EH, KD, GS, TB, MT, and BP acquired funding to support the project leading to this publication. HB wrote the initial draft of the study, and all authors provided critical review, commentary, or revisions prior to its submission for peer review. EH provided oversight and leadership for all aspects of the research reported herein.

How To Help If Someone Is Injecting Drugs

• This method of drug administration poses significant health risks, including the potential for infections, vein damage, and overdose.
• Scar tissue can develop in the limbs, and the risk for skin abscesses and infection are high.
• This is understandable when one realises that most will have witnessed an overdose in others, and which is the rationale for providing naloxone injection kits.
• Dr Élise Roy holds a research chair entitled Chaire de recherche en toxicomanie supported by la Fondation de l’Hôpital Charles-Lemoyne and the Faculty of Medecine and Health Sciences, Université de Sherbrooke.

Cellulitis, characterized by redness, swelling, and tenderness of the skin, is a common complication that arises from IV drug use. HIV, which weakens the immune system, and hepatitis, which causes inflammation of the liver, can have severe health consequences. Sharing needles can transfer infected blood from one person to another, facilitating the rapid spread of these viruses. One of the main concerns is the transmission of bloodborne viruses, including HIV and hepatitis B and C. A .gov website belongs to an official government organization in the United States. Fearing decompensation, the EP starts empiric antibiotic therapy with vancomycin and cefepime, non-invasive positive pressure ventilation, and afterload reduction with nitroglycerin.

• MAT uses medications like methadone, buprenorphine, or naltrexone to reduce cravings and withdrawal symptoms, which can be particularly effective for opioid dependency.
• For example, abscesses may be drained, and antibiotics may be used to treat infections.
• Additionally, injecting drugs in group settings may lead to a higher susceptibility to overdose if people are not adequately monitoring each other or are unaware of the substances being used.
• All patients who appear septic (i.e., febrile, lethargic) or who present outside of clinic hours should be referred the nearest ED with the warmest handoff possible (e.g., written referral, ambulance, walking the patient over to the ED if practical, see Fig. 4).
• Injected drugs refer to substances that are introduced into the body via a needle and syringe, bypassing the digestive system for direct entry into the bloodstream.
• USF Health, an integral part of the University of South Florida, integrates research, education and health care to reach our shared value – making life better.

Understand the Risks:

Insite (), a supervised injection facility, was subsequently opened as a pilot project following an exemption from the Controlled Drugs and Substances Act granted by the Government of Canada. It provides IDUs with a supervised safe setting where sterile needles and syringes are supplied for the users to inject their own drugs. Health care personnel, including registered nurses, monitor patients and are available for management of adverse events. Despite the growing importance of NMUPO, and to some degree the injection of POs, little is known about injection practices and the health risks they pose to users. The mental healthcare needs of this group cannot be disregarded in a description of the management of physical healthcare needs. People injecting drugs have a high prevalence of psychotic illness, personality disorders, and common mental health problems such as anxiety and depression.

Reduce drug use and increase treatment uptake

Our study extends this work by exploring in depth the perspectives and experiences of VAD injection among a sample of PWID hospitalized on medical or surgical units of a large tertiary care facility. The specific clinical manifestations of injected-related wounds depend on the type of drug or additives, route of injection, particular injection practices, and presence of infectious agents. As a result of repeated injections into a single site, skin and surrounding tissue become damaged and susceptible to infection.

Mental healthcare needs

Hepatitis C is a serious health risk for people who inject drugs, many of whom have been exposed to the virus at  some point in their  lives. HEPATITIS B ( “HBV”) is spread through blood-to-blood contact of the kind that occurs when injection equipment is shared; contact with infected body fluids like semen, blood, vaginal fluids s; and from a parent to their infant at birth. Hepatitis B infection can be acute (short-term) and/or chronic (long-term); chronic HBV can cause serious liver damage, including cirrhosis (scarring), liver cancer, and death from liver failure. Hepatitis B is much more infectious than HIV, which means it is spread much more easily. It is one of the most important reasons people who inject should avoid sharing injection equipment of any kind. Always using new, sterile injection equipment; never sharing injection equipment; thoroughly washing your hands and clean- ing the skin prior to injection; and preparing your drugs on  a clean surface will all help prevent necrotizing fasciitis infections.

Reduce infections

As such, awareness of and experience with VAD injection may have been higher than other hospitalized patients with a history of drug use. Also, use of VADs for injection emerged as an independent theme as the study progressed, limiting a more in-depth a priori exploration of this topic. Finally, this study was conducted in a large city in Western Canada and may not be generalizable to other dissimilar contexts. Chronic use of injected drugs can result in infectious diseases, with users facing risks of contracting HIV, hepatitis C, and other blood-borne pathogens.

Understanding the Psychological Dangers of Injecting Drugs

A few participants described how the psychoactive effects of drugs were stronger when using a VAD compared to injecting intravenously and believed some people may prefer injecting via this route. Nearly all participants had heard of patients injecting into their VADs (specifically PICC and IV lines). Participants implied that hospitalized PWID with VAD would have at least contemplated participating in the practice. Some participants had unsuccessfully attempted to inject into their VADs, but a few had successfully injected into their VADs at least once during their current hospitalization, or during previous hospitalizations.

As with any foreign substance, potential health complications of injection drug use injection drug use can also illicit a hypersensitivity reaction from the immune system, including urticaria, wheezing, and dyspnea. It is not exactly known when drug injections started to be abused, but it is postulated that the Civil War in the U.S. and the Franco-Prussian War in Europe might have been contributing factors by creating widespread morphine addiction (2). General symptoms of early HIV infection (soon after the point of transmission) may include a low-grade fever and fatigue.

Infected pseudoaneurysms can occur with contaminated intra-arterial injections, causing subsequent necrosis and rupture, which can lead to hemorrhage and limb loss. The majority of pseudoaneurysms occur in the femoral artery, although they can also occur in the upper limb vessels (40). Direct intra-arterial injection can also lead to direct endothelial injury and subsequent thrombosis, subsequent particulate emboli leading to ischemia, and local intimal damage leading to large vessel arterial occlusion and limb edema (40). These processes put patients at risk for limb ischemia and compartment syndrome. For example, those who inject into the radial artery who develop significant tissue loss may require digital amputations and fasciotomy (40).

Injecting drugs increases the risk of overdose, which is a potentially life-threatening consequence. Abscesses frequently develop at injection sites due to bacteria, especially when using shared or contaminated needles. The repeated use of shared or unclean needles and the introduction of substances directly into the bloodstream create an environment that can cause bacterial infections. Stimulant drugs such as cocaine and methamphetamine can induce intense vasoconstriction when injected, elevating blood pressure and increasing the chance of heart attacks and strokes.

Upon completion of the interview, participants were remunerated $15 for their time. Furthermore, injecting drugs can damage the skin and underlying soft tissues, providing entry points for pathogens. The most commonly injected drugs are opioids, but cocaine, amphetamine and amphetamine derivatives, benzodiazepines, barbiturates, or any water-soluble drug may also be injected (1). If you do seek medical care to have your abscess drained, try to find a wound clinic where you can get your dressing changed on a regular basis and make sure the abscess is healing properly. If there isn’t a wound clinic available near you and you need your abscess drained, try a community clinic or emergency room.. If you do seek care for your abscess at the emergency room or a community clinic, know in advance that the doctor may cut into your abscess and scoop the pus out with their (gloved) fingers, and that they should provide you with lidocaine to numb the area.