Administering a substance via injection involves delivering it into the body through a syringe or needle, commonly directly into the bloodstream. This method, frequently associated with drug administration, carries significant health risks, including the potential for transmitting HIV, hepatitis and other bloodborne pathogens. Additionally, injection drug use can cause physical complications such as collapsed veins, infections and abscesses, alongside various social and psychological repercussions.

Intravenous drug use or IV drug use, involves injecting drugs directly into a vein, allowing substances to enter the bloodstream rapidly. This method is sought after for its ability to deliver drugs quickly into circulation, achieving a faster and more intense high. Commonly injected drugs include cocaine, heroin, fentanyl, hydrocodone, oxycodone, morphine, methamphetamine, ketamine, PCP and sometimes prescription stimulants like Adderall. However, this method introduces significant risks, including the transmission of diseases and other health complications. Intravenous drug use requires a needle and syringe to inject the liquid drug form directly into the bloodstream, though some users may inadvertently inject into muscle or just under the skin, methods known as intramuscular injection and “skin popping,” respectively. Injecting drugs offers a swift, high concentration of the substance to the brain, highlighting both its appeal and danger.

Injecting a drug carries greater risks compared to other modes of consumption. Users face not just the consequences of the drug’s effects but also issues specific to the injection process, including:

• Contaminants: These are foreign substances mixed into drugs to modify their consistency or potency, often without the consumer’s awareness. This practice, common in illicit drugs like heroin and cocaine, aims to either extend the quantity to reduce production costs or to enhance the drug’s effects. Such contaminants, ranging from amphetamine to fentanyl and LSD, introduce unknown risks to users, potentially leading to unexpected reactions, toxicity or overdose due to their varied and potent nature.
• Binding Agents: When prescription tablets are crushed, dissolved and injected, the binding agents within these tablets—such as cellulose, talc and cornstarch—are also introduced into the bloodstream. These agents can block blood vessels, leading to inflammation in the lungs and damage to heart valves. This damage significantly raises the risk of infections like endocarditis.
• Pathogens: The use of non-sterile needles, especially those previously used by others, can introduce pathogens into the body. This practice can lead to the development of abscesses at the injection site and the spread of infections to vital organs, including the heart, brain and liver. Conditions such as endocarditis are notably common among individuals who inject drugs with contaminated equipment. Further to that shared needles can facilitate the transmission of severe infections, including hepatitis B, hepatitis C and HIV.
• Needle-Related Injuries: Repeated improper needle use can cause a condition known as “drug abuser’s elbow,” where muscle tissue around the elbow turns into scar tissue. Skin injections or “skin popping,” can result in persistent sores, while intravenous injections can cause vein scarring making future injections challenging and disrupting normal blood flow.

Injection practices involve not only illicit drugs but also prescription medications and performance enhancers with significant risks across the board. To combat these dangers, initiatives like needle exchange programs have been developed to reduce disease transmission and support recovery by providing clean needles and access to education and counselling.

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