Introduction to Intravenous Injection

Intravenous Injection is the infusion of a liquid substances directly into a vein. Intravenous simply means "within vein". This is a common Route of Administration (ROA) for many illicit substances. Heroin, Cocaine, and Methamphetamine, to name a few, can all be injected intravenously. Commonly referred to as "slamming, banging, shooting, mainlining, pushing, popping, whapping, rigging, poking," and a whole glossary of other terms besides. Compared with other ROA, the intravenous route is the fastest way to deliver fluids throughout the body. The bioavailability of a substance via intravenous injection is 100%.[2] because it bypasses the body’s natural defences to protect itself against toxins; like the liver. An instantaneous "rush" is associated with most IV drug use.[3]

Injecting illicit drugs often comes at great health cost to the user. Especially when done wrong. Track marks, scars, infections are easily encountered. In this regard intravenous injection is a high risk route of administration that many drug users will try to avoid if they can.

Intravenous Injection's Path to Systemic Circulation

Routes of Administration (ROA) that produce systemic effect are divided into two groups: Enteral or Parenteral. Enteral means it passes through the intestine, Parenteral means it avoids the intestinal tract. This is important because some drugs are poorly absorbed by the intestines, and others are well absorbed but almost completely metabolized by "first pass effect." This is what happens when a drug is ingested orally and is subjected to the filtering mechanisms of the liver, thereby decreasing its effects greatly.[4]

Injection directly into the systemic circulation bypasses both the liver and intestines, making it the fastest and most certain and controlled method, making it the most common parenteral route. It is used when rapid onset of effects is desired.

Advantages of Intravenous Injection

Advantages of Intravenous Injection can vary from drug to drug, but there are a few universal advantages. For one, when using intravenously a drugs' bioavailability is 100%, which means that 100% of the drug enters the blood stream and can be used. Other methods do not guarantee that all of the drug taken will be absorbed by the body into the bloodstream. Also, when using IV, the onset of the high is much faster, almost instantaneous. With other ROA it takes time to use an amount of a substance, but with IV the amount used is only limited by its solubility and the size of the rig. While there are many health risks associated with IV use, some of the health risks of other ROA can be avoided; for example, smoking can cause damage to the lungs and throat, and insufflation can cause damage to the nasal cavity, but this can be avoided with IV by exposing the veins to the drug. That does NOT in any way, make IV safer! On the contrary: It simply exposes you to different dangers and higher risks.[4]

The Dangers of Intravenous Injection

Disadvantages of Intravenous Injection include a heightened risk of infection because this method bypasses the body's natural filtering mechanisms against viruses, bacteria, and foreign objects. Abscesses can occur from using non sterile equipment and methods. Other diseases and infections can be passed to users who share needles and other equipment for injecting. NEVER SHARE! [3]

Missed Shots

Missing a shot can lead to a lump of fluids sitting under the skin. This takes much longer for the body to break down and may lead to infection. Keep an eye on this.

Infection & Amputation

An abscess is a hottish mass beneath the surface of the skin, looks like a goose egg at the injection site, forming over a few days. This is the most serious situation, because basically what has happened is you have introduced god-knows-what bacteria under the skin where it has grown a possibly deadly amount of colonies and toxins, and can affect all sorts of crap.

If left untreated, it can infect the bone. This is the one that people loose their arms over. You could also go septic and die.

Method of treatment is somewhat harsh; If the Dr. is nice, he will try to numb it, but abscesses are notoriously difficult to numb. Then the abscess is lanced, or cut or sliced, then vigorously squeezed like a zit until the blood coming out no longer is discolored or stinks. follow up with oral antibiotics or in worse cases travenous infusion of antibiotics that work on the bacteria you are infected with.

This does not happen in the space of a few hours, but rather days. Perhaps the first signs might be there at T+24hrs.

When do you need to seek medical help?

If an injection site becomes red, warm and painful, or if the mark grows in area, or especially begins to darken or turn black, go to a doctor immediately! Drug users do lose limbs from untreated infections at injection sites.

Thrombosis

This one can be a little dangerous, (and unbelievable painful), especially in the case of DVT's, or "Deep Vein Thrombosis". This occurs when there is a blockage in the actual vein itself, sometimes clotted blood, sometimes crap in the rig. The danger with this one is if the clot or blockage forms in specific parts of the veins, it "THEORETICALLY" can break loose and float around in your circulatory system, lodge in the tiny veins or arteries servicing the heart or brain, stopping blood flow, causing strokes, embolism, Myo-Infarct. That being said, I was assured by a quite knowledgeable MD once that this could not happen when discussing thrombosis in the superficial veins in the arm.

Increased Risk of Overdose

There is also an increased risk of overdose because IV injection delivers a dose of drug straight into the bloodstream; it is harder to gauge how much to use (as opposed to smoking or snorting, where the dose can be increased incrementally until the desired effect is achieved). In addition, because of the rapid onset, overdose can occur very quickly, requiring immediate action. [3] This does not necessarily mean that overdoses do always occur immediately, they can, in case of combined use of several substances (i.e. cocaine & heroin together aka "speedball")occur when effects of one drug are counteracted by the second and the latter ceases to act, thus leaving the system with an overdose of the first drug.

Scarring of the peripheral veins

Scarring of the peripheral veins arises from the use of blunt injecting equipment. This is particularly common with users who have been injecting while in jail or live in an area without a needle exchange program and re-use disposable syringes. IV drug use for an extended period may result in collapsed veins. Though rotating sites and allowing time to heal before reuse may decrease the likelihood of this occurring, collapse of peripheral veins may still occur with prolonged IV drug use. IV drug users are among the most difficult patient populations to obtain blood-specimens from because of peripheral venous scarring. The darkening of the veins due to scarring and toxin build-up produce tracks along the length of the veins and are known as "track marks."[3][2]
An often unnoticed and overlooked fact is that veins do get much less damage from injecting when equipment is used that is produced for intravenous injection respectively vein punctation in general.
A big mistake that has probably done the biggest harm is the use of insuline syringes. These are made for injecting insuline under your skin by poking a hole through the skin and for nothing else.
The needles that are produced for injection are detachable from the syringe body and exchangeable if needed.
the syringes, the needles of different sizes, butterfly needles that have a tube attached, wheel filters, syringe caps; all these parts share a common standard connector size (LUER-LOCK) and can therefore easily be exchanged when one piece of the equipment goes defunct.
Which in most cases will be the needle having gone blunt after some trying to hit.

Arterial pseudoaneurysms

Arterial pseudoaneurysms may form at injection sites, which can rupture, potentially resulting in hemorrhage, distal ischemia, and gangrene. Inadvertent intra-arterial injection can also result in endarteritis and thrombosis.[5]

Increase potential for addiction

Another major disadvantage is an increased risk of addiction. The heightened effect of administering drugs intravenously can make the chances of addiction more likely, as well as rapidly increase a person's tolerance to a substance, requiring more and more to achieve the desired effect. Also, the stigma of IV drug use can be cause enough to seek out other ROA. In many societies, there is a social stigma attached to IV drug use, in addition to the more general stigma around illegal drug use and addiction. People who are satisfied taking drugs by other routes may not inject. This may be because of its perceived prevalence in inner cities and with lower-income people.[2]

Infectious Disease

Sharing needles or accidentally reusing someone else's needle can have disastrous consequences. You risk infection with diseases like HIV (AIDS), Hepatitis B & C of which you will suffer the gruesome consequences for the rest of your life.

Rule #1: Never, ever share any equipment!

this is particularily true for needles and syringes, but not limited to these, through sharing of any piece of injection and preparation equipment infections are possible and probable as there are: cookers or spoons, cans used for this purpose, alcoholic and dry swabs, tourniquets/tie-offs, filters (cotton and wheel filters), tweezers and scissors, razor blades and knives (and probably some more items).

Vein Damage from Caustic Drugs

This section needs expansion.

Materials Required for Intravenous Injection

Materials Required for Intravenous Injection

The materials required for IV drug use are simple and straightforward. However, using the proper equipment is very important. All equipment (also called "gear" or "works") must be new or at least properly sterilized. The most basic injection kit consists of a syringe with needle (either fixed or detachable), a spoon or other such container to mix the drugs in, distilled water (or at least clean, sterile water), a filter of some kind (usually a sterile cotton ball), a tourniquet (although many people use a belt for this purpose), alcohol wipes to disinfect the injection site, a lighter if the drugs to be mixed require heat or "cooking," and the drugs to be injected.