Drugs can be abused in a variety of ways; while some people may take them orally, others may smoke, snort, or inject them. The practice of “shooting up,” or injecting drugs directly into the bloodstream by means of a needle is particularly dangerous, as it can instantaneously produce intense and intoxicating effects that can speed the development of an addiction and otherwise result in significant health risks.
Some drugs that are commonly injected include heroin, cocaine, methamphetamine, opioid painkillers, and prescription stimulants. Each drug is extremely dangerous to inject and can have fatal consequences.
What Is Intravenous Drug Use?
Intravenous drug use involves injecting a substance into a vein using a syringe. This method of administration produces rapid and heightened effects because it bypasses the process of first pass metabolism that all orally administered drugs undergo, in which the drug must first be absorbed in the intestines, carried to the liver and subjected to hepatic metabolic processing before reaching the bloodstream. Injecting a drug allows it to enter the bloodstream immediately, which increases the speed of delivery to the brain. The effects can often be felt within a minute of injecting the drug 1.
Due to the rapidly felt, intensely rewarding effects, shooting up a drug such as heroin can raise the user’s risk of developing an addiction, as well as the likelihood of experiencing overdose.
Injection-Related Health Effects
Any method of drug injection – be it intravenous, intramuscular or subcutaneous – can result in a slew of harmful health effects that may include 2:
- Inflamed and/or collapsed veins.
- Puncture marks / track lines.
- Skin infection – abscesses, cellulitis, necrotizing fasciitis.
- Bacteria on the cardiac valves, endocarditis, and other cardiovascular infections.
- Swelling of the feet, ankles, and legs secondary to poor peripheral blood flow.
While the above are general injection-related health effects, there are some other dangers common to drugs prepared with many adulterant chemicals, binders and other toxic substances. Black tar heroin, for example, which is named after its tar-like consistency, contains a large amount of additives and contaminants 3. These can cause local inflammation, clog blood vessels and contribute to widespread damage to the following organs 3:
Because chronic, repeated injection of drugs such as heroin may lead to venous sclerosis, or a loss of veins to inject in, users will often switch to injecting intramuscularly or subcutaneously as opposed to intravenously 8. This increase in intramuscular injection can lead to the following dangers:
- Necrotizing fasciitis 6,7: A serious skin infection caused by bacteria that kills tissue in the body. This can cause a user to lose his or her limbs.
- Wound botulism 4,5: The bacteria, Clostridium botulinum, which enters a wound caused by needle puncture, can lead to paralysis and death.
- Gas gangrene 8,9: This potentially fatal infection is often caused by Clostridium perfringens, and can lead to tissue death.
- Tetanus 8,10: Caused by Clostridium tetani, this infection can cause lockjaw, problems swallowing, rigid muscles in the abdomen, and stiffness in the neck.
Dangers of Sharing Needles
Many people suffering from a drug addiction do not take the necessary safety precautions when shooting up; they often share needles, which can lead to exposure to and exchange of bodily fluids and subsequent infectious diseases. Those who share needles are at risk of contracting the following:
- Hepatitis B and C.
- Multitudes of other blood borne bacterial, fungal and viral infectious agents.
In order to decrease the spread of these diseases, needle exchange programs have been formed, which provide intravenous drug users with free sterile syringes. They also collect the used and contaminated syringes to prevent transmission to others. These syringe exchange programs are located across the country, as well as in Puerto Rico. In addition to clean needles, these programs usually distribute alcohol pads and condoms 11.
Interested in learning more about drug & alcohol abuse? Check out the DrugAbuse.com research library here.
Long-Term Health Risks
Chronic intravenous drug users are at risk for developing long-term health problems associated with continued and persistent use. Although different kinds of drugs have varying long-term health risks, some examples of potential consequences include:
- AIDS as a result of HIV.
- Chronic hepatitis leading to liver cancer or cirrhosis.
- Severe weight loss.
- Increased risk of suicide.
- Sexual dysfunction.
- Decay of white matter in the brain. (Negatively impacts behavioral regulation and decision-making.)
- Cardiovascular disease.
- Heart failure.
Another danger associated with intravenous drug use is that of overdosing, an event made all-too-common in association with this route of use. According to the World Health Organization (WHO), injection drug users have a higher risk of death than non-injection users, due largely to overdose and HIV/AIDS-related mortality. Those with HIV have a higher risk of mortality when injecting — not just from HIV-related causes but from overdose itself.20
If you or someone you know is an intravenous drug user, there are some ways in which the harms of needle injecting can be reduced. Syringe exchange programs can help prevent the spread of infections and will oftentimes offer preventative services, such as:
- Testing for HIV, Hepatitis C, STDs, and tuberculosis.
- Referrals to drug addiction treatment programs.
- Hepatitis A and B vaccinations.
These needle exchange programs can aid in harm reduction by either preventing a user from contracting an infection or preventing him or her from spreading one to others.
These programs will often refer users to drug addiction treatment programs so that they can work towards achieving and maintaining sobriety. Some examples of drug addiction recovery programs include:
- Inpatient treatment: These programs require that you live at the facility for the duration of the treatment program while receiving services, such as detox, therapy, group counseling, medical maintenance, and aftercare planning.
- Outpatient treatment: These programs work around your schedule so that you don’t have to abandon your home, work, or school responsibilities in order to receive rehab services. They may not be suitable for those suffering from a severe drug addiction.
- 12-Step programs: Fellowships, such as Cocaine Anonymous, Narcotics Anonymous, Heroin Anonymous, and Crystal Meth Anonymous, provide a supportive and encouraging environment in which to share your story and learn from the experiences of others.
- Individual therapy: A therapist will use a variety of techniques to help you uncover the underlying issues related to your addiction, as well as help you build coping skills to be used in stressful situations.
- Group counseling: A group counselor will facilitate an interactive session focused on interpersonal interaction and personal growth, while encouraging the practice of coping strategies.
If you or someone you know is struggling with a drug addiction, help is available around-the-clock. Call our helpline at 1-888-744-0069 to speak to a trained professional about which recovery program is best for you.
- 5.2 Speed of drug effect. (2004). Retrieved May 02, 2016, from http://www.health.gov.au/internet/publications/publishing.nsf/Content/drugtreat-pubs-front6-wk-toc~drugtreat-pubs-front6-wk-secb~drugtreat-pubs-front6-wk-secb-5~drugtreat-pubs-front6-wk-secb-5-2
- Diagnostic and statistical manual of mental disorders: DSM-5. (2013). Washington, D.C.: American Psychiatric Association.
- (2014, October). Retrieved May 02, 2016, from https://www.drugabuse.gov/publications/drugfacts/heroin
- Anderson MW, Sharma K, Feeney CM. Wound botulism associated with black tar heroin. Acad Emerg Med. 1997 Aug; 4(8):805-9.
- Wound Botulism. (2016). Retrieved May 02, 2016, from http://www.sfcdcp.org/woundbot.html
- Kimura, A. C., Higa, J. I., Levin, R. M., Simpson, G., Vargas, Y., & Vugia, D. J. (2004). Outbreak of Necrotizing Fasciitis Due to Clostridium sordellii among Black-Tar Heroin Users. Clinical Infectious Diseases, 38(9). doi:10.1086/383471
- Necrotizing Fasciitis: A Rare Disease, Especially for the Healthy. (2015, April 17). Retrieved May 02, 2016, from http://www.cdc.gov/features/necrotizingfasciitis/
- Sheehy, J. (2004, January 26). Black tar heroin use explains lower HIV levels among injection drug users in the Western U.S. Retrieved May 02, 2016, from https://www.ucsf.edu/news/2004/01/5049/black-tar-heroin-use-explains-lower-hiv-levels-among-injection-drug-users-i
- Gas gangrene: MedlinePlus Medical Encyclopedia. (2013, November 20). Retrieved May 02, 2016, from https://www.nlm.nih.gov/medlineplus/ency/article/000620.htm
- (n.d.). Retrieved May 2, 2016, from http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/tetanus.pdf
- Syringe Exchange Programs. (2010, November 19). Retrieved May 02, 2016, from http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5945a4.htm/Syringe-Exchange-Programs-United-States-2008
- More on How HIV Causes AIDS. (2009, January 5). Retrieved May 02, 2016, from https://www.niaid.nih.gov/topics/HIVAIDS/Understanding/howHIVCausesAIDS/Pages/howhiv.aspx
- Hepatitis: MedlinePlus. (2014, June 16). Retrieved May 03, 2016, from https://www.nlm.nih.gov/medlineplus/hepatitis.html
- What are the long-term effects of cocaine use? (2010, September). Retrieved May 03, 2016, from https://www.drugabuse.gov/publications/research-reports/cocaine/what-are-long-term-effects-cocaine-use
- What are the long-term effects of heroin use? (2014, November 1). Retrieved May 03, 2016, from http://www.drugabuse.gov/publications/research-reports/heroin/what-are-long-term-effects-heroin-use
- Amphetamines | CESAR. (2013, October 29). Retrieved May 03, 2016, from http://www.cesar.umd.edu/cesar/drugs/amphetamines.asp
- Mau, M. (2009). Risk factors associated with methamphetamine use and heart failure among Native Hawaiians and other Pacific Island peoples. VHRM Vascular Health and Risk Management, 5, 45-52.
- What are the short-term effects of cocaine use? (2010, September). Retrieved May 03, 2016, from https://www.drugabuse.gov/publications/research-reports/cocaine/what-are-short-term-effects-cocaine-use
- Ghuran, A., & Nolan, J. (2000). The cardiac complications of recreational drug use. Western Journal of Medicine, 173(6), 412-415. Retrieved May 3, 2016.
- Bulletin of the World Health Organization 2013;91:102-123. doi: 10.2471/BLT.12.108282