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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


Looking after your veins – a brief guide

Rotate your injection sites
When you prick your skin with a needle, it always leaves a small hole that must be allowed to heal. The same goes for your veins.

If you do not allow your veins to heal, you may experience the following:

  • Collapsed veins
  • Infections and swelling
  • Leaking veins caused by poor injection technique
  • Re-injecting a site that has not healed may cause a blood clot that can break off and travel into your brain

Advice on injecting and choosing your injection site

  • Always vary your injection site. It takes at least a couple of days for your vein to heal. The longer you leave it, the better.
  • If you use the same vein, choose a site that is further along the direction of blood flow (closer to the heart). This helps to prevent blood clots and prevents infections.
  • If you self-inject, practice injecting with both hands. This gives you more choice of injection sites.
  • Always use a tourniquet. This makes it easier for you to find the vein. Always release the tourniquet before you push the plunger down. Leaving the tourniquet in place might cause excessive pressure to build up and could cause the vein to collapse. 

Take it easy
We recommend that you always vary your injection sites. However, sometimes veins can be hard to find or you simply don’t have time to look for one.

Always plan what you are doing, don’t rush it. Save the “easy” sites for when you know you will be in a hurry.

Don’t inject the backs of your hands, they are very sensitive and you might lose you hand.
If you allow yourself to panic, you might ruin a vein. Take a deep breath. Try to calm down.

And remember!
If you inject, try to do it in a place with plenty of light. Always plan ahead. Always use a fresh needle. A sharp needle is better for your veins. A thinner needle causes less tissue damage. Avoid injecting medicine. The best way to dispose of your equipment is to return them to your local Terveysneuvontapiste.


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