How Heroin is Injected
Heroin injection requires the most paraphernalia out of all the different ways to get heroin into the body. Heroin syringes are used to inject the drug into the body. A small cotton ball is used in order to strain the drug. Spoons or bottle caps are used with a lighter to liquefy the powdered form of heroin. Finally, individuals who inject heroin use some sort of a band to wrap around their arm to make their veins stick out which prepares them for the needle. The liquid heroin is then inserted into a needle so it can be injected into the body. Heroin is generally injected into the hand, leg or groin with the use of a needle. This is typically referred to as shooting heroin.
Heroin can be injected directly into the body using a needle or a syringe through intramuscular (IM) injection, and intravenous (IV) injection, or subcutaneous injection. IV injection is when an individual injects heroin or any substance directly into a vein. This is also called mainlining. This gets the drug directly into the bloodstream, which increases how quickly the drug is felt as well as its intensity. IM injection is when an individual injects heroin or another substance deep into a muscle. The results of IM injections are felt much more slowly than IV injections. The “rush” that is felt from IV heroin injections is not felt by individuals who inject heroin IM. Another form of injection is called subcutaneous or skin popping. In a recent study, skin popping was found to have the strongest risk factors for abscess, followed by the use of a dirty needle. Skin popping is when a person injects heroin or another substance just under the skin.
Health Risks and Dangers of Injecting Heroin
Injecting heroin is the most dangerous route of administration. Using a heroin needle to inject heroin directly in the body increases an individual’s chances of overdose which can be fatal. Shooting heroin can cause an individual to experience drowsiness, slowness of breathing, and a slow heart rate. Also, regular use of injecting heroin can lead to an increased tolerance leading a person to become dependent on the drug and later addicted to it.
Injecting heroin can have severe consequences if needles are shared among people who use the drug. This is because they have a higher chance of contracting and spreading infectious bloodborne diseases like Hepatitis B Virus (HBV), Hepatitis C Virus (HCV), and Human Immunodeficiency Virus (HIV). Prolonged use of injecting heroin can also lead to scarred or collapsed veins, other vein issues, abscesses, soft tissue infection, and clogged blood vessels which can lead to blood clots in the lungs, liver, kidneys, and brain. A final serious risk of injecting heroin is a bacterial infection of blood vessels and the heart. These bacterial infections can lead to endocarditis which is inflammation of the inner lining of the heart. This can be life-threatening as it destroys heart valves and other areas of the heart.
Dangers of IM and IV Injection
There are a multitude of dangers associated with IM and IV injections. The dangers associated with IV are the potential for bloodborne viruses like HIV, HBV and HCV, abscesses, infections, blood clots, deep venous thrombosis (a potentially fatal blood clot), overdose, and gangrene if the needle is injected into an artery. There are a lot fewer dangers associated with IM. These dangers include deep and painful abscesses.
The risks associated with skin popping are that the drug absorbs a lot slower which can lead to germs causing damage under the skin, abscess, infection, lumps, bumps, and long term damage. With IM, IV, and skin popping there is a higher risk of overdose due to the injection delivering a large amount of the drug directly into the bloodstream, which rapidly absorbs into the brain.
Needles and Infection
The injection of illegal drugs adds remarkably to the epidemic of bloodborne infection in the United States and around the world. The problem with sharing needles is that they are not sterile and are contaminated with the prior person’s bodily fluids. Once someone uses a needle the viruses on their body contaminate it. The infections that needles can pass onto other people are HBV, HCV, and HIV. HBV is an infection of the liver that is caused by a virus that spreads through blood and other bodily fluids. Symptoms of HBV are tiredness, fever, loss of appetite, diarrhea, stomach pain, and jaundice. HCV is another type of virus that can infect the liver. If left untreated HCV can cause serious life-threatening damage to a person’s liver. Symptoms of HCV are similar to HBV and include muscle aches, high temperature, tiredness, loss of appetite, and abdominal pain. HIV is a virus that damages the cells in a person’s immune system and weakens their ability to fight infection and diseases in the body. Symptoms of HIV are similar to the flu and can last two weeks. After those symptoms pass a person may not have any symptoms. That is why many people with HIV do not even know they are infected. In order to prevent infection, a new needle needs to be used every time. Heroin injection is the most harmful route of administration. This is mainly due to the transmission of bloodborne diseases like HIV, HBV, and HCV through the use of needle sharing. Needle sharing is very common among individuals who use heroin. Needle sharing puts individuals at the highest-risk group for acquiring hepatitis C infection and HIV. Each person who needle shares is likely to infect 20 other people. According to the National Institute on Drug Abuse, in 2014 HBV infections among people who share needles was as high as 25 percent in the United States. This is concerning because there is currently a vaccine to protect people against HBV.
Dirty and Shared Heroin Needles
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Heroin injection is the most harmful route of administration. This is mainly due to the transmission of bloodborne diseases like HIV, HBV, and HCV through the use of needle sharing. Needle sharing is very common among individuals who use heroin. Needle sharing puts individuals at the highest-risk group for acquiring hepatitis C infection and HIV. Each person who needle shares is likely to infect 20 other people. According to the National Institute on Drug Abuse, in 2014 HBV infections among people who share needles was as high as 25 percent in the United States. This is concerning because there is currently a vaccine to protect people against HBV.
Risk Factors for Infection
The risk factors associated with increased risk for an individual who injects heroin getting an infection are not sterilizing the needle and area of injection as well as contamination of heroin with bacteria and irritants. Significant risk factors for abscess include skin popping and use of a dirty needle. Cleaning the skin with alcohol prior to injection of the drug is the only protective factor in decreasing a person’s risk of obtaining an abscess. Hygiene is also important to reduce the amount of bacteria on the skin and reduce a person’s risk for infection.
If you or a loved one is struggling with a heroin addiction, it might be time to seek treatment. The right rehab can offer a wide variety of treatment options to fit your individual needs.
Written by Stephanie Moloney
- Addiction Treatment Options. Sunshine Behavioral Health.
- Association between heroin use, needle sharing and tattoos received in prison with hepatitis B and C positivity among street-recruited injecting drug users in New Mexico, USA. Epidemiol. Infect.
- Comparing injection and non-injection routes of administration for heroin, methamphetamine, and cocaine uses in the United States. Journal of Addictive Diseases.
- Fire in the vein: Heroin acidity and its proximal effect on users’ health. International Journal Drug Policy.
- Heroin. National Institute on Drug Abuse.
- Heroin. Center for Substance Abuse Research.
- Risk Factors for Skin and Soft-Tissue Abscesses among Injection Drug Users: A Case-Control Study. Journal of Clinical Infectious Disease.
- Safer injecting – Drug.ie
- What Infections Can Used Needles or Sharps Pass On? National Health Service.
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