Injecting Drugs: 9 Hidden Dangers

man looking at heroin needle
Injecting drugs into your body can result in a number of serious health problems.

Did you know that injecting drugs into your body can increase your risk for a number of health problems?

Additionally, did you know that injection-related injuries not only include bruising, scarring, and venous injury, but also infectious diseases like human immunodeficiency virus (HIV), tuberculosis (TB), and hepatitis C virus (HCV)?

Unfortunately, persons who inject drugs (PWID) are at risk for a number of unwanted health issues that affect their bodies and their overall health. And because of the illegal status of most drugs that are injected and the perceived stigma of injection drug use, many PWIDs do not seek medical attention.

Continue reading to find out what some of the hidden dangers of injecting drugs include.

Track Marks

PWIDs may develop scarring in places where they inject the drugs into their skin. “Track marks” develop when a person repeatedly injects into the same site. As a result, the overlaying skin can become discolored.

The most common site for injection is in a person’s non-dominant arm. That means that if you are right-handed, you will probably inject in your left arm and vice versa. Other common locations of injection include the back of the knee joint, the groin, and the veins that are on top of your feet.

From a social perspective, track marks can further stigmatize PWIDs. In a study, injection drug users (IDUs) living in Tijuana, Mexico reported that it was common to be arrested for having visible track marks.

Bruising

Injecting drugs can also cause bruising. How does this happen? When a person is injecting a needle into the vein, blood can actually leak out and cause bruising.

There are a number of ways that PWIDs can prevent bruising. One includes using a new needle each time they inject. Additionally, PWIDs can rotate sites of injection so that they are not using the same part of the body to inject into every time.

Skin Popping

One method of injecting is called “skin popping.”

Skin popping is another name for injecting drugs underneath the skin or into the muscle, as opposed to directly in to the vein. Skin popping can happen on accident or when a person’s veins are affected by sclerosis. Overall, it is a dangerous route of administration because it can result in permanent tissue damage.

Skin popping can leave scars or keloids (lumps of tissue) on the skin. One study found that skin popping increased the odds of causing infection in the user when compared to standard intravenous (IV) injection by 5 times.

Stronger drugs such as morphine and fentanyl are commonly injected using the skin popping method.

Puffy Hand Syndrome

Some PWIDs may experience “puffy hand syndrome.” When this occurs, the back of the hands become puffy, except for the fingers.

It has been noted that a contaminant of heroin, called quinine, may cause puffy hand syndrome.

Sooting Tattoos

PWIDs will sometimes use a match to flame a needle before injecting drugs into their veins. Altogether, this route of administration can result in carbon and soot getting lodged underneath a person’s skin, causing discoloration.

Furthermore, some PWIDs will get tattoos to cover up the damaged skin.

Venous Injury

A PWID can experience collapsed veins when they repeatedly inject in the same site. Unsurprisingly, using a blunt needle can injury and damage the veins as well.

Black Tar Heroin

Black tar heroin is a dark, tarry form of heroin. One study found that people who reported injecting black tar heroin had visible wounds, difficulty speaking, vision problems, and trouble swallowing.

When PWIDs inject the substance under the skin or into the muscles, it can cause wound botulism. In the long run, wound botulism can be quite dangerous as can be seen by the spores of bacteria that may begin growing inside of the wound.

HIV

PWIDs can get HIV by sharing needles, syringes, and other drug equipment.

If you inject drugs, your risk for getting HIV is very high if you are sharing needles or drug equipment (“works”) with a person who has HIV.

*Equipment such as cookers, cotton, or water as the “works.”

All in all, you can lower your risk of HIV by not injecting drugs or using only new and sterile needles and/or works every time you inject. All in all, you should never share needles or works.

Hepatitis C

Hepatitis C is a liver infection caused by the Hepatitis C virus (HCV). In the United States, HCV is the most common blood-borne virus and 4 to 5 million people are currently infected.

PWIDs can become infected with HCV by sharing needles or works. Unfortunately, HCV can cause long-term health problems, and in some cases, even death.

In the United States, PWIDs are the group with the highest risk for contracting HCV. Correspondingly, studies have found that 70 to 90% of PWIDs have HCV. To date, there are no vaccines available to help people treat their HCV.

Clearly, injection drug use is risky and can result in unwanted health effects. Fortunately, there are a number of harm reduction strategies such as needle exchanges and using sterile injection equipment that can help prevent a number of these dangers.If you are interested in learning about more of the harmful effects of injection drug use, including sexually transmitted infections, tuberculosis, and arterial injury, visit the World Health Organization’s website.

Sources

Hennings, C., & Miller, J. (2013). Illicit drugs: what dermatologists need to know. Journal of the American Academy of Dermatology, 69(1), 135-142.

Murphy, E. L., DeVita, D., Liu, H., Vittinghoff, E., Leung, P., Ciccarone, D. H., & Edlin, B. R. (2001). Risk factors for skin and soft-tissue abscesses among injection drug users: a case-control study. Clinical Infectious Diseases, 33(1), 35-40.

Binswanger, I. A., Kral, A. H., Bluthenthal, R. N., Rybold, D. J., & Edlin, B. R. (2000). High prevalence of abscesses and cellulitis among community-recruited injection drug users in San Francisco. Clinical Infectious Diseases,30(3), 579-581.

Strathdee, S. A., Lozada, R., Pollini, R. A., Brouwer, K. C., Mantsios, A., Abramovitz, D. A., … & Magis-Rodriguez, C. (2008). Individual, social, and environmental influences associated with HIV infection among injection drug users in Tijuana, Mexico. Journal of acquired immune deficiency syndromes (1999), 47(3), 369.

Deiss, R. G., Rodwell, T. C., & Garfein, R. S. (2009). Tuberculosis and illicit drug use: review and update. Clinical infectious diseases, 48(1), 72-82.

Andresz, V., Marcantoni, N., Binder, F., Velten, M., Alt, M., Weber, J. C., & Stephan, D. (2006). Puffy hand syndrome due to drug addiction: a case–control study of the pathogenesis. Addiction, 101(9), 1347-1351.

Strathdee, S. A., Lozada, R., Pollini, R. A., Brouwer, K. C., Mantsios, A., Abramovitz, D. A., … & Magis-Rodriguez, C. (2008). Individual, social, and environmental influences associated with HIV infection among injection drug users in Tijuana, Mexico. Journal of acquired immune deficiency syndromes (1999), 47(3), 369.

Del Giudice, P. (2004). Cutaneous complications of intravenous drug abuse.British Journal of Dermatology, 150(1), 1-10.

Yuan, J., Inami, G., Mohle-Boetani, J., & Vugia, D. J. (2011). Recurrent wound botulism among injection drug users in California. Clinical infectious diseases, cir005.

Harm Reduction Coalition. (n.d.). Hepatitis C.

Thorpe, L. E., Ouellet, L. J., Hershow, R., Bailey, S. L., Williams, I. T., Williamson, J., … & Garfein, R. S. (2002). Risk of hepatitis C virus infection among young adult injection drug users who share injection equipment. American journal of epidemiology, 155(7), 645-653.

Centers for Disease Control and Prevention (CDC). (2016). Hepatitis C FAQs for the Public.

World Health Organization (WHO). (n.d.). Hepatitis: frequently asked questions.

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