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The hidden danger: How does injecting drugs increase overdose risk?
Drug injection is a method of introducing drugs into the bloodstream through a hollow hypodermic needle that penetrates the skin and enters the body (usually intravenously, but also intramuscularly or subcutaneously). Intravenous therapy is a common practice in modern medical care. According to 2004 data, 13.2 million people worldwide choose to inject drugs without medical supervision, 22% of whom are from developed countries. The drugs injected range from opioids to legally prescribed drugs, such as morphine, to more potent compounds commonly used recreationally, which are usually illegal.
While there are many ways to administer medication, the so-called injection method is particularly popular with some people because it allows the effects of the drug to be felt quickly, in just five to ten seconds. This approach bypasses first-pass metabolism in the liver, resulting in many drugs (such as morphine or heroin) becoming more bioavailable in the blood, thus inducing effects more quickly and more intensely. However, this intense high comes with a very high risk of overdose.
Drug injection is often associated with substance dependence, and has spawned unique "drug use" terminology in recreational drug culture, such as "shooting", "busing", and "injecting".
Risks of Injection Drug Use
In addition to the risks associated with IV injection in general, there are specific issues associated with drug injection by nonprofessionals. For example:
- Increased risk of overdose
- Arterial injury — Arterial pseudoaneurysms may form at the injection site and, if ruptured, may result in hemorrhage, distal ischemia, and necrosis.
- Injections into the wrong artery can lead to endarteritis and thrombosis, which may ultimately lead to similar consequences.
Injection Methods
The drug usually comes in powder or crystal form and is dissolved in water, often in a spoon, jar or other metal container. The user draws the required amount of water into a syringe, sprays the water over the medication, and mixes, heating if necessary. This process is particularly common when using heroin, but other drugs, such as powdered cocaine, can be easily dissolved without heating.
Challenges of safe injection
During the injection process, infection may occur due to unclean or unsafe injection habits, such as frequent injections in the same area. Users who fail to properly disinfect their skin or use unclean injection products increase their risk of developing diseases such as cellulitis and abscesses. If untreated, these infections can lead to sepsis and bacteremia and can be fatal.
In the fight against viruses, bacteria and foreign substances, the risks of injection are much higher than other methods of drug use.
Social impacts of injecting drugs
Not only that, needle sharing is also a key issue in injecting drug use, especially when people are unaware of the blood-borne pathogens they may be carrying. This means that data shows that 30%-50% of adults will not experience symptoms of acute hepatitis B, posing a huge public health challenge.
Globally, injecting drug use is closely linked to the spread of HIV.
Harm Reduction Strategies
To address this issue, various harm reduction approaches have emerged, including needle exchange programs and safe injection facilities. These measures are aimed at providing a safe environment for drug injectors, providing sanitary needles and syringes, and reducing the spread of AIDS and other infectious diseases.
In Southern Nevada, for example, a needle exchange program provides sealed needles to users, an innovative way to prevent the spread of disease. This has been explored in Europe for a long time, and the results show that increasing the availability of needles has significantly reduced the number of cases of blood-borne pathogens.
The goal of harm reduction is to reduce the negative effects of drug use, but does it completely solve the problem?
People often consider what is the safest way to take drugs, including oral or other forms of alternatives to reduce the health risks of injecting drugs. Which of these options has the best chance of actually reducing overdose risk and improving public health?
