Controlling the spread of the AIDS epidemic demands more knowledge about the size of the IV drug-using population and the dynamics of viral transmission in this group. Efforts to control the spread of other viral infections have not produced information on the dynamics of infection that would be helpful in preventing the spread of HIV. Data are still needed on the distribution and variation of behaviors that transmit HIV, the number of IV drug users, and the proportion of users infected with the virus. Such data are critical to planning for future health care needs, targeting prevention programs, counseling the infected, and protecting the uninfected. The AIDS epidemic and the role of IV drug use in the transmission of HIV have also focused the nation’s attention on the prevention of drug use and the efficacy of drug treatment programs.
IV Drug Use: Signs, Dangers, and Treatment
- Both conditions require prompt medical treatment and can become life-threatening if not adequately treated.
- In June 1988, the report issued by the IOM/NAS AIDS committee concluded that federal efforts to reduce HIV transmission among IV drug users were grossly inadequate.
- Moreover, the knowledge base needed to design, implement, and evaluate measures to change high-risk behavior in IV drug users continues to grow.
- Some individuals experiment with it for a period of time and then quit; others are intermittent users, injecting only on weekends (so-called “weekend warriors”) or on isolated occasions (“chippies”) (Zinberg et al., 1977).
For example, it is common for PWID to inject heroin multiple times per day,thereby reusing or sharing needles due to limited resources. Because of the fast drugeffect on the brain, the highest bioavailability, and cost, intravenous injection andsharing of needles are more among the PWID with the most severe craving symptoms. Withmore severe craving symptoms, substance abusers are at higher risk of risky behaviors andare more likely to use drugs impulsively, regardless of the hazard of blood-borne diseases6. Also needed are methodological studies of how to obtain better self-reported information and how to determine when a particular subject is not providing valid data.
Harm Reduction Methods for Intravenous Drug Use
Greenberg and Roberson’s (1978) study found no support for the notion that the composition of race, sex, and age in cities and neighborhoods is correlated with heroin use. The difficulties involved in conducting research on IV drug use, some of which were discussed in the preceding sections, are only part of the challenge researchers face in this area. There are several additional policy-related and methodological issues that must be addressed to permit the development of intervention programs to interrupt the spread of HIV. Contamination can also occur when a droplet of infected blood remains inside or outside the needle.
Peripherally inserted central catheter (PICC)
In the past decade, NSEP and MAT have succeeded in reducing the rate of HIV infection;meanwhile, there is strong evidence that HAART is effective in reducing HIV transmissionrates and prolonging life59. However, as there is no proven cure for HIV, the best way to reduce infectionrates is to prevent its spread. NSEP is a widely used public health innovation which issignificantly reducing contaminated needle distribution, but the relationship between NSEPand the incidence of HIV is controversial. Only heroin agonist pharmacotherapy isavailable for treating heroin addiction in MAT, despite other substance such as cocaineand amphetamine being injectable.
Types of central venous catheters
Another theory explains this association of baking soda to pass drug test and DVT to be due to the citric acid used to dissolve these drugs. Most heroin available reaches a pH of nearly 4, which is quite low as compared to the normal pH within blood vessels [6,33-34,42]. Watch and listen to stories of research, compassion, and HIV services for people who use drugs.
Applied research should include planned variation and evaluation of experimental programs. There are now enough studies of AIDS risk reduction among IV drug users to derive some generalizations that describe the current state of knowledge. First, it is quite clear that IV drug users will modify their behavior to reduce their risk of AIDS. Although the studies that support this conclusion tend to rely heavily on self-reported behavioral modifications, there are enough studies in which there is some independent evidence of change to conclude that the self-reports reflect what has actually occurred. Examples of the independent confirmation of change include the increased demand for sterile injection equipment in New York City, increased use of syringe exchange programs, and acceptance of bottles of bleach for decontamination of used injection equipment. Since the 1990s, it has been demonstrated that vascular complications including deep vein thrombosis (DVT) have high morbidity among intravenous drug users (IVDU).
An accurate drug history, including route of administration, should be completed for all patients on admission, acknowledging that this may need to be repeated until an accurate picture is gained. All IDUs should be asked about the use of other substances, especially alcohol and benzodiazepines. For patients on opioid maintenance therapy, the dose and timing of the last dose should be confirmed with the dispensing centre at the first opportunity. Substance use disorder is a complex phenotype, and is the result of a series of causalinfluences such as genetic factors, diverse environmental factors, and predicteddrug-induced effects1–4.
Skin and veins can easily become scarred, inflamed, and infected, which is evident in most cases. Speak with your healthcare provider to determine which option may be more beneficial for you or your loved one. Be sure to carefully clean the injection site prior to injecting (see ‘Mainlining’ section above for more detail).
Multiple, prospective longitudinal studies are needed to keep abreast of problems and changes as they occur. Sharing injection equipment is common among IV drug users (Black et al., 1986; Brown et al., 1987). Indeed, some studies have shown that essentially all IV drug users report needle-sharing during some period of their drug-use careers (Black et al., 1986). People are not born injectors; they learn this behavior in the presence of others who have already been initiated (Powell, 1973; Harding and Zinberg, 1977).
See the latest data on HIV among people who inject drugs, and learn what CDC is doing to prevent HIV infections among this population. But drugs such as opioids, amphetamines, methamphetamines, and cocaine are also taken intravenously. IV drugs are injected directly into alcohol-related crimes: statistics and facts the bloodstream with a sterile syringe and hypodermic needle through veins. This is different from intramuscular injections, which are delivered directly into the muscle. Once you think you’re in a vein, pull the plunger back to see if blood comes into the syringe.
Moreover, because respondents may be considerably embarrassed to admit that they cannot read or do not understand a question, researchers cannot expect them to bring these difficulties to the attention of the person collecting the data. Tied as it has been to policy needs, research on drug use in the past suffered the vicissitudes of shifting policies and resource availability. For example, the Client-Oriented Data Acquisition Process (CODAP)8 collected demographic data and drug-use histories on all individuals entering federally and state-funded drug treatment programs. In the early 1980s, however, what had previously been direct federal support for this and other drug-related programs was superseded by a block grant program that shifted control from federal agencies to the states.
Veins are blood vessels that carry blood from the extremities of the body back to the heart and lungs where it becomes re-oxygenated. Veins have no pulse, and the the link between alcohol use and suicide blood they carry is a deep, dark red because it is low in oxygen. Arteries carry blood rich in oxygen from the lungs and heart to all the other parts of the body.
Because of the link between IV drug use and perinatal transmission of HIV, information is needed about contraceptive and childbearing behaviors in the IV drug-using population. Unfortunately, currently available data permit only a rudimentary picture of these behaviors. Despite heroin’s capacity to suppress fertility to a certain extent in women, Cuskey and Wathey (1982) found that, in New York City, birth rates for addicted women were higher than those for nonaddicted women.
There are over 50 conditions that present with swollen and painful limbs comparable to DVT in IVDU, making precise diagnosis critical for timely treatment. Extended anticoagulant therapy with low-molecular-weight heparin combined with warfarin is the recommended treatment. The pathogenesis of DVT development in IVDU is mainly attributed to the interplay of trauma to the vessel by repeated injection and the injected drug itself. Prevalent clinical presentations include local pain, swelling, and redness with typical systemic symptoms including fever, cough, dyspnea, and chest pain on top of addiction features. There appeared to be a delay in reporting symptoms, which was most likely due to the social stigma attached to IVDU. Placement of an IV line may cause pain, as it necessarily involves piercing the skin.
A deadly consequence of the opioid crisis is increased incidence of blood-borne infections, including hepatitis B virus and hepatitis C, human immunodeficiency virus (HIV), and bacteria that cause heart infections (endocarditisexternal icon). The use of contaminated injection drug equipment is a primary transmission route for both HIV and hepatitis C. Increasing injection drug use has placed new populations, including young people, at risk. Unfortunately, less is known about the rates of HIV infection among IV drug users than is known about the prevalence of AIDS.