What Is Intravenous Drug Use?

Intravenous (IV) drug use refers to the practice of injecting substances directly into a vein using a syringe and needle. This method allows drugs to reach the bloodstream rapidly, leading to quicker effects. However, it also significantly increases the risk of serious health complications, both short-term and long-term.

What Are the Common Complications of Intravenous Drug Use?

Intravenous drug use can result in a wide range of medical, infectious, vascular, and psychological complications.

1. Infections

IV drug use compromises the skin barrier and introduces bacteria directly into the bloodstream or surrounding tissues.

• Skin infections – cellulitis, abscesses
• Endocarditis – infection of the heart lining or valves, often life-threatening
• Sepsis – a widespread infection in the bloodstream
• HIV and AIDS – due to sharing contaminated needles
• Hepatitis B and C – spread through infected blood
• Bone infections (osteomyelitis) – especially in recurrent users

2. Vascular Complications

Injecting into veins can lead to damage, inflammation, and clotting.

• Collapsed veins
• Thrombophlebitis – inflammation and clotting in the veins
• Deep vein thrombosis (DVT) – clots that can travel to the lungs (pulmonary embolism)
• Aneurysms and pseudoaneurysms – abnormal blood vessel dilation due to trauma

3. Tissue Damage

Using impure substances or poor injection techniques can lead to:

• Necrosis (tissue death)
• Compartment syndrome – dangerous swelling that can damage muscles and nerves
• Amputation – in extreme untreated cases

4. Respiratory Issues

Depending on the substance injected:

• Respiratory depression – especially with opioids like heroin
• Pulmonary embolism – clots or foreign material block blood flow in the lungs
• Non-cardiogenic pulmonary edema – fluid accumulation in the lungs

5. Neurological Effects

• Stroke or brain abscess – from clots or infected material traveling to the brain
• Peripheral nerve injury – due to injection site trauma

6. Psychiatric and Social Complications

IV drug users are at higher risk of:

• Addiction and dependency
• Mental health disorders – including depression, anxiety, and psychosis
• Social isolation, homelessness, and unemployment
• Criminal behavior and incarceration

How Are These Complications Diagnosed?

Diagnosis depends on the complication but generally includes:

• Blood tests – to detect infection, inflammation, or organ damage
• Imaging (X-ray, CT scan, MRI) – to find abscesses, bone infection, or vascular damage
• Echocardiography – to check for endocarditis
• Urine and blood cultures – to detect bacteria or viruses

How Are Complications Treated?

Treatment varies depending on the specific issue but often includes:

• Antibiotics or antivirals – for infections
• Surgical drainage – of abscesses or removal of necrotic tissue
• Anticoagulants – for blood clots
• Substance use treatment programs – including detox, rehab, and counseling
• Needle exchange programs – to reduce the risk of infectious disease

Can These Complications Be Prevented?

Yes, prevention is possible through a combination of medical, social, and harm-reduction strategies.

Prevention tips include:

• Avoid IV drug use
• Seek help for substance use disorder
• Use clean, sterile needles if actively using (via needle exchange programs)
• Do not share injection equipment
• Engage in regular health screenings
• Access rehabilitation and mental health support