Guidelines for Steroid Injections

Understanding the correct techniques and procedures for steroid injections is critical, not only in terms of where and how to administer the shots but also regarding sterility practices and anatomical knowledge. First, it's important to address the prevalent myths, rumors, and truths surrounding steroid injections. There are numerous misconceptions both in the general public and within the anabolic steroid-using community about how to inject steroids. This section aims to debunk the common myths, starting with those widely believed by the public and moving on to misconceptions held by steroid users.

Debunking Injection Myths

Myth: Steroids are injected into a vein or artery.

Truth: Anabolic steroids should never be injected intravenously. Typically suspended in oil or water-based solutions, if steroids are introduced directly into the bloodstream, they can cause a pulmonary embolism, and in severe cases, a heart attack. Steroids are meant to be injected into the muscle (intramuscularly), not into a vein or artery.

Myth: Injecting even a tiny air bubble can be fatal.

Truth: The fear of air embolisms from injections is largely overblown, stemming from movie scenes rather than medical reality. It would take a significant volume of air, injected intravenously, to cause harm. Small air bubbles are often intentionally left in a syringe by steroid users to ensure no product is wasted, without adverse effects.

Myth: Steroids injected into a specific muscle will cause growth only in that area.

Truth: This is not the case for almost all anabolic steroids due to esterification, which prolongs hormone release into the system. Once injected, the steroid doesn't remain localized but circulates in the body, working wherever the body needs it, not just at the site of the injection.

Myth: Incorrect injection techniques, like subcutaneous injection or not going deep enough, will always cause an abscess.

Truth: Steroids can be injected subcutaneously, though they're primarily designed for intramuscular injections. An abscess only occurs if the injection site becomes infected, emphasizing the importance of proper technique and sterility.

Preparation for Steroid Injections

Prior to administering steroid injections, one must be well-informed about the process, have the necessary sterile supplies, and ensure a suitable environment to avoid complications such as infections, abscesses, or tissue damage. Here are the key preparation steps:

  • Collect all necessary materials (syringes, needles, alcohol swabs, etc.) before starting any cycle. It's critical to avoid reusing or sharing needles due to the risk of transmitting infectious diseases like HIV/AIDS and hepatitis.
  • Verify the integrity of the syringes, needles, and alcohol swabs, ensuring they are hermetically sealed to maintain sterility.
  • Do not pre-load syringes. Chemicals in the solution may degrade the syringe material if left in contact for too long, leading to potential health hazards if injected.

Categories of Steroid Injections

Intramuscular (IM) Injections

Designed for anabolic steroids, IM injections deliver a preparation (usually oil-based) deep into the muscle tissue. The goal is to achieve a consistent release into the bloodstream. This technique allows for larger volumes of liquid, accommodating up to 4 – 5 mL (or CCs) in some muscles, with most muscles handling 2 – 3 mL (or CCs) without discomfort. It's crucial to alternate injection sites to prevent administering to the same muscle more frequently than every 7 – 14 days.

Subcutaneous (SQ) Injections

Typically involving a water-based solution, SQ injections are made into the fat layer beneath the skin. While oil-based solutions can also be administered subcutaneously, it's less common. SQ injections are predominantly used for insulin, HGH, HCG, and peptides. With SQ injections, small volumes are standard, as the subcutaneous layer is less suited for larger quantities. Research indicates that anabolic steroids maintain effective blood plasma levels when administered subcutaneously, just as they do with IM injections.

Injection Gear: Syringes, Needles, and Accessories

Understanding medical jargon is essential:

  • mL or CC: Milliliter and cubic centimeter are interchangeable units of volume measurement, with 1 mL equaling 1 CC.
  • Gauge: Refers to needle thickness – the higher the gauge number, the thinner the needle.
  • Length: The needle's length, which typically ranges from ½” to 1.5”.

Common injection supplies include:

  • 3mL Syringes: The norm for IM injections, occasionally sold with pre-attached needles.
  • 5mL Syringes: Larger syringes for holding more liquid, similar to 3mL syringes in their packaging.
  • Hypodermic Needles: Available in various gauges and lengths, tailored for both withdrawing the solution from vials and for the injection itself.
  • Alcohol Swabs: Crucial for maintaining a sterile environment.
  • Insulin Syringes: Standardized syringes with fixed needles, ideal for SQ injections, typically with a 1 mL volume.
  • Band-Aids or Cotton Balls: Suggested for stemming any bleeding post-injection.

Steroid Injection Techniques

Intramuscular (IM) Injection Steps:

  1. Start with clean hands and sanitized equipment.
  2. Prepare the injection area with an alcohol swab.
  3. Use separate syringes and needles where possible.
  4. Assemble your gear, taking care to maintain sterility.
  5. Draw the solution into the syringe, ensuring no air bubbles remain.
  6. Disinfect the injection site with alcohol, allowing it to dry.
  7. Replace the drawing needle with an injection needle.
  8. Insert the needle firmly into the muscle at a 90-degree angle.
  9. Aspirate before injecting to avoid blood vessels.
  10. Inject the solution slowly.
  11. Withdraw the needle and cover the site with a Band-Aid or cotton ball.

Subcutaneous (SQ) Injection Steps:

  1. Disinfect the vial and injection site thoroughly with alcohol swabs.
  2. Fill the insulin syringe with the prescribed dose.
  3. Pinch the skin to access the subcutaneous layer and insert the needle at a 45-degree angle.
  4. Inject the substance slowly.
  5. Remove the needle and cover the injection site if necessary.

Injection Sites for Steroids

  • The injection site should be clearly marked and located in a recommended area, such as the upper outer quadrant of the gluteus muscle.
  • Rotate injection sites to avoid using the same muscle within a 7 – 14 day period.
  • Allow time for alcohol to dry to ensure sterilization and prevent contamination.
  • Avoid touching, blowing on, or breathing on the needle tip or rubber stopper of the vial after it has been sterilized.

Final Reminders and Best Practices for Steroid Injections

  • Rotate IM injection sites.
  • Allow alcohol to dry completely for sterilization.
  • Maintain needle and site sterility at all times.
  • Consider the Z-track method for IM injections to prevent the medication from leaking from the muscle.

This comprehensive guide ensures the safe and effective administration of steroid injections, whether intramuscularly or subcutaneously.