There’s a whole new population of injecting drug users. They buy peptides online for muscle building, weight loss, to aid workout recovery, or improve their skin or sleep. Few see themselves as injecting drug users.But these peptides are drugs, injected like any other. They’re often distributed by illicit online sellers and don’t come with safety advice.Peptide injectors may not go looking for injecting advice, or assume the safety information doesn’t apply to them – those who do often don’t know where to find it. Injecting without that guidance is already harming the health of these new drug injectors. Peptide-related hospitalisations in New South Wales have surged, from five in July 2025 to more than 200 in September 2026.Let’s look at how we got here and the safety basics injectors need to know.Syringe services are stretchedAustralian needle and syringe programs are free services that hand out sterile equipment. Many of these services have reported a dramatic increase in people seeking injecting equipment for peptides. This is putting pressure on needle and syringe programs that were historically funded to distribute injecting equipment to reduce the spread of blood-borne viruses such as HIV.Services in some regional towns have reported that syringe vending machines have emptied within hours of restocking.Unfortunately, when sterile equipment runs out, it’s not long before people who use drugs share needles. This can lead to much more serious health complications, such as the spread of HIV and hepatitis C.These services need to be funded to scale up to meet the rise in demand that peptides are bringing.Injectors are making basic mistakesThere is no source of health expertise when someone is sold peptides. Someone buying peptides online may receive a vial in a padded envelope. Perhaps a few syringes are thrown in. There is no leaflet and certainly no health practitioner. Injectors are left to learn from forums, influencers, or a friend at the gym.This is very different to a person being prescribed weight loss injections by their local GP. They’re shown how to inject safely, provided a sharps container for their used needles, and told what signs of injection site infection to watch for.Without this information, injectors are making basic mistakes. There have been reports of re-using needles, poor injecting hygiene and missing early signs of infection.Australia’s medicines regulator, the Therapeutic Goods Administration, is seeking to restrict the illegal, or black and grey market of peptides.But this doesn’t help the people who already have peptide vials in the fridge and will keep using them. Those people need safety information now.So, here are five safety basics they may not have been told.1. Don’t re-use needlesNeedles blunt after a single use, and a used needle carries bacteria from your skin into your body. Reusing one is a common cause of skin infections and abscesses. Use a new, sterile needle and syringe every time.2. Never share injecting equipmentDon’t share needles and syringes (yes, sharing a vial with a partner or gym mate counts).Blood-borne viruses can also spread through shared vials, even if you never share a needle. So this advice also extends to vials, bacteriostatic water (the sterile water used to dissolve peptide powder before injecting), swabs and anything else that touches the injection. Never share this equipment. 3. Treat what’s in the vial as unknownPeptides sold online are not tested like medicines. Research shows the label does not match what’s inside, and the product may be contaminated.Know the signs of infection: redness that spreads, heat, swelling, pus, or feeling feverish and unwell. If you become suddenly very unwell after injecting, seek urgent medical care. Tell them exactly what you injected, when you injected it, and where it came from. Don’t be embarrassed about telling them.4. Get a sharps container and use itDon’t leave used needles loose in the car, a drawer or a gym bag, where someone else can be stabbed by one.Used needles should never go into a regular waste bin, where they can injure family members, cleaners or waste workers. Needle and syringe programs give out sharps containers for free. When the container is full, return it to a needle and syringe program, a public sharps disposal bin, or a participating pharmacy.5. Walk into a needle and syringe programThese services exist for anyone who injects. The staff are non-judgemental and experts in safer injecting.You can find your nearest service through your state health department. New South Wales, for example, provides this interactive map. Services are confidential and you won’t be asked to give your name. Carrying equipment you got from a program is legal.The health system needs to catch upPeople using peptides may not see themselves as drug users because peptides are marketed and thought of more along the lines of wellness.Health services need to bear this in mind when distributing information. That means safety information has to reach them where they already are: online, in gyms, and in the places they buy.It also means needle and syringe programs must be funded for the number of people they are actually serving, not the number they were serving years ago. Right now, the services absorbing this new population are doing it on budgets built for a different era, and a different injector.Jason Ferris receives or received funding from National Institute of Health, Medical Research Future Fund, National Health and Medical Research Council, Australian Research Council, Queensland and Western Australia Mental Health Commission, and Australian Defence Force. He is currently a Technical Advisory Group member for the Australian National Drug Strategy Household Survey and The World Health Organization Alcohol and Drug Epidemiology Group. From 2019-2025 he was an Advisory Council member for the Queensland Mental Health Commission.Timothy Piatkowski receives funding from National Health and Medical Research Council, Queensland Mental Health Commission, Queensland Injectors Voice for Advocacy and Action, and Alcohol and Drug Foundation. He is affiliated with Queensland Injectors Voice for Advocacy and Action (Vice Chair), The Loop Australia (Research Lead – QLD), and The Enhanced Games (Performance Enhancement Task Force). He is a co-founder of Safe Pulse, a charity focused on harm reduction for individuals who use human enhancement drugs.Kimberley Akrigg and Samuel Cornell do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.