When you’re prescribed a biologic therapy, you’re not just getting a new drug-you’re taking on a new responsibility. These powerful medications, used for conditions like rheumatoid arthritis, psoriasis, or Crohn’s disease, come in pens or syringes you’re expected to inject yourself. Sounds simple? It’s not. Many people are sent home with a device and a quick demo, then left to figure it out alone. And that’s where things go wrong.
Training Is Often Incomplete-And It’s Dangerous
You’d think if you’re going to inject yourself with a biologic, you’d get proper training. But according to a 2022 study, nearly one in three patients received no formal training at all. Even worse, many got just a five-minute demo and were told to "do it like that." That’s not training. That’s a gamble. Real training has three parts: tell, show, and try. Tell means someone explains the steps. Show means they demonstrate it with a training device. Try means you do it-under supervision-until you get it right. Only 27% of patients in one study got all three. The rest? They wing it. And when you wing it, mistakes happen. The CDC says improper injection technique increases infection risk by 37%. That’s not a small number. It means more redness, swelling, pus, even hospital visits. One patient in a Reddit thread said: "They showed me once, had me do it once, and sent me home with six months of medication. No follow-up." That’s the norm.Why Infections Happen (And How to Stop Them)
Infections from biologic injections don’t come from the drug itself. They come from how you handle it. The skin isn’t sterile. Your hands aren’t sterile. Your environment isn’t sterile. If you don’t clean properly, bacteria get pushed under the skin-and biologics suppress your immune system. That means your body can’t fight back as well. Here’s what actually works:- Wash your hands for 20 seconds with soap and water. Don’t just wipe them with alcohol. Soap removes more germs.
- Let the injection site air-dry after cleaning with alcohol. Don’t wipe it off. Letting it dry fully kills more bacteria.
- Use a new needle every time. Reusing needles-even once-creates tiny burrs that tear skin and trap bacteria.
- Rotate injection sites. Never inject in the same spot twice within a week. Use your thigh, abdomen, or upper arm. Keep injections at least one inch apart.
- Check for signs of infection: redness larger than two inches, warmth, swelling, pus, or fever above 100.4°F (38°C). If you see any, call your doctor. Don’t wait.
The Hidden Problem: Anxiety and Rushed Steps
It’s not just about technique. It’s about fear. Many patients freeze during their first injection. They rush. They skip steps. They don’t let the alcohol dry. They press the button too early. They pull the device away before the full dose is delivered. A technique called "breathing room" helps. It’s simple: have someone gently place their hand over yours while you inject. Just enough pressure to stop you from jerking away. This reduces premature device removal by 88%. It’s not about holding your hand-it’s about calming your nerves. And then there’s the emotional side. One patient described her ritual: "I light a candle, play my favorite song, and sit in the same chair every time. It’s not about the medicine. It’s about feeling in control." That’s not silly. That’s smart. Studies show patients who create a consistent routine are 41% more likely to stick with treatment. Rituals reduce anxiety. Anxiety reduces mistakes.
Training That Actually Works
Single sessions don’t work. Your brain doesn’t retain complex steps after one 30-minute demo. The best training is spread out. Three short sessions over two weeks beat one long session every time. Here’s what real training should look like:- Session 1: Learn the steps. Watch a video. Handle the training device. Practice the motion without a needle.
- Session 2: Do it with supervision. Use a training pen. Have your provider watch and correct your grip, angle, and timing.
- Session 3: Do it alone, then teach it back. Explain each step out loud. If you can’t describe it, you don’t know it.
Who Should Be Helping You?
Doctors don’t have time to teach injection technique. Nurses might. But the real experts? Pharmacists. They’re trained in medication counseling. They know how to explain complex drugs in plain language. They’ve seen what goes wrong. And yet, only 12% of patients get injection training from a pharmacist. Ask for it. Say: "Can I meet with the pharmacist before I start? I want to make sure I do this right." Most pharmacies have time for this. They want you to succeed.
What to Do If You’re Already Injecting
If you’re already on biologics and haven’t had proper training, don’t panic. But don’t wait either.- Call your clinic. Ask for a return demonstration. Say: "I want to make sure I’m doing this correctly. Can we go over it again?"
- Use a training device from the manufacturer. Most companies give them out for free. Practice daily for a week.
- Record yourself injecting. Watch it back. Do you pause after clicking? Do you hold the device steady for 10 seconds? If not, fix it.
- Find a support group. Reddit’s r/rheumatology has thousands of people who’ve been there. Ask questions. Learn from their mistakes.
The Bottom Line
Biologic therapies can change your life. But only if you use them safely. Training isn’t a formality. It’s your safety net. Infection risk isn’t theoretical. It’s real-and preventable. You don’t need to be a nurse. You just need to know the steps, have the right tools, and feel confident doing them. That’s not too much to ask. And it’s not too hard to get. You just have to ask for it.Can I reuse a biologic injection needle if I only use it once?
No. Never reuse a needle, even if you think it’s still sharp. Each use dulls the tip slightly, creating tiny rough edges that can tear your skin and trap bacteria. Reusing needles also increases pain and risk of infection. Always use a new needle for every injection.
How do I know if my injection site is infected?
Look for redness larger than two inches, warmth to the touch, swelling, pus, or a fever above 100.4°F (38°C). Mild redness right after injection is normal-but if it spreads or gets worse after 24 hours, contact your doctor. Don’t wait. Biologics weaken your immune system, so infections can spread faster than usual.
Is it safe to inject in the same spot every time?
No. Injecting in the same spot repeatedly can damage tissue, cause lumps under the skin, and increase infection risk. Always rotate sites. Use your abdomen, thigh, or upper arm. Keep injections at least one inch apart. Keep a log or use an app to track where you’ve injected.
Why do I feel dizzy or nauseous after injecting?
Dizziness or nausea after injection is often caused by anxiety, not the medication itself. The stress of the procedure triggers your body’s fight-or-flight response. Practice slow breathing before and during the injection. Try the "breathing room" technique-have someone gently place their hand over yours. If symptoms persist, talk to your doctor. It could also be a reaction to the drug, not the technique.
Can I skip training if I’ve injected before?
No. Even if you’ve injected before, each biologic has different devices, activation methods, and dosing rules. What worked for one drug won’t work for another. Always get trained on the specific device you’re using. Never assume you know how to use it.
Do I need to refrigerate my biologic before injecting?
Check the label. Most biologics must be refrigerated until use, but some can be kept at room temperature for a few days. Never leave them in a hot car or direct sunlight. If your medication looks cloudy, clumpy, or discolored, don’t use it. Call your pharmacy. Proper storage ensures the drug stays effective and safe.