Complications From Intravenous (IV) Drug Use

Medically reviewed by

Dr. Ted Bender, Ph.D., LCDC

March 25, 2019

Many legal and illicit drugs are abused through intravenous (IV) drug use. Intravenous drug use can also be referred to as “injecting drugs” or “shooting up”. Unfortunately, a multitude of complications can occur as a result of  IV drug use that can be extremely dangerous to the users health and wellness.

Some of these complications are direct, such as to the skin, muscle, and bone of the area to which the drug was injected. Others are indirect, and can happen as a result of abusing the drug for an extended period of time, such a weakening of the immune system, heightened risk of infectious diseases, including less common infections, heart and lung complications, psychosocial effects, and effects on the central nervous system (CNS).

When drugs are “injected,” they’re taken by method of injecting the drug of abuse into the muscle, skin, or vein. Injecting drugs into the bloodstream is the fastest way for the user to feel the desired effects of the drug.

Some drugs commonly abused intravenously include:

• Cocaine
• Heroin
• Methamphetamine
• Prescription opioids (Oxycontin, Dilaudid, Morphine, etc)
• Prescription amphetamines (Adderall, Vyvanse, etc)

Understanding IV Drug Use

Drugs abused through intravenous drug use work by entering the body and flowing directly into the bloodstream, which means they have instant results. With some drugs, such as prescription opioids, instant results can be dangerous. Many prescription opioids are marketed and prescribed with the intention of having an extended (delayed) result.

Forcing faster effects of the drugs can be dangerous in a number of ways, depending on the drug. Opioids slow body functions such as heart rate and breathing, while stimulants, like cocaine and amphetamines, work to stimulate body functions. Each drug, when injected, could increase or decrease breathing and/or heart rates to dangerously low or high levels.

More than this, increasing the speed at which the person abusing the drug feels the effects of it increases his or her risk of developing addiction. Addiction occurs when you form a psychological dependence on the drug, feel a loss of control over use of it, have urges or uncontrolled cravings for it, or experience adverse symptoms when not taking it.

For some drugs of abuse,  physical dependence can also occur. With repeated injections, you increase your risk of dependence, which will manifest in physical withdrawal symptoms. Withdrawal can be highly uncomfortable, and with some drugs may even be life-threatening.

Complications From Intravenous Drug Use

The following are some of the most common complications which can arise with abuse of drugs by injection.

• Abscesses (boils)
• Bacterial infections in the blood vessels and heart valves
• Clogging of blood vessels leading to the  brain, heart, lungs, liver, or kidneys
• Collapsed/scarred veins
• Soft tissue infections
• Weakened immune system

Other Complications From Intravenous Drug Use

Perhaps one of the biggest and most immediate complications of intravenous drug use is the increased risk of contracting infectious diseases.  Infectious diseases can be carried to the person abusing the drug through the drug itself, through use of shared needles, contaminants in the skin, or through other substances mixed with the drug.

Because so many illicit drugs sold on the street contain additives, infectious disease is a large risk for people abusing drugs by injection.You may form a bacterial infection from breaking the skin and exposing it to the contaminants on the skin or on the needle, or you may pick up a disease as mild as the flu or as serious as HIV when sharing needles with others.

Some of the most concerning bacterial or viral complications of intravenous drug use may include:

• HIV
• Hepatitis: B and C
• Sepsis
• Cellulitis
• Pneumonia
• Endocarditis (infection in the heart chambers and valves)
• Abscesses of multiple organs, skin, and tissues

Other less common infectious complications and risks may include:

• Brain abscess
• Tetanus or botulism
• Injectional anthrax
• Malaria
• Syphilis
• Necrotizing fasciitis: a serious bacterial skin infection that can be fatal
• Toxic shock syndrome

Some of the most common complications from intravenous drug use begin with the injection itself, commonly called “skin-popping.” For someone who regularly abuses drugs by injection, whether due to dependence or addiction, the skin in the area of abuse may be overcome with injection wounds, bacteria, or abscesses. An abscess is a tender, pus-filled mass that results from (among other things) cuts or breaks in the skin.

The unfortunate fact about abscesses is people with weakened immune systems get them more often, and people who abuse drugs intravenously tend to have weakened immune systems. Injecting drugs, and breaking the skin, more often exposes you to infection on a regular basis, in turn weakening your immune system.

With time, your body begins to lose its ability to ward off infection. This is especially true if, like so many people who have fallen into addiction, you begin to neglect your health (i.e. lack of proper nutrition, sleep, and hygiene).

How To Recognize Signs Of Intravenous Drug Use

Intravenous drug use requires a person to inject the drug into the skin or muscles with tools, called Paraphernalia. Because of this, finding paraphernalia is one of the biggest signs of IV drug use.

Example of intravenous drug use paraphernalia include:

• Acid of some sort, such as lemon
• Alcohol swabs for sterilization
• Filter materials, such as cigarette filters or cotton balls
• Powdery residue on hard surfaces; preparing drugs for injection involves cutting and crushing them
• Razor blades and lighters
• Spoons or soda cans
• Belt or piece of rubber

In addition to the paraphernalia, there may also be some physical signs on the person and behavioral cues of intravenous drug use.

The following are some of the signs and symptoms:

• Needle marks, scabs, or bruising on the arms, legs, neck, hands, feet, or groin
• Scarring, inflammation, or skin infections
• Vascular scarring, known as “track marks”
• With prolonged abuse, “flesh-eating” diseases such as cellulitis
• Secretive behavior/denial of drug use
• Loss of interest in activities
• Shirking responsibilities
• Rise to anger or emotion when accused of drug use
• Strong cravings/urges to take the drugs
• Loss of control over drug use

Abuse of drugs will look different for each person, but these signs may help you determine if someone you know is at risk for addiction or dependence, or the complications associated with intravenous drug use. If you suspect someone close to you is at risk, you should seek help right away.

Inpatient drug and alcohol rehab programs can help individuals overcome addiction and dependence issues, and learn ways to manage addictive behaviors long-term. It may be difficult to admit that you or someone close to you has a substance abuse problem. Entering addiction recovery is one of the best things you can do to avoid the risks and complications that can come with a substance use disorder.

Find A Treatment Program Today

If you’re struggling with drug abuse, we’d like to help you find help in healing from the complications from intravenous drug use, abuse, and addiction. Contact a treatment specialist today to learn more about inpatient addiction treatment programs and the best drug and alcohol rehabs that offer it.