Reducing harm through the development of good preparation practices for the injection of slow release morphine sulphate capsules

When slow release morphine sulphate capsules are diverted by injection, the use of filters is essential to prevent long term complications due to the injection of insoluble drug fillers such as talc and starch. This research provided us with a “best preparation practice” for slow release morphine sulphate capsules. This practice consists of preheating water, followed by adding beforehand crushed microbeads to the solution, then waiting and stirring for about a minute, followed by filtration through a membrane filter. The three membrane filters tested were equivalent in number of particle reduction. Filtration ease and time was acceptable for all and best for the Sterifilt and the Sterifilt+. As for active compound yield, though all membrane filters recovered more than 86% of the available morphine, the Sterifilt+ was associated with the highest yield (99%). The provision of a method that is easy to use, reduces harms associated to the injection of insoluble particles and recovers virtually all the active drug has a large chance to be adopted by people who use drugs. This type of “best practices” can be provided by drug workers and by people who use drugs to actively promote harm reduction.