Injecting Drug Use

Of all the ways to administer drugs, injecting drugs carries the most risks as it bypasses the body’s natural filtering mechanisms against disease and bacteria. Injection drug use is the preferred method of ingestion by people because the effects of the drug are felt quicker and the high is more intense. However, the effects are felt for a shorter period and injection drug use can more quickly lead to dependency than other methods. Heroin, cocaine, crack and methamphetamine are the most commonly injected street drugs.

Intravenous drug taking has many risks. Scarring of the veins is common, collapsed veins and abscessing of arteries and injection spots are often reported issues. Ulcers, tetanus, septicemia, and thrombosis are all very real complications of injecting drugs along with the potential risks of injecting toxic and harmful adulterant substances. Unsanitary conditions, sharing of needles and equipment, blunt needles and dirty water all contribute to disease and infection. Infection rates can be reduced by using new needles every time and following safe injection methods. However, even these approaches do not safeguard against all diseases or infections.


Hepatitis is an inflammation of the liver, most commonly caused by a viral infection. Hepatitis B and C are the most serious and can lead to chronic disease that causes liver cirrhosis and liver cancer. They are typically transmitted though contact with contaminated blood or blood products or sexual conduct. The majority of Hepatitis C positive people are aged between 20 – 39 years of age.

Over 80 percent of people infected with the hepatitis C virus contracted it from unsafe injecting drug use. Hepatitis is a common disease among intravenous drug users because of the chronic incidence of unsafe needle use. Transmission of the disease can occur through sharing both needles and injecting drug equipment such as filters, cooking implements and tourniquets.

When a person is infected with hepatitis B or C they can have a range of symptoms. For the most part, symptoms for individuals who have been recently diagnosed are often mild or nonexistent. Some symptoms that can be experienced include fatigue, nausea, loss of appetite, dark colored urine and pale bowel movements, pain in upper abdomen and flu-like symptoms.

In some cases, individuals may have jaundice which is a yellowing of the skin and eyes. If hepatitis progresses to the chronic stage and develops into cirrhosis or liver cancer serious health impacts will be experienced. These include fatigue, decreased liver function, ascites which is an accumulation of fluid in the abdomen, bruising, enlarged veins and jaundice.


Injecting drug use has long been linked to the spread of HIV and AIDS viruses. Individuals infected with HIV are at risk of contracting other, life threatening diseases because the virus weakens a persons immune system. Cancer, pneumonia, tuberculosis, gastrointestinal problems, neurological conditions and tumors are some of the known linked diseases.

HIV/AIDS is preventable, especially in relation to intravenous drug administration. Drug users should follow safe practices of using clean, new needles every time, no sharing of equipment and adhering to safe injection methods. HIV is contracted when an infected person’s blood or other bodily fluid comes in contact with the blood, broken skin, or mucous membranes of an uninfected person. Injection drug use is one of the most high risk HIV/AIDS related activities that a person can be engaged in.

When people share needles and drug equipment, the virus can easily be drawn up into the syringe and injected into the body along with the drugs. Infected blood can also be present on hands, cookers, filters, tourniquets or rinse water. Needles and drug equipment should never be shared for this reason. HIV/AIDS can also be spread through unsafe sex which is unfortunately a commonly reported risk-behavior that people under the influence of drugs will engage in.


Tetanus is an illness caused by the tetanus bacillus, or bacterium, that live in soil, animal and human faeces, saliva, dust and nature. Injecting drug users are often exposed to the bacteria through infected shared equipment, adulterant substances or dirty, unwashed skin at the site of injection. The infection is not always known until some time after being exposed, up to 21 days, and the first symptom is abnormal rigidity and stiffening in the jaw.

Lock jaw can make it impossible to swallow or open the mouth and suffocation is a real risk when this occurs. Additionally, painful body spasms can occur particularly in skeletal muscle. Up to 11 percent of reported cases of tetanus worldwide result in death with young and old people and drug users being in the highest risk categories.


Cellulitis is a common bacterial infection of the skin that usually affects a limb but can occur anywhere on the body. Symptoms usually localized to the infection area but patients can become generally unwell with fevers, chills and shakes. Severe or rapidly progressive cellulitis may lead to blood poisoning, necrotising fasciitis or endocarditis which is an infection of the heat valve.

Injecting drug users commonly contract cellulitis which can be identified by redness, swelling, tenderness and blistering at the infected spot. Additionally, abscessing and ulceration can occur. This infection can be successfully treated with antibiotics, however most injecting drug users will experience this infection regularly if they continue to inject drugs.


Thrombophlebitis is a condition in which a blood clot and inflammation occurs in the vein. There are a number of different types of thrombitis including septic thormbitis and deep vein thrombitis. This condition can cause a person to have extremley painful and swollen extremities which are red and warm.

Septic thrombophlebitis is the inflammation of a vein caused by a bacterial infection. Symptoms include fever, tenderness of infection site, pain, swelling and warmth at the site. This infection causes pus to be drained into the veins which can result in septicemia or blood infections. Treatment with intravenous antibiotics may stop the infection, however, if left untreated, this condition may cause severe health problems and may result in renal failure or amputation.

Necrotising Fasciitis

This rare condition affects injecting drug users and is caused by a bacteria infection, commonly staphylococcus. Nectrotising faciitis appears as an area of cellulitis but is extremely painful and some people may experience a cracking or popping sensation under the skin due to a build up of gas in the soft tissue. The bacterial infection causes clotting of blood vessels with high levels of toxins that leads to destruction of soft tissue and the fascia which is the tissue covering the muscles in the body.

Individuals who are suffering from this infection may have severe nausea, fever, dizziness and dehydration. The infection site will become blistered and dark and the wound will begin to turn black and skin in the area will begin to die. If the infection spreads to the blood stream, blood poisoning will occur and the body will go into toxic shock. Some individuals may require skin grafting, amputation and up to 25 percent of those who contract the infection can die from associated complications.

Preventing Risks

Although injecting drug use has substantially higher risks associated with the practice, the majority of the problems are easily avoided. Drug users should never share equipment or needles. They should always sterilize their equipment, clean the site of injection and dispose of needles safely. If any sign of disease of infection is noted, the drug user should immediately seek medical assistance to reduce the potentially fatal consequences of infection.