Information taken directly from “Guide to Developing and Managing Syringe Access Programs” by Harm Reduction Coalition, 2010.
“Cottons”, also called filters, are used to filter impurities in the drug mix when pulling it into the syringe. Filters should be 100% cotton (or a medically appropriate alternative) and usually come in the form of smaller and/or larger pellets. Cottons will often be reused in an effort to get as much residual drug out of the cotton; this is referred to as a rinse. Smaller pellets are harder to use multiple times; less reuse will decrease the likelihood of cotton fever, ac condition related to injection drug use that is cause by injecting bacteria that can develop in used cottons or filters.
Blood in used cottons can transmit HCV and other blood-borne injections if a contaminated cotton is used to fix drugs for injection. Blood can get into cottons in the same ways as with cookers (see above). In addition, cottons can easily grow/collect harmful bacteria when left over time and reused. IDUs should be encouraged to use a clean cotton and/or their own cotton for every injection.
In the absence of safe and sterile cottons, drug users will commonly use other products to filter their drugs, including cotton swabs, tampons, pieces of clothing and cigarette filters among other things. Participants should be advised that cigarette filters contain tiny particles of plastic or glass and are dangerous for use as a filter. Participants should also be advised that if they are using other items as filters, cotton works best, the cleaner the item the better, and it is important to wash hands when pulling pieces off for use, to reduce the likelihood of bacteria being transferred to the filter. (p. 37)
Information taken direction from “Getting Off Right: A Safety Manual for Injection Drug Users”, by Harm Reduction Coalition 1998.
Most injectors draw their drug solution from a cooker or spoon into a syringe through some type of filter- most often a pieces of cotton or other absorbent material. The filter acts to keep out particulate matter and other foreign objects you don’t want in your shot, and enables you to get just about every drop of the drug solution into your syringe so that none of it is wasted.
-Clean, 100% cotton from a Q-Tip or cotton ball is the safest thing you can use to filter your drug solution. Filter paper or a small piece of tampon are safe alternatives.
-Rayon and other synthetic fibers often don’t absorb liquid as well as cotton, and may prevent you from being able to adequately draw up all of your drug solution.
-Cigarette filters are not safe to use since they contain tiny pieces of glass, and, if from a cigarette that has already been smoked, substances from the smoke that can be harmful if injected.
-Pocket lint may work if it’s all you got.
-You might consider skipping the filter altogether if you have nothing safe to use.
-Use a fresh cotton every time you shoot up, and as with needles, syringes, and cookers, never use someone else’s cotton or let them use yours; infections, bacteria, and viruses can all be transmitted through sharing cottons.
-Make sure your fingers are as clean as possible before you tear off and roll up your cotton.
-Finally, many of us cook up our old cottons to squeeze what we can out of them when we have no more money for drugs. Unfortunately, fungi and bacteria can live and grow in these old cottons (which, because they are moist after use, provide ideal environments for microbes) and cause “cotton fever” when re-used at a later time. Cotton fever is an infection characterized by chills, sweating, fever, and other flu-like symptoms. It may go away on its own or, if it persists or worsens, require medical attention. (pp. 15-16).