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Identifying the risks
There are two major problems that may occur during the process of preparing, taking and injecting:
Infection
Any non–sterile substance entering the body is able to cause infection. This can take the form of a local reaction such as an abscess, or more generalised infections such as septicæmia. These can be due to bacteria, viruses, fungi, yeasts, etc. If there are traces of blood in the substance entering the body, there is also the risk of transmitting infections such as hepatitis B, hepatitis C and HIV from one person to another.
Dirty hit
This is an allergic or toxic reaction to an injected substance, which could be small particles of paper, cotton, soot or any unknown substance mixed with the drug. This seems to be a transient reaction, but often lasting many hours, where the user feels cold, shaky and may have a severe headache. This reaction may also be known as cotton fever or paper fever.