Intravenous drug use and risk management

Published 7 August 2007. Updated 1 November 2011.

The intravenous use of drugs and medicines is not recommended. Medicines intended for oral administration always represent a serious health risk when injected and the practice is associated with overdose, inflammation and infectious disease. However, if you cannot avoid injecting drugs, please try to maintain the best possible hygiene and be aware of your injection site, technique and the equipment you are using.

Always wash your hands using soap and plenty of water before injecting. The area were you prepare and administer the drugs should be as hygienic as possible. Your injecting equipment should always be unused in order to reduce the risk of HIV and Hepatitis. In addition to your needles and syringes, all your cups and filters should also be previously unused. We also recommend the hepatitis vaccine.

Filtering has been shown to be beneficial. The filtering process removes additives such as cornstarch, which can cause damage to blood vessels. If injected into the vessel, the additives accumulate and restrict normal blood flow. They can then be passed into your small blood vessels, responsible for circulation in areas such as the eye. Over time, the blood vessels in the eye can become blocked, causing blindness.

A British comparative study assessed the efficacy of different types of filters. Eight filters were included, ranging from cigarette filters to purpose-made varieties. The top two filters were the filters available at the Vinkki centres in Finland (98% filtration) and the Dental filters (86% filtration). The free filters supplied at A-Clinic Foundation information centres (terveysneuvontapiste) offered 56-86% filtration and tobacco filters 22% filtration.

A drug used in opiate replacement therapy (ORT) was used in the study. After the test, significant levels of the active ingredient were not detected in the filters. This finding supports the use of filters.

Choosing the correct injection site is an essential part of your injection technique. Developing a good injection technique is important in order to protect your blood vessels. Always vary your injection site to allow the vein to heal. If the vein is not healed before you next inject, it may cause inflammation, leaking and even complete collapse of the vein.

When the veins used for injecting deteriorate, users tend to opt for more high-risk techniques, such as injecting muscles or large veins. If you inject drugs directly into muscle tissue, you run the risk of significant skin and tissue damage.

Never inject into your head, sexual organs or neck. Injections to the neck are always associated with particular risks as the veins are directly linked to the large vessels, allowing bacteria to spread rapidly and reach vital organs such as the heart. In Finland, amputations of fingers, hands and even legs due to blood vessel damage are not unknown.

If you are addicted to drugs, we recommend that instead of injecting, you try less risky methods. We would also encourage you to visit one of our information centres (terveysneuvontapiste) and to seek help with your addiction.

Aino Rukkila
Social Therapist
Espoon Vinkki

Updated 1 November 2011:
Tuija Vilkko
Master of Health Sciences, Psychiatric Nurse, Development Coordinator
Kettutien erityispoliklinikka/Järvenpään sosiaalisairaala