Intravenous Drug Use: Risks, Signs & Treatment Options

Transmission of these pathogens often occurs due to improper and unhygienic handling of needles. As a person becomes addicted, the need to use becomes so intense that they disregard their health. This behavior increases the risk that a pathogen will be transmitted by blood-to-blood contact.

• While necrotizing fasciitis is rare, it is a serious and life-threatening complication from intravenous drug use.
• Applied research should include planned variation and evaluation of experimental programs.
• Whileintravenous injection is a frequently discussed risk factor in the HIV-related literature,it is a much less frequent topic in the addiction literature.
• Indeed, as described later in this chapter, the use of the same injection equipment within a close relationship is sometimes not even thought of as “sharing” (Des Jarlais and Friedman, 1988).
• Cotton fever is a slang term used to describe a temporary fever that sometimes occurs when using IV drugs that have been filtered through cotton.
• In more severe cases of botulism, symptoms can worsen and even result in death if left untreated.

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As the number of people with whom injection equipment is shared increases, so does the risk of HIV infection (Chaisson et al., 1987b). As with other blood-borne infections to which IV drug users are prone, HIV spreads from the infected to the uninfected user primarily by the sharing of blood-contaminated injection equipment, which serves as the vector of the virus. In this paper, we describe the epidemiology, presentation, diagnosis and management of infections in IDUs who may present to acute physicians and the management of drug dependency on acute medical wards.

Blood-Borne Infections from Injection Drug Use: Hepatitis, HIV, and More

In fact, next to marijuana, prescription painkillers are the most abused drugs in the U.S. and more people die from overdosing powerful opioid painkillers each day than from traffic accidents and gun deaths combined. Addiction to opioid painkillers can be so powerful it has become the major risk factor for heroin abuse. People who inject IV drugs are at risk for many illnesses, the most common being hepatitis and HIV. Each time someone injects a drug, they increase their risk of contracting infections and developing sepsis, whether they use these drugs occasionally or on a regular basis.

Clostridial infections

One-year follow-up consisted of a clinical visit or direct contact with the patient and the referring cardiologist. The primary composite outcome was the occurrence of a serious cardiac event – cardiovascular death, non-fatal heart attack (MI) or stroke. Subgroup analysis was performed in patients hospitalised at baseline for acute coronary syndrome (non-fatal heart attack / angina lasting more than 20 minutes).

• DAWN is also used to acquire information on currently used drugs that may be creating a local epidemic or local health problems.
• CODAP was supported by NIDA from 1973 to 1981 to collect basic drug-related information on clients of treatment programs receiving federal or state funds.
• Intravenous drug use comprises a complex set of behaviors that are enacted in diverse social situations.
• As of November 14, 1988, 20,752 cases of AIDS had been diagnosed in individuals who reported IV drug use (CDC, 1988).
• These variations have important implications for the spread of HIV that cannot be captured by or understood through cross-sectional studies that provide only a “snapshot” view of evolutionary and variable behaviors.
• The total number of IV drug users is a function of the estimated number of AIDS cases among IV drug users divided by the probability that an IV drug user will have had AIDS.

The first obstacle is to recognize and admit you have a problem, or listen to loved ones who are often better able to see the negative effects drug use is having on your life. As drug abuse takes hold, you may miss or frequently be late for work or school, your job performance may progressively deteriorate, and you may start to neglect social or family responsibilities. What began as a voluntary choice has turned into a physical and psychological need. Recovery can begin at any point in the addiction process—and the earlier, the better. The longer drug abuse continues, the stronger the addiction becomes and the harder it is to treat.

It should not be used in place of the advice of your physician or other qualified healthcare providers. HIV is only normally transmitted through anal or vaginal intercourse or by contaminated medical equipment. While medical equipment used in clinical settings normally goes through rigorous sterilization processes to prevent the spread of disease, medical equipment used outside of the health care system can easily spread infection.

• Two independent lists of IV drug users are generated—for example, a list of persons in heroin treatment programs and a list of persons treated in emergency rooms for adverse reactions to heroin use.
• Toxicity, sometimes referred to as drug poisoning, can occur if you overdose on a drug or have health problems like liver disease or kidney disease that prevent the normal elimination of a drug from the body.
• Needle exchange programs may make referrals for chemical dependency treatment and medical treatment and may participate in other public health initiatives, such as distributing condoms and arranging HIV testing.
• We provide innovative treatments, including withdrawal management, trauma therapy programs and relapse prevention.

The severity of a drug overdose will depend on the type and quantity of the drug taken. An overdose can cause serious medical complications and can result in permanent damage or even death in the most severe cases. Continual injections at the same site can cause scarring, bruising and even vein collapse.

On further probing he noted that in the preceding six months leading up to admission he had not shared syringes but could recall sharing equipment including cookers, cottons, and drug diluting water with up to 5 individuals who were not close injection network members. Although the articles in this supplement were submitted prior to the coronavirus disease 2019 (COVID-19) pandemic, people who inject drugs (PWID) have in no way been spared. The social distancing measures that helped slow the spread of severe acute respiratory iv drug use syndrome coronavirus 2 may increase feelings of anxiety and loneliness among PWID while making it more difficult to obtain prevention, treatment, and social services. Although the full impact of the pandemic on PWID has not been defined, PWID are likely at risk for infection and severe disease, due to high rates of comorbid health conditions, homelessness, and other suboptimal social conditions [5–11]. There are several ways in which IV drug users can use the same injection equipment and not think of themselves as sharing.

• It can develop quickly (called acute endocarditis) or more slowly (called infective endocarditis).
• Most studies on IV drug use have investigated the injection of heroin; much less is known about the injection of cocaine or other drugs.
• Dual-systems estimates, also known as capture-recapture or tag-recapture estimates, are perhaps the most widely used method for making direct estimates.
• The studies use different outcome measures that range from the increased use of sterile injection equipment to entrance into drug treatment to any self-reported change in behavior.
• Opioid withdrawal symptoms while hospitalized for SBI were present among most participants.

Some people like to ‘boot’ their syringe after they’ve injected their drugs—that is, pull back the plunger, draw blood into the syringe, and re-inject it. Some injectors like to do this several times, ostensibly to rinse out any drug solution that remains in the syringe. Because of all the blood involved, you might want to refrain from booting if you know you’re going to be cleaning your needle and syringe and allowing someone else to use it. Be sure to thoroughly flush your needle and syringe with water after booting if you plan to re-use it at a later time, so that blood doesn’t clog the needle. Once you think you’re in a vein, pull the plunger back to see if blood comes into the syringe. If so, and the blood is dark red and slow moving, you know that you’ve hit a vein.

Lack of appropriate hygiene, storing of used (contaminated) syringes, re-using and sharing equipment, use of non-sterile drug diluting fluid, can provide opportunities for introduction of bacteria during the injection process. Socioeconomically disadvantaged participants frequently reported difficulties finding sterile water to use as a drug diluent and would often use discarded or re-used bottles as a source of water, increasing the risk of oral flora contamination of these water sources. Failure to adequately perform skin hygiene prior to injection and subsequent re-use of the needle could lead to the contamination of the syringe with skin flora. Storage of cottons/filters and cookers already exposed to wet material could provide an environment for bacteria to remain viable and proliferate. The re-use of this drug injection equipment not only exposes the PWID to bacteria [45] but potentially a higher inoculum than other possible pathways for bacterial introduction. This study indicates the need for widespread provision of harm reduction supplies to PWID including clean injecting equipment and sterile water.