 1/2 inch ]

16
 Alternatives

Notes 12 mm Nevershare 30G

If you can find a vein with a 27G 12 mm Yellow 30G

or insulin syringe, then you should 12 mm Insulin 29G
consider switching to the nevershare
12 mm Grey 27G
syringe because it has a thinner
needle. There is less tissue damage 12 mm Brown 26G
with a thinner needle, and less risk 16 mm Grey 27G
of accidental sharing when using
16 mm Orange 25G
a syringe with coloured plungers.
16 mm Blue 23G
If you have difficulty finding a vein
20 mm Grey 27G
consider switching to a 1 ml Luer
slip syringe (although see page 10 25 mm Brown 26G

for more information about the 25 mm Orange 25G

extra risks) and changing the 25 mm Blue 23G
needle before it gets blunt. If you
30 mm Blue 23G
do this pick up more needles than
syringes from the needle exchange. 30 mm Black 22G

40 mm Orange 25G

40 mm Black 22G

40 mm Green 21G

50 mm Green 21G

17
12 mm [ 1/2 inch ] Grey [ 27G ]
Product code: A221

Main use
A slightly thinner and shorter
27 GAUGE
[ NEEDLE THICKNESS ] (and therefore safer) alternative
to the commonly used orange
50 needle.

The 12 mm and 20 mm grey

40 needles are widely used for
injecting into the small veins of
30 the arms, hands, legs and feet.

If you need a thicker needle than

20 the nevershare or yellow needle
so that you can inject into riskier,
deeper veins, the 12 mm grey
10
needle is less of a step up the risk
ladder than a move to the 16 mm
0 orange needles.

LENGTH
[ 12 mm / 1/2 inch ]

18
 Alternatives

Notes 12 mm Nevershare 30G

The 12 mm grey needle isn’t 12 mm Yellow 30G

stocked by all needle exchanges, 12 mm Insulin 29G
so you may have to ask staff to
12 mm Grey 27G
order it for you.
12 mm Brown 26G
If you’re changing from a thicker
16 mm Grey 27G
needle to a thinner one, you may
need to pull back more carefully, 16 mm Orange 25G
pause to see if you’re in the vein, 16 mm Blue 23G
and inject more slowly. It’s worth
20 mm Grey 27G
being patient – it’s causing less
damage to your veins. 25 mm Brown 26G

25 mm Orange 25G

25 mm Blue 23G

30 mm Blue 23G

30 mm Black 22G

40 mm Orange 25G

40 mm Black 22G

40 mm Green 21G

50 mm Green 21G

19
12 mm [ 1/2 inch ] Brown [ 26G ]
Product code: A233

Main use
A slightly thinner and shorter
26 GAUGE
[ NEEDLE THICKNESS ] (and therefore safer) alternative
to the commonly used 16 mm
50 orange needle.

The 12 mm brown needles are

40 mainly used for injecting into
the small veins of the arms,
30 hands, legs and feet.

If you need a thicker needle than

20 the nevershare or yellow needle
so that you can inject into riskier,
deeper veins, the 12 mm brown
10
needle is less of a step up the risk
ladder than a move to the 16 mm
0 orange needles.

LENGTH
[ 12 mm / 1/2 inch ]

20
 Alternatives

Notes 12 mm Nevershare 30G

The 12 mm brown needle isn’t 12 mm Yellow 30G

stocked by all needle exchanges, 12 mm Insulin 29G
so you may have to ask staff to
12 mm Grey 27G
order it for you.
12 mm Brown 26G

16 mm Grey 27G

16 mm Orange 25G

16 mm Blue 23G

20 mm Grey 27G

25 mm Brown 26G

25 mm Orange 25G

25 mm Blue 23G

30 mm Blue 23G

30 mm Black 22G

40 mm Orange 25G

40 mm Black 22G

40 mm Green 21G

50 mm Green 21G

21
16 mm [ 5/8 inch ] Grey [ 27G ]
Product code: A234

Main use
For injection into surface veins,
27 GAUGE
[ NEEDLE THICKNESS ] the 16 mm grey offers a thinner,
less damaging alternative to the
50 widely used orange needle.

Anyone using the 16 mm grey

40 needle for injecting into surface
veins could consider one of the
30 shorter or thinner needles.

The 16 mm grey may also be

20 suitable for injecting in the groin
by people who are thin, and whose
femoral vein has not been pushed
10
back by long term injecting.

Great care must be taken when

0
using a grey needle for injection
in the groin to avoid movement
or bending that could break it.
LENGTH
[ 16 mm / 5/8 inch ]

22
 Alternatives

Notes 12 mm Nevershare 30G

The 16 mm grey needle isn’t 12 mm Yellow 30G

stocked by all needle exchanges, 12 mm Insulin 29G
so you may have to ask staff to
12 mm Grey 27G
order it for you.
12 mm Brown 26G

16 mm Grey 27G

16 mm Orange 25G

16 mm Blue 23G

20 mm Grey 27G

25 mm Brown 26G

25 mm Orange 25G

25 mm Blue 23G

30 mm Blue 23G

30 mm Black 22G

40 mm Orange 25G

40 mm Black 22G

40 mm Green 21G

50 mm Green 21G

23
16 mm [ 5/8 inch ] Orange [ 25G ]
Product code: A213

Main use
The orange needle used to be the
25 GAUGE
[ NEEDLE THICKNESS ] most commonly used detachable
needle, although the grey and
50 yellow needles are a better choice
for many injectors. It is mainly
used for injecting into the veins
40
of the arm, leg, hands and feet.

30 Some groin injectors, especially

those of light build, where the
femoral vein is just below the surface
20 and not scarred or pushed back
by long term injecting, may be
10 able to use a 16 mm orange
needle to reach the vein.

0 Great care must be taken when

using an orange needle for injection
in the groin to avoid movement
LENGTH or bending that could break it.
[ 16 mm / 5/8 inch ]

24
 Alternatives

Notes 12 mm Nevershare 30G

It’s important to know that although 12 mm Yellow 30G

some insulin syringes come with 12 mm Insulin 29G
orange caps, they are not orange
12 mm Grey 27G
needles. Insulin syringe needles
are thinner than the orange 12 mm Brown 26G
detachable Luer slip needle. 16 mm Grey 27G

If you are switching from an insulin 16 mm Orange 25G

syringe to separate needles and 16 mm Blue 23G
syringes, use a thinner grey or
20 mm Grey 27G
yellow needle rather than orange.
25 mm Brown 26G

25 mm Orange 25G

25 mm Blue 23G

30 mm Blue 23G

30 mm Black 22G

40 mm Orange 25G

40 mm Black 22G

40 mm Green 21G

50 mm Green 21G

25
16 mm [ 5/8 inch ] Blue [ 23G ]
Product code: A228

Main use
The 16 mm blue can be used by
23 GAUGE
[ NEEDLE THICKNESS ] groin injectors whose femoral
vein hasn’t been pushed too far
50 back to be reached by it.

A shorter, and therefore potentially

40 less damaging, alternative to the
25 mm blue needle. For injectors
30 who have scarring at the femoral
injecting site, it offers a slightly
stronger alternative to the grey and
20 orange needles of the same length,
but it will leave a bigger hole.
10

LENGTH
[ 16 mm / 5/8 inch ]

26
 Alternatives

Notes 12 mm Nevershare 30G

If you are injecting into the groin, 12 mm Yellow 30G

it would be much safer to use 12 mm Insulin 29G
a yellow needle or nevershare to Injecting in the groin is always
12 mm try
dangerous: Grey
a short thin needle
27G
inject into small veins instead. to find surface veins instead.
12 mm Brown 26G

16 mm Grey 27G

16 mm Orange 25G

16 mm Blue 23G

20 mm Grey 27G

25 mm Brown 26G

25 mm Orange 25G

25 mm Blue 23G

30 mm Blue 23G

30 mm Black 22G

40 mm Orange 25G

40 mm Black 22G

40 mm Green 21G

50 mm Green 21G

27
20 mm [ 3/4 inch ] Grey [ 27G ]
Product code: A211

Main use
Some groin injectors, especially
27 GAUGE
[ NEEDLE THICKNESS ] those of light build, where the
femoral vein is just below the
50 surface and not scarred, may be
able to use a 20 mm grey needle
to reach the vein.
40
Using a 20 mm grey needle will
30 cause less damage to injecting
sites and veins than blue or
orange needles.
20

10

LENGTH
[ 20 mm / 3/4 inch ]

28
 Alternatives

Notes 12 mm Nevershare 30G

The 20 mm grey needle offers a 12 mm Yellow 30G

slightly thinner alternative to the 12 mm Insulin 29G
brown and ‘long orange’ needle. Injecting in the groin is always
12 mm try
dangerous: Grey
a short thin needle
27G
If you are injecting into the groin, to find surface veins instead.
12 mm Brown 26G
it would be much safer to use
16 mm Grey 27G
a yellow needle or nevershare to
inject into small veins instead. 16 mm Orange 25G

16 mm Blue 23G

20 mm Grey 27G

25 mm Brown 26G

25 mm Orange 25G

25 mm Blue 23G

30 mm Blue 23G

30 mm Black 22G

40 mm Orange 25G

40 mm Black 22G

40 mm Green 21G

50 mm Green 21G

29
25 mm [ 1 inch ] Brown [ 26G ]
Product code: A212

Main use
The 25 mm brown is too long for
26 GAUGE
[ NEEDLE THICKNESS ] injecting into surface veins.

It is used by some groin injectors

50
instead of a 25 mm orange needle.
Great care must be taken when
40 using it to inject into the groin to
avoid movement or bending that
30 could break it.

20

10

LENGTH
[ 25 mm / 1 inch ]

30
 Alternatives

Notes 12 mm Nevershare 30G

The 25 mm brown needle is not 12 mm Yellow 30G

stocked by all needle exchanges, 12 mm Insulin 29G
but it is worth asking for if you’re Injecting in the groin is always
12 mm try
dangerous: Grey
a short thin needle
27G
currently using the ‘long orange’, to find surface veins instead.
and don’t need the extra strength 12 mm Brown 26G
of the thicker needle to push 16 mm Grey 27G
through scar tissue.
16 mm Orange 25G

16 mm Blue 23G

20 mm Grey 27G

25 mm Brown 26G

25 mm Orange 25G

25 mm Blue 23G

30 mm Blue 23G

30 mm Black 22G

40 mm Orange 25G

40 mm Black 22G

40 mm Green 21G

50 mm Green 21G

31
25 mm [ 1 inch ] Orange [ 25G ]
Product code: A214

Main use
This needle is too long to use for
25 GAUGE
[ NEEDLE THICKNESS ] surface veins.

It can be used to inject into deep

50
veins, including the femoral vein.
Whilst still damaging, this will be
40 less damaging than the thicker
blue or green needles.
30 With thin needles there is increased
risk of snapping, so care should be
20 taken not to move during injection.

Don’t use the orange needle if

10 there is a lot of tough scar tissue
to push through.

LENGTH
[ 25 mm / 1 inch ]

32
 Alternatives

Notes 12 mm Nevershare 30G

This 25 mm orange needle is almost 12 mm Yellow 30G

twice the length of a ‘short orange’ 12 mm Insulin 29G
and it is sometimes known as a Injecting in the groin is always
12 mm try
dangerous: Grey
a short thin needle
27G
‘long orange’. However, there is to find surface veins instead.
also a 40 mm orange available 12 mm Brown 26G
– a seriously long orange! 16 mm Grey 27G

So, if you ask for ‘long orange’ 16 mm Orange 25G

you should make sure you get 16 mm Blue 23G
the right one!
20 mm Grey 27G

25 mm Brown 26G

25 mm Orange 25G

25 mm Blue 23G

30 mm Blue 23G

30 mm Black 22G

40 mm Orange 25G

40 mm Black 22G

40 mm Green 21G

50 mm Green 21G

33
25 mm [ 1 inch ] Blue [ 23G ]
Product code: A216

Main use
Some people who inject in the
23 GAUGE
[ NEEDLE THICKNESS ] groin use the 25 mm blue needle.

If possible, a move down to the

50
thinner 25 mm orange needle
would be preferable. The thinner
40 needle will cause less damage to
the site and the vein.
30 However, if you have a lot of scarring
at the injection site, this might not
20 be possible for you.

10

LENGTH
[ 25 mm / 1 inch ]

34
 Alternatives

Notes 12 mm Nevershare 30G

Injecting in the groin is particularly 12 mm Yellow 30G

dangerous and this blue needle 12 mm Insulin 29G
is in the middle of the risk range: Injecting in the groin is always
12 mm try
dangerous: Grey
a short thin needle
27G
thinner and shorter than the to find surface veins instead.
green or black needles, but 12 mm Brown 26G
slightly thicker than the brown 16 mm Grey 27G
and orange needles.
16 mm Orange 25G

16 mm Blue 23G

20 mm Grey 27G

25 mm Brown 26G

25 mm Orange 25G

25 mm Blue 23G

30 mm Blue 23G

30 mm Black 22G

40 mm Orange 25G

40 mm Black 22G

40 mm Green 21G

50 mm Green 21G

35
30 mm [ 11/4 inch ] Blue [ 23G ]
Product code: A217

Main use
Some people who inject in the
23 GAUGE
[ NEEDLE THICKNESS ] groin use the 30 mm blue needle.

If it will reach, a move to the shorter

50
25 mm blue would reduce the risk
of going right through the femoral
40 vein. If it will reach the vein, and
doesn’t bend when hitting scar
30 tissue, switching to the shorter
and thinner 25 mm orange would
be preferable, as it will make a
20 smaller hole, and cause less
damage to the vein.
10
However, if you have scarring at
the injection site, or a vein that
0 has been pushed back by repeated
injections, moving to a shorter
needle may not be possible, and
LENGTH there isn’t a thinner 30 mm needle.
[ 30 mm / 11/4 inch ]

36
 Alternatives

Notes 12 mm Nevershare 30G

Injecting into any deep vein – 12 mm Yellow 30G

particularly the groin – is always 12 mm Insulin 29G
dangerous. Injecting in the groin is always
12 mm try
dangerous: Grey
a short thin needle
27G
For deep vein injection, this blue to find surface veins instead.
12 mm Brown 26G
needle is in the middle of the risk
16 mm Grey 27G
range: thinner and shorter than
the green or black needles, but 16 mm Orange 25G
slightly thicker than the brown 16 mm Blue 23G
and orange needles.
20 mm Grey 27G
The extra 5 mm adds additional 25 mm Brown 26G
risk over the 25 mm blue needle:
25 mm Orange 25G
take care.
25 mm Blue 23G

30 mm Blue 23G

30 mm Black 22G

40 mm Orange 25G

40 mm Black 22G

40 mm Green 21G

50 mm Green 21G

37
30 mm [ 11/4 inch ] Black [ 22G ]
Product code: A218

Main use
The 30 mm black needle can be
22 GAUGE
[ NEEDLE THICKNESS ] used for injecting in the groin.

If possible, a move down to a

50
thinner and/or shorter 25 mm
or 30 mm blue or orange needle
40 would be preferable as the thinner
needle will cause less damage to
30 the site and the vein.

However, if you have scarring at

20 the injection site, or a vein that
has been pushed back by repeated
injections, moving to a thinner or
10
shorter needle may not be possible.

LENGTH
[ 30 mm / 11/4 inch ]

38
 Alternatives

Notes 12 mm Nevershare 30G

The 30 mm black needle is not 12 mm Yellow 30G

commonly available from all 12 mm Insulin 29G
needle exchanges, but it offers Injecting in the groin is always
12 mm try
dangerous: Grey
a short thin needle
27G
a slightly safer alternative to the to find surface veins instead.
commonly available green needle 12 mm Brown 26G
– so if you think it could reduce 16 mm Grey 27G
your risk, ask them to order it.
16 mm Orange 25G

16 mm Blue 23G

20 mm Grey 27G

25 mm Brown 26G

25 mm Orange 25G

25 mm Blue 23G

30 mm Blue 23G

30 mm Black 22G

40 mm Orange 25G

40 mm Black 22G

40 mm Green 21G

50 mm Green 21G

39
40 mm [ 11/2 inch ] Orange [ 25G ]
Product code: A215

Main use
The 40 mm orange is used by groin
25 GAUGE
[ NEEDLE THICKNESS ] injectors who can no longer reach
the femoral vein with a 25 mm or
50 30 mm needle, and who don’t
have access to the vein restricted
by scar tissue.
40
For those who can use it, the 40 mm
30 orange offers a less damaging
alternative to other, thicker, 40 mm
needles – although it must always
20 be used with great care to avoid
breaking the needle.
10

LENGTH
[ 40 mm / 11/2 inch ]

40
 Alternatives

Notes 12 mm Nevershare 30G

Using a 40 mm orange needle to 12 mm Yellow 30G

inject in the groin must be done 12 mm Insulin 29G
with great care to avoid breaking Injecting in the groin is always
12 mm try
dangerous: Grey
a short thin needle
27G
the needle. to find surface veins instead.
12 mm Brown 26G
This means is being steady during
16 mm Grey 27G
injection, and being careful to
avoid the use of force or bending 16 mm Orange 25G
the needle. 16 mm Blue 23G

Injecting in the groin is always 20 mm Grey 27G

dangerous. The long term health 25 mm Brown 26G
consequences can be serious but
25 mm Orange 25G
using the thinnest needle possible
can reduce the tissue damage and 25 mm Blue 23G

delay health problems. 30 mm Blue 23G

30 mm Black 22G

40 mm Orange 25G

40 mm Black 22G

40 mm Green 21G

50 mm Green 21G

41
40 mm [ 11/2 inch ] Black [ 22G ]
Product code: A222

Main use
The 40 mm black needle can be
22 GAUGE
[ NEEDLE THICKNESS ] used for injecting in the groin.

It offers an alternative to the

50
slightly thicker green needle,
reducing the tissue and vein
40 damage and so can help slow the
progression to serious problems.
30 If possible, a move down to a
thinner and/or shorter blue or
20 orange needle would be preferable
as the shorter needle will cause less
damage to the site and the vein.
10

LENGTH
[ 40 mm / 11/2 inch ]

42
 Alternatives

Notes 12 mm Nevershare 30G

Injecting in to any deep vein – 12 mm Yellow 30G

particularly the groin – is always 12 mm Insulin 29G
dangerous, but using a 40 mm Injecting in the groin is always
12 mm try
dangerous: Grey
a short thin needle
27G
needle causes serious tissue and to find surface veins instead.
vein damage, and increases the 12 mm Brown 26G
risk of damaging the artery or nerve. 16 mm Grey 27G

16 mm Orange 25G

16 mm Blue 23G

20 mm Grey 27G

25 mm Brown 26G

25 mm Orange 25G

25 mm Blue 23G

30 mm Blue 23G

30 mm Black 22G

40 mm Orange 25G

40 mm Black 22G

40 mm Green 21G

50 mm Green 21G

43
40 mm [ 11/2 inch ] Green [ 21G ]
Product code: A219

Main use
Used by some to reach a femoral
21 GAUGE
[ NEEDLE THICKNESS ] vein that has been pushed deep
by years of injecting it will cause
50 further tissue damage, and serious
damage to the vein.

40 People injecting into a femoral vein

often suffer from clots that form in
30 the vein – known as deep vein
thrombosis (DVT). DVTs can break
loose and lodge in the lung and
20 heart, which can be life threatening.
This complication is very common
10 in people using green needles.

The vein damage can also cause

0 circulation problems in the leg
and foot, and injecting with this
needle will speed up, and worsen,
LENGTH these problems.
[ 40 mm / 11/2 inch ]

44
 Alternatives

Notes 12 mm Nevershare 30G

Injecting in the groin is always 12 mm Yellow 30G

dangerous, but using a 40 mm 12 mm Insulin 29G
needle causes serious tissue and Injecting in the groin is always
12 mm try
dangerous: Grey
a short thin needle
27G
vein damage, and also increases to find surface veins instead.
the likelihood of damaging the 12 mm Brown 26G
artery or nerve. 16 mm Grey 27G

Anyone using this needle should 16 mm Orange 25G

consider using a black needle or, 16 mm Blue 23G
if there’s not much scar tissue,
20 mm Grey 27G
an orange or brown needle.
25 mm Brown 26G
If you need to use a 40 mm green,
25 mm Orange 25G
you should seriously consider
switching to other ways of taking 25 mm Blue 23G

drugs such as smoking or sniffing. 30 mm Blue 23G

30 mm Black 22G

40 mm Orange 25G

40 mm Black 22G

40 mm Green 21G

50 mm Green 21G

45
50 mm [ 2 inch ] Green [ 21G ]
Product code: A220

Main use
Used by some to reach a femoral
21 GAUGE
[ NEEDLE THICKNESS ] vein that has been pushed deep
by years of injecting it will cause
50 further tissue damage, and serious
damage to the vein.

40 People injecting into a femoral vein

often suffer from clots that form in
30 the vein – known as deep vein
thrombosis (DVT). DVTs can break
loose and lodge in the lung and
20 heart, which can be life threatening.
This complication is very common
10 in people using green needles.

The vein damage can also cause

0 circulation problems in the leg
and foot, and injecting with this
needle will speed up, and worsen,
LENGTH these problems.
[ 50 mm / 2 inch ]

46
 Alternatives

Notes 12 mm Nevershare 30G

Your needle exchange may not 12 mm Yellow 30G

stock the 50 mm green, and we 12 mm Insulin 29G
can understand why: it causes Injecting in the groin is always
12 mm try
dangerous: Grey
a short thin needle
27G
so many problems. to find surface veins instead.
12 mm Brown 26G
Anyone considering using this
16 mm Grey 27G
needle should seriously consider
switching to other ways of taking 16 mm Orange 25G
drugs such as sniffing or smoking, 16 mm Blue 23G
and getting into treatment.
20 mm Grey 27G

25 mm Brown 26G

25 mm Orange 25G

25 mm Blue 23G

30 mm Blue 23G

30 mm Black 22G

40 mm Orange 25G

40 mm Black 22G

40 mm Green 21G

50 mm Green 21G

47
 Cleaning works
If you can, always use a new sterile needle
and syringe. If you are going to re-use a
needle or syringe, clean it like this:

WATER
AN
E
CUP OF CL

BLEACH
IN
H
CAPFUL OF T

1
WATER
AN
E
CUP OF CL

Get two clean cups.

Fill them with clean water.
(do not use boiling water – it can make the blood clot)

Pour out a capful of thin bleach.

48
 WATER
AN
E
CUP OF CL

Draw up water from the first cup.

(Fill the syringe completely to rinse and clean it)

Empty the syringe into the sink.

BLEACH
IN
H
CAPFUL OF T

Draw up the thin bleach.

(Make sure the outside of the needle gets dipped
in bleach to kill any virus that is on the outside)

Empty the syringe into the sink.

49
 WATER
AN
E
CUP OF CL

Draw up water from the second cup.

Empty the syringe into the sink.

Carefully put the cap back on the syringe.

Pour the contaminated water

and bleach down the sink.

Wash both cups.

1 x water 1 x bleach 1 x water

kills

But always use a new sterile

needle and syringe if you can.

50
 0 10 20 30 40 50

S140 12 mm Nevershare 30G

A210 12 mm Yellow 30G

A257 12 mm Insulin 29G

A221 12 mm Grey 27G

A233 12 mm Brown 26G

A234 16 mm Grey 27G

A213 16 mm Orange 25G

A228 16 mm Blue 23G

A211 20 mm Grey 27G

A212 25 mm Brown 26G

A214 25 mm Orange 25G

A216 25 mm Blue 23G

A217 30 mm Blue 23G

A218 30 mm Black 22G

A215 40 mm Orange 25G

A222 40 mm Black 22G

A219 40 mm Green 21G

A220 50 mm Green 21G

0 10 20 30 40 50
What works? is a guide to injecting
equipment for people injecting illicit
drugs such as heroin, cocaine, crack,
and amphetamine.
This booklet does not cover the use
of equipment for injecting steroids.
You can use it to look up the needle
and syringe you’re using, and see if
there are alternatives that might cause
less damage to your injecting site
and veins.
You can order copies of this book
from exchangesupplies.org,
the product code is A299.

tools for harm reduction