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What is Intravenous Drug Use (IV Drug Use)?
Intravenous (IV) drug use and substance use typically refers to illicit drug use via injections. However, prescription medications may also be delivered this way.
IV drugs are injected directly into the bloodstream with a sterile syringe and hypodermic needle through veins. This is different from intramuscular injections, which are delivered directly into the muscle.
Intravenous therapy, or IV therapy, is a common form of intravenous medication administration. IV therapy delivers liquids directly into a patient’s vein and is usually done only in medically supervised settings.
This form of administration is commonly utilized for administering rehydration or other oral solutions. IV is commonly used to provide nourishment to people who cannot orally ingest food or water. It is also used to administer blood or electrolytes to stabilize imbalances.
IV drug use is most common as a form of substance use. Some signs to look out for to differentiate it from IV therapy or other intravenous medicine administration include:
- Injecting a drug that was not designed to be delivered intravenously
- Unsuccessful efforts to reduce or stop injecting substances
- Excess time and energy spent obtaining, using, or recovering from a substance
- Injecting the substance leads to unfulfilled life obligations
- Drug use continues despite causing job, family, and other social disturbances
- Tolerance increases
- Withdrawal symptoms result from stopping drug administration
Most Common Drugs Used Intravenously
Nearly all drugs can be injected intravenously, but some are more commonly used than others. It is also common to dissolve various pills, powders, and salts into a liquid solution that is consumed as a part of IV drug use.
Heroin is the most commonly injected illegal drug in the United States. But drugs such as opioids, amphetamines, methamphetamines, and cocaine are also taken intravenously.
Drugs that are commonly injected include:
- Amphetamines (Adderall)
- Ecstasy or MDMA
- Hydromorphone (Dilaudid)
- Meperidine (Demerol)
- Oxycodone (OxyContin)
- “Z-drugs” (sleeping medications)
- Prescription IV medications
Why Do Some People Prefer IV Drugs Over Other Types?
IV drugs are often preferred over oral capsules because intravenous injection gets the desired substance to the brain much faster.
Oral drug use requires waiting for the substance to be digested and absorbed in the intestines before the effects can be felt in the brain. Using drugs in this manner helps spread them throughout the body. This makes them take significantly longer to produce the desired impact. While this typically results in a longer high, it is also less intense and too delayed for some people.
On the other hand, injected drugs only need to pass through the heart and lungs before the oxygenated blood carrying the substance reaches the brain. This process is not only rapid but also means the drug is delivered to the brain all at once in a more concentrated amount.
The resulting feeling is often referred to as an intense feeling of euphoria known as a “rush.” It may only last for a few seconds before levelling off into a sustained high that typically lasts less than 20 minutes.
The combination of immediate sensation, intense euphoria, and a shortened high result in higher instances of intravenous drug users engaging in bingeing behavior.
What are the Physical Signs of IV Drug Use?
IV drug use is very invasive to veins. The most common injection site for injections is the forearm. However, areas on the leg, neck, hand, foot, or groin are sometimes also used.
Immediately after administering IV drugs, there will be physical signs on the skin. Needle marks, scabs, or bruising may be visible soon after, especially if the same areas are repeatedly targeted.
Over time, the physical signs of IV drug use can become very apparent. Skin and veins can easily become scarred, inflamed, and infected, which is very evident in most cases.
Abscesses or even ulcers can also develop with continued intravenous drug use. Repeatedly injecting drugs into the same area causes vascular scarring, commonly referred to as “track marks.”
Infections near injection sites can become severe and cause necrotizing fasciitis, also known as a “flesh-eating disease,” or cellulitis. With each of these conditions, skin becomes red, swollen, and warm.
In addition, cellulitis leads to skin often appearing taut and glossy, while necrotizing fasciitis results in darkened skin patches as tissues begin to die. Both conditions require prompt medical treatment and can become life-threatening if not adequately treated.
Dangers & Health Risks of Intravenous Drug Use
There are countless dangers and health risks associated with injection drug use. Some of these risk factors arise from how the drugs are administered, while some are due to the method of administration and effects from repeated injections.
Below are some of the most prevalent risks and dangers that affect IV drug users:
Many of the most commonly injected drugs can become habit-forming and lead to physical dependence.
For example, opiates such as heroin can become physically addictive after only a few injections. Dependency is problematic because it causes withdrawal symptoms when usage is stopped, leading to difficulties in stopping IV drug addictions.
IV drugs damage veins due to the nature of repeated injections, often in the same areas. This is further complicated and exacerbated by poor injection technique, infections, and irritation from chemicals.
In particular, Heroin users suffer from vein damage due to the amount of injections users typically administer.
More dangerous injection sites are often used as easily accessible veins are exhausted. Injecting into the pulmonary or femoral vein is common after forearms become damaged. This can cause deep vein thrombosis (DVT), septicemia, arterial bleeding, neuropathic pain, and other complications.
Since illicit drugs are usually not created in sterile conditions, this creates the opportunity for pathogens to enter the bloodstream even if injection techniques are perfect.
Common examples of bacterial infection resulting from IV drug use include:
- Right-sided endocarditis
- Staphylococcus aureus
Blood-borne virus infection
Rates of needle sharing among injecting drug users have declined during the 21st Century, leading to a decrease in viral infections from this transmission method.
However, several viral infectious diseases are still transmitted between IV drug users, including hepatitis C (HCV), hepatitis B (HBV), and HIV/AIDS.
While the HIV infection rate has steadily dropped, hepatitis C remains a high-risk viral pathogen with a prevalence rate still nearly 20 percent.
Summary of risks and dangers
Below is a condensed summary of many of the most common and serious risks and dangers associated with IV drug use:
- IV abscesses at the administration sites
- Serious vein damage
- Various infections, including blood infections
- Blood clots
- The risk of sepsis
- Collapsed veins
- Hardened veins
- Staph infections
- Necrotizing fasciitis
- Septic thrombophlebitis
- Hepatitis C
- Bacterial endocarditis
- Cotton fever
Addiction Treatment Options for IV Drug Users
IV drug use is difficult to stop without proper treatment. Fortunately, there are several treatment options available.
Detoxing is often a necessary part of the treatment and recovery process. This is designed to allow the body to get through the withdrawal phase without complications. It is critically important to detox under the direct supervision of a healthcare professional trained in this form of treatment.
There are several types of specific IV drug treatment programs. Finding the right one for yourself or a loved one suffering from IV drug addiction will depend on several factors. These may include which drugs are being taken and how long they have been administered intravenously.
Outpatient programs can provide benefits in some instances, but inpatient treatment centers are usually needed for addressing IV drug rehabilitation. These can consist of 30-day inpatient treatment programs or a longer-term rehab program that can last several months.
Speak with your healthcare provider to determine which option may be more beneficial for you or your loved one.