However, they may not (yet) be suitable for all types of injectors or injections. Education on proper equipment and cleaning should include counseling on proper injection technique. The Harm Reduction Coalition provides a manual guiding these practices 34, though a few key points have been extracted and included below. PWID should be advised to rotate sites, even if it is uncomfortable initially 2, 34. Injecting into the same locations repeatedly can interfere with circulation and cause phlebitis, and veins can collapse or become reducing harm from injecting pharmaceutical tablet or capsule material by injecting drug users leaky if they are not given adequate time to heal 2, 34. Additionally, loss of peripheral vein function or venous sclerosis may occur, which increases the risk of other serious complications, noted below, due to use of alternative, potentially dangerous central injection sites 2, 34, 38.
Phrases Containing reduce
This development underscores the potential for long-acting injectables to play a significant role in both the prevention of HIV and the treatment of other infectious diseases among individuals who inject drugs. Injecting drugs can lead to a range of organ damage due to various factors, including the toxicity of the substances used, the method of administration, and the potential for contamination and infection. Research indicates that individuals who inject drugs are at a heightened risk for developing chronic conditions such as cardiovascular diseases, liver cirrhosis, and kidney failure. One of the most pressing concerns of intravenous drug use is the heightened risk of overdose, which can occur when drugs such as opioids are administered directly into the bloodstream, leading to rapid and potent effects. Practitioners may suspect problems with drug use when they notice changes in mood or behavior in a person. Track marks are lines of tiny, dark dots (needle punctures) surrounded by an area of darkened or discolored skin.
Essential for broader health: health interventions
Most intravenous injectors use either a standard insulin set which typically has a 27G or 28G needle (and an orange cap), or a standard tuberculin set with a 25G needle (frequently referred to as a blue tip because of its color, but they can vary in color). Treatment of complications is the same as that for similar complications with other causes. For example, abscesses may be drained, and antibiotics may be used to treat infections.
Challenges, opportunities and the role of CNIOs in shaping safer, smarter healthcare
- Education on proper equipment and cleaning should include counseling on proper injection technique.
- HIV from injecting drugs is therefore 100% preventable as long as you always use your own sterile works and never share them with anyone.
- For example, abscesses may be drained, and antibiotics may be used to treat infections.
- You should always be aware of how you’re feeling prior to altering your consciousness.
- Hepatitis is an inflammation of the liver that can be caused by certain toxic drugs, alcohol, or street drugs (iatrogenic or chemically-induced hepatitis); or that is the result of infection with a hepatitis virus (viral hepatitis).
This method of drug delivery is known for its rapid effects, as it allows the drug to reach the brain quickly. Common types of medicines that are often injected include opioids like heroin and synthetic variants such as fentanyl, stimulants like cocaine and methamphetamine, and prescription medications when misused intravenously. If you find yourself in a situation where you must use someone else’s injection equipment or they must use yours, follow the cleaning instructions of this manual to reduce the likelihood of transmitting a blood-borne illness. Sharing injection equipment even after it has been cleaned is definitely a second-best choice because blood and other matter can remain in a needle or syringe even after cleaning with bleach.
Understanding the Tools and Risks of Drug Injection
In this new consolidated guidelines document on HIV prevention, diagnosis, treatment and care for key populations, the World Health Organization brings… In this consolidated guidelines document on HIV prevention, diagnosis, treatment and care for key populations, WHO brings together all existing guidance… One of the results of the United States’ “zero tolerance” approach to drug policy is a serious lack of accurate information about drugs and drug use. This lack of information makes it extremely difficult for people to make rational and informed decisions about using drugs.
In 2022, WHO published the Consolidated guidelines on HIV, viral hepatitis and STI prevention, diagnosis, treatment and care for key populations…. A comprehensive package of services is recommended to address these infectious diseases in people who inject drugs. Injecting drug use accounts for approximately 10% of new HIV infections globally (UNAIDS, 2020). And an estimated 23–39% of new HCV infections occur among people who inject drugs. In some regions, such as Eastern Europe and Central Asia, prevalence rates for both HIV and HCV are particularly high. Furthermore, there are approximately 2.3 million HIV–HCV co-infections worldwide, of which more than half (1.3 million) occur in people who inject drugs (WHO, 2016).
In addition, SCS services lead to greater uptake of addiction and other treatment resources, retain people in care, and expand medical services 6, 7. To expand access to services provided by SSPs and SCS, ID clinicians are uniquely positioned to provide resources and patient education to PWID. Preventative measures, such as supplying sterile equipment, educating on proper injection techniques, and providing postexposure prophylaxis (PEP) or pre-exposure prophylaxis (PrEP) to those who qualify can be taken to attenuate risk of infections. The following is a noncomprehensive list of strategies that ID clinicians could familiarize themselves with and incorporate into a harm reduction–informed service within their practice.
- If there isn’t a wound clinic available near you and you need your abscess drained, try a community clinic or emergency room..
- The caveat with HBV vaccination is the extended follow-up necessary for completion of the vaccination schedule (0, 1, and 6 months), which can be a barrier to care in this population 54.
- Our physician-led, evidence-based rehab programs include medical detox, inpatient and outpatient rehab, and a full continuum of care in between.
- HEPATITIS A ( “HAV”) is excreted in feces (shit) and spread by fecal-oral contact (feces-to-hand- to-mouth contact).
- The world drug problem has multiple public health dimensions encompassing vulnerability to drug use disorders and dependence, treatment and care of people…
Lastly, don’t re-cook a shot with a lot of blood in it as the blood can coagulate and clog your needle. Standard insulin and tuberculin syringes are typically 1cc in size and are calibrated by .10 cc’s along the barrel of the syringe. Most people who inject find this size ideal and would rarely need use of a larger syringe, although some drug injectors like to use 1⁄2 cc syringes. The needle and syringe is arguably the most important piece of equipment needed to inject drugs. Due to legal restrictions on possession and over-the-counter sale, it can also be the most difficult piece of equipment to obtain.
Injection Technique
Skin-poppers and muscle- poppers are particularly susceptible to tetanus infection and should always use new, sterile equipment. Of note, the fentanyl test strips now being used as a harm reduction strategy were originally intended for urinalysis. To properly use fentanyl test strips, the end product to be used should be prepared by the individual and drawn up into the syringe first. Then, 10 drops of water should be added to residual content in the cooker and thoroughly mixed. The test strip can then be dipped in the water up to the first line and held for 15 seconds, and afterwards placed on a sterile surface.
In addition to disease transmission, improper use of injection tools can lead to injection site infections, which have risen with the increase in injection drug use. These infections can range from skin abscesses to serious bloodstream infections and endocarditis. The Institute for Safe Medication Practices emphasizes the importance of best practices to prevent medication errors, which can be extrapolated to include safe injection practices to minimize harm. Vein collapse occurs when veins close up due to repeated injections into the same site, repeated local infections, or trauma to the veins and surrounding tissues. You know you have a collapsed vein when you can’t draw blood from it or when the vein “disappears.” Thrombosis is the formation of an obstruction of a blood vessel bya blood clot. Using the same injection site over and over without letting the vein heal is one of the surest ways to cause vein collapse.