Cookers

Product Description

Cookers or spoons are used when dissolving pills, powdered or solid drugs with water, and/or acidifiers. They are often heated prior to injection. If reused, this piece of equipment can be a transmitter of blood-borne viruses, so it is important to remind clients that just like needles, cookers are for single use only. There are two types of cookers distributed by OHRDP: The Spoon and The Stericup. These cookers are sterile safer than table spoons, cans, or bottle caps, as they heat more evenly and quickly. These cookers retain heat longer helping to kill bacteria and viruses.

Practice/Usage

• Cookers are used when diluting or mixing a drug with sterile water and/or an acidifier, and for cooking or heating the drug. Cookers may smoke a little when heated, but there is no paint, plastic or residue on them that could be potentially harmful.
• Clients should be informed to heat their drug mixture for a minimum of 15 seconds to kill as much bacteria as possible (City of Ottawa Memo File # 003, Dec 2004). The handle is shorter than that of a cutlery spoon so clients need to be careful when heating. Depending on the source used for heating the time may need to be increased or decreased, example a lighter emits less heat than a gas burner.
• The two types of cookers are slightly different in shape and depth which can affect their stability on a surface and increase the potential of spilling the contents. Clients should be advised to take care when using the cookers and to ensure that the surface they are using to prepare on is clean and level.
• Like needles, it is best to provide one cooker for each injection per person. It is recommended to estimate approximately 1,000 needles per person, per year so, a Needle Exchange Program (NEP) should estimate 1000 cookers per person per year.
• Best Practice Recommendations (2006) indicate that guidelines for the safe disposal of injection equipment other than sharps are not available at this time. Until such time as best practice guidelines are available for the safe disposal of this product, used equipment should be disposed of following the BPRs for needles and syringes (in the biohazard containers).

Discussion/Associated Risks

• Studies have shown people injecting drugs share injection equipment more often than they share needles (Strike C and Leonard L, 2006 p105).
• Further studies have revealed that although people may inject with their own new sterile needle they may have shared other injection equipment like, cookers, filters and water containers (Strike C and Leonard L, 2006, p105).
• A Seattle study measuring the HCV seroconversion among a cohort of 317 active Seattle residents who inject drugs, who tested negative for HCV antibody at recruitment found that those who shared cookers and filters (but not syringes) had elevated the risk of HCV seroconversion six-fold. It was determined that 54% of HCV infections among this group were attributed to cooker and filter sharing (Strike C and Leonard L, 2006 p106).

Sources

• City of Ottawa memo, from Paul Lavigne, Harm Reduction Project Officer, December 2004
• Strike C, Leonard L, Millson M, Anstice S, Berkeley N, Medd E. Ontario needle exchange programs: Best practice recommendations. Toronto: Ontario Needle Exchange Coordinating Committee. 2006
• Getting off Right, A Safety Manual for Injection Drug Users, Harm Reduction Coalition
• www.exchangesupplies.org/publications/safer_injecting_briefing/section3.html