Injection of drugs is a method of introducing drugs into the bloodstream through hypodermic needles and hypodermic needles, which penetrate the skin into the body (usually intravenous, but also intramuscular or subcutaneous). This often applies to substance dependence and drug use. Usually, powder drugs are mixed with water to create a solution, and then the solution is injected. These actions are often colloquially referred to as "slamming", "shooting", "banging", "pinning", or "jacking up", often depending on the subculture of the particular drug in which the term is used (ie heroin, cocaine, or methamphetamine).
Although there are different methods of taking medication, injection preferred by some users, as the full effect of the drug experienced very quickly, usually within five to ten seconds. It also pass metabolism first pass in the liver, resulting in bioavailability and a higher efficiency for many drugs (such as morphine or diacetylmorphine/heroin, with about two-thirds of which were destroyed in the liver when taken orally) than oral consumption, meaning users get a better effect strong (but shorter) amount of the same drug. This shorter, stronger "high" can lead to dependence - both physical and psychological - developing faster than with other methods of taking drugs. In 2004, there were 13.2 million people worldwide who used injection drugs, where 22% came from developed countries.
Video Drug injection
Benefits
There are various reasons why drugs will be more interesting to inject than take other methods, such as:
- Increased effects - Injecting intravenous drugs means more drugs will reach the brain faster. This means that the drug will have a very strong and rapid onset. With some medications, this can produce a sensation not found with other administrative routes, known as rush.
- More efficient use - Smaller amounts are enough because injection means more drugs will reach the brain than other methods. This is because the body's defense and detoxification mechanisms (such as the first flow metabolism in the liver with oral use) are bypassed. Injection increases the bioavailability of the drug. This means requiring fewer drugs (and thus less money) to achieve the same effect (ignoring the effect of tolerance).
Maps Drug injection
Loss
In addition to the common problems associated with administering any IV medication (see the risk of IV therapy), there are some specific problems associated with non-professional drug injection, such as:
- Opportunities for infection - This is generally a major issue:
- Needle sharing or sharing of syringes can transmit blood-borne diseases between users, such as HIV-AIDS and Hepatitis C
- Uncontrolled infection from the injection site is caused by a lack of good hygiene and lack of aseptic technique during the injection process.
- Increased likelihood of overdose - Since IV injection provides a direct dose of the drug into the bloodstream, it is more difficult to measure how much to use (compared with smoking or grunting, where the dose can be increased relative gradually until the desired effect is achieved, this gives the user who is in danger of overdosing the opportunity to seek medical treatment before the inhalation entrance set). In addition, due to the rapid onset of intravenous drugs, overdose can occur very quickly, requiring immediate action. Another reason why overdose is a risk is because the purity of street drugs varies greatly.
- Peripheral venous scars - This arises from the use of blunt syringe equipment. It's very common for users who have been injecting while in jail and reusing syringes occasionally occasionally hundreds of times. The use of IV drugs for prolonged periods may cause a collapsed vein. Although turning the site and allowing time to heal before reuse can reduce the likelihood of this occurrence, peripheral venous destruction may still occur with prolonged use of IV drugs. IV drug users are among the most difficult patient populations to obtain blood specimens from due to peripheral venous scar tissue. Darkness of the veins due to scarring and toxic buildup produces traces along the blood vessels and is known as marks traces .
- Artery damage - Arseial pseudoaneurysms can form at the injection site, which can rupture, potentially resulting in bleeding, distal ischaemia, and gangrene. Accidental intra-arterial injection can also cause endarteritis and thrombosis, with consequences that are ultimately similar.
- Increased chance of addiction - An increased effect of intravenous administration of drugs may make the possibility of addiction more likely.
- Social stigma - In many societies, there is a social stigma attached to IV drug use, in addition to the more common stigma surrounding illegal drug use and addiction.
Procedures
Drugs - usually (but not always) in powder or crystal - are dissolved in water, usually in spoons, cans, bottle caps, under cans of soda, or other metal containers. Cylindrical metal containers - sometimes called "stoves" - are provided by needle exchange programs. The user pulls some of the required water into the syringe and sprays it onto drugs. The solution is then mixed and heated from the bottom if necessary. Heating is used primarily with heroin (though not always, depending on the type of heroin), but it is also often used with other drugs, especially crushed tablets. Cocaine HCl (cocaine powder) soluble easily without heat. Heroin prepared for the European market is not soluble in water and usually requires the addition of acids such as citric acid or ascorbic acid (Vitamin C) powder to dissolve the drug. Due to the danger of using lemon juice or vinegar to acidify the solution, citric acid packages and Vitamin C powders are available in the needle market in Europe. In the US, vinegar and lemon juice are used to shoot cocaine. Acid converts the water-insoluble cocaine base into cracks into cocaine (cocaine acetate or cocaine citrate) salt, which is water soluble (such as cocaine hydrochloride).
After the drug is dissolved, a small needle (usually 0.5 or 1 cc) is used to pull the solution through a filter, usually cotton from a cigarette or cotton filter. The "Tuberculin" syringe and the type of syringe used to inject insulin are usually used. Usually used syringes usually have a 28 (or approximately) measuring needle that is usually 1/2 or 5/8/8 inches.
The preferred injection site is the curve of the elbow (ie, Median cubital vein), on the hands of the non-writing user. Other users choose to use the Basilica vein; while it may be easier to "hit", caution should be done because two nerves run parallel to the vein, increasing the likelihood of nerve damage, as well as the possibility of "nick" the artery.
recreational drugs
Risk
The risks of drug injections are caused by various factors, including unsafe or unsafe injection practices and repeated injections at the same site. Injecting drug users who fail to cleanse the skin adequately or use a clean injection product have a high risk for cellulitis, abscesses, and thrombophlebitis; this infection can cause septicemia and bacteremia, which can be fatal if left untreated. Repeated injections, especially with unsafe practices, may cause additional medical problems that include the formation of thrombosis and infection endocarditis. In rare cases chest Osteomyelitis may be caused by IV drug use.
The additional risk of unsafe injector practice is mainly generated from sharing materials (needles, stoves, syringes) used in injection. Blood-borne pathogens, such as HIV, Hepatitis B, and Hepatitis C are of particular concern among injection drug users who share supplies, and increase the likelihood of infection. An additional challenge, is that not only infected individuals who know their positive status and continue to share inventory, put other users at risk of infection as well. 30-50% of adults will not experience symptoms of acute Hepatitis B, and those who experience lethargy, nausea, upper abdominal pain, muscle aches, or darkening of urine need to connect these symptoms to possible infections to seek treatment and limit the spread of the virus.
Of all the ways to swallow a drug, injections carry the greatest risk so far as it passes through the body's natural filtering mechanisms against viruses, bacteria, and foreign matter. There will always be less risk of overdose, disease, infections, and health problems with alternatives to injections, such as smoking, insufflation (inhalation or swallowing of the nose), or swallowing.
Drug injections are also generally a component in HIV-related syndrome. Fragments of a pill injection are known to clog small blood vessels in the lungs, brain, and elsewhere, potentially leading to pulmonary embolism (PE), stroke, or venous embolism. A small percentage of PE is due to air embolization, fat, and talc in drug intravenous drug abusers. More generally, this inflammatory response to a foreign body causes the granulation tissue to form in the capillary layer, resulting in vasculitis, and, when it occurs in the pulmonary capillary bed, talcosis is potentially lung. Hitting the arteries and nerves is dangerous, painful, and presents the same spectrum of problems.
Hazard reduction
Harm reduction is a public health approach that serves as an alternative to abstinence-only abstinence. While it does not justify the use of illegal or illegal drugs, it seeks to reduce the dangers, risks and dangers associated with drug use, both for people who use illicit drugs and the wider community. Injecting drug users who reuse drug delivery components place themselves and others at risk for diseases such as HIV, hepatitis B and hepatitis C, as well as increasing their chances of acquiring a serious infection. In 2015, the CDC conducted an HIV Surveillance Report and linked 2,392 (6%) new HIV diagnoses to IV drug use in the US.
Prominent methods to address the issue of disease transmission among intravenous drug users are needle exchange programs (also known as syringe exchange programs, syringe service programs or syringe programs), where people who inject drugs (IDUs) can access sterile needles, syringe, and other trinkets. In addition to providing sterile devices used in drug injections, these programs often offer access to infectious disease testing, referrals to drug abuse or mental health care programs, and more. The idea behind a harsh reduction approach is to slow the transmission of diseases, such as HIV/AIDS and hepatitis B and C, and promote public health by reducing the practice of sharing used needles.
In countries where the harm reduction program is limited or non-existent, it is quite common for IV users to use one needle repeatedly or share it with other users. It is also not unusual for a sterilizing agent to be used on needles and syringes. This creates a high risk population for the spread of blood-borne pathogens.
A new approach to reducing the dangers to IV drug users has recently begun in Southern Nevada by 2017. Trac-B Exchange - Southern Southern Southern Harm Reduction program was approved in early 2017 to help reduce the spread of HIV in "People Who Inject Drugs" €. In Nevada, sharing drug needles has led to increased spread of HIV and hepatitis B and C. In an effort to reduce the spread of blood-borne pathogens, Southern Nevada installs vending machines to provide access to sterile needles for those who use them for drug injections. Individuals using this vending machine are required to register with Trac-B and allowed 2 boxes a week. Boxes containing sterile needles and other equipment needed to reduce the risk of spreading blood-borne pathogens. If this pilot program succeeds in reducing the spread of blood-borne pathogens, we can see such programs are spreading to other parts of the country.
Although this is a new idea in the United States, it has been tested in Europe more than 20 years ago. To combat the AIDS epidemic that spread throughout Europe, France allowed pharmacies to remove needles without a prescription and apply needle exchange programs. In 1996, they started a pilot program of a needle-vending machine, similar to a coin-operated vending machine. The first vending machines were placed in Marseille due to the high incidence of AIDS caused by sharing needles. Their results were published in 1999. They found that when the availability of hypodermic needles increased, more and more people began to buy sterile needles. It also provides a way for people to buy needles without having to feel ashamed to go to a pharmacy. They theorized that with greater access to sterile needles, they would expect to see a reduction in cases of blood-borne pathogens.
Secure injection
The harm reduction philosophy promotes information and resources for IV drug users to practice safer injections. General guidelines for safe intravenous injection are usually based on the following steps:
The medication preparation area should be cleaned with warm soapy water or alcohol to minimize the risk of bacterial infection.
Equipment typically includes new syringes and needles, alcohol swabs, eye drops as sterile water, filters (cotton or syringe filters such as Sterifilt), tourniquets, and clean spoons or Stericup. To minimize the possibility of bacteria or virus entering the bloodstream, people are advised to wash their hands with soap and warm water. However, since people do not always have access to hot water and soap when they inject, the hazard-reduction philosophy seeks to find the most realistic and reliable option that drug users will take; a process that takes a lot of time or access to material will not be used often. Alcoholic swabs are generally distributed with injection equipment, and while they are less effective than hand washing, its use is more effective than none. Any sharing of injecting equipment, even tourniquets, is strongly discouraged, due to the high danger of bacterial and viral transmission through equipment.
Sterile water is also recommended to prevent infection. Many needle syringe programs distribute USP sterile vials or water amps for this reason. Where sterile water is not available, the harm reduction approach recommends boiled tap water for five minutes, and then allowed to cool.
After water and substance are combined in the mixing vessel, heat is sometimes used to help mixing. Filtering is recommended by health care, since the mixture may consist of wax or other insoluble substances that damage the artery. In addition, talc injection has been associated with pulmonary fibrosis in intravenous drug users. Wheel filters are the most effective filters. 5.0 micron wheel filters (eg Apothicom Sterifilt) - now shared in some needle exchange programs, not cotton - are intended to remove talc from prescription tablets such as benzodiazepines, dextroamphetamine, methadone tablets and other recreational drugs such as MDMA. However, cotton (at risk of cotton fever) or tampon may be used, although more effectively, some screening should be performed; cigarette filters should not be used, because the risk of fibers is broken and injected together with the solution, the filter should also never be reused either as a filter or in an attempt to recover existing medicines, as many risks, ranging from cotton fever to life-threatening sepsis.
After the mixture is pulled into the syringe, the air bubbles must be removed by flicking the barrel with the needle pointing upward and pressing the plunger to remove the bubbled bubbles at the top. This is done to prevent air injections into the bloodstream.
A tourniquet can be used to help access the vein. The tourniquet should not be too tight, or left too long, because this causes the blood vessels to swell and stretch. When injecting, the bevel or "hole" of the needle must be facing upward and loosened to the vein at a shallow angle between 10 and 35 degrees to minimize the risk of penetration through the vein completely. To prevent stress on the veins, the needle should point toward the heart.
Plunger must be pulled back a bit (colloquially known as "back hijacking" or "marking") to make sure the needle is in the blood vessels. Blood should appear in the barrel of the syringe if this is the case. This process is called aspirating needle or register. When accessing a vein with unimpeded blood flow, a "flashback" - or sudden flash of red blood inside the needle tip - can occur spontaneously as the needle enters the vein. Since the sudden emergence of blood in the needle/syringe alone does not guarantee proper needle placement (flashbacks can also occur when the needle passes through the blood vessel completely, enter the artery accidentally, or otherwise is extravasation), the plunger aspiration of the syringe is still considered as a necessary step.
So the tourniquet should be removed and the pusher pushed gently. After injection, clean tissue or cotton should be pressed to the injection site to prevent bleeding. Although many people use swab alcohol for this purpose, it is not recommended by health services because alcohol interferes with blood clots.
Injecting tooth should be removed using "trash" if provided. Other rigid walled containers such as bottles are recommended as the second best option.
Modify
Especially for intravenous administration, self-injection in the arm may become awkward, and some people modify the needle for one-handed operation by removing the plunger and installing bulbs such as from a large pipette or baby pacifier to the end of the barrel to its effect makes it a large eyedropper with needles attached. Therefore this is a variant of the general method of injection with a pipette with an embedded syringe, using a "collar" made of paper or other material to make a seal between a needle and a pipette. Removing part of the plunger assembly by cutting most of the shaft and thumb rest and attaching the bulb to the end of the barrel, allowing the bulb to operate the thruster with suction, also works in many cases.
The alternative to syringes in the 1970s was to use glass drops, which should be more easily manipulated with one hand. A large hairpin is used to create a hole in the skin and a drug-containing pipette (usually heroin) is inserted and the bulb is squeezed, releasing it into the tissue. This method is also reported - by William S Burroughs and other sources - for intravenous administration at least since 1930.
Alternative
Insufflation (sniffing or sniffing) is usually safer than injection in terms of the relative danger of transmission of blood-borne virus. However, the membrane in the nose is very smooth and can break when snorting, so the user must have their own snorting equipment that is not shared with others, to prevent transmission of the virus. Like injection, a clean preparation surface is needed to prepare the medication for snorting. The nasal membranes can be severely damaged by regular grunting.
Drugs can also be smoked or "chased". Smoking and chasing have a negligible risk of bacterial or viral transmission and the risk of overdose is reduced compared with injections, but they still retain many "rush" from injection because the effects of the drug occur very quickly. Pursuing is a much safer way to use heroin than injecting, with one common option is to use new aluminum foil, first passing fire lighters on either side/or just the glossy side at least, which helps sterilize ("curing").
Swallowing tends to be the safest and slowest method of swallowing the drug. More secure because the body has a greater chance to filter out the dirt. When the drug comes slower, the effect tends to last longer as well, making it a favorite technique in the world of dance for speed and ecstasy. People rarely take heroin verbally, because it is converted into morphine in the stomach and its potency is reduced by more than 65% in the process. However, the bioavailability of oral opioids depends heavily on substance, dosage, and patients in a way that is not yet understood. Pills like benzodiazepines are best swallowed because they have talc or wax fillers in them. This filler will not irritate the stomach, but poses serious health risks for the veins or nasal membranes.
Oral sublingually or bucally substituted tablets (between the gums and jaws) are the techniques used clinically to improve the bioavailability of many drugs. A significant increase in the effects of drugs taken in this way is noted for many opioids and almost all benzodiazepines.
"Shebanging" involves spraying the drug into the nose for absorption by the nasal membrane.
"Striking", or swallowing rectal, depends on many blood vessels in the anal canal that pass medication into the bloodstream pretty quickly. Some users find that trading off some "rush" for fewer health risks is a good compromise. Shafting usually involves about 1.5 ml of fluid mixed with the drug.
Women have an additional option "shelf", where drugs can be inserted into the vagina. This is similar to the rectum, where there are many blood vessels behind the very thin cell wall, so the drug gets into the bloodstream very quickly. Treatment should be taken with drugs such as amphetamines that can irritate the rectal lining and the sensitive vagina.
Substances below a certain molecular weight can be absorbed through the skin and into the bloodstream when dissolved in a dimethyl sulfoxide (DMSO) solvent available as a liquid or gel; Therefore there is the possibility of creating a topical herb with DMSO medical class and given drugs that will solve the problem of first digestive tract and GI destruction in addition to the onset of faster effects.
History
The use of IV drugs is a relatively recent phenomenon arising from the discovery of reusable syringes and the synthesis of pure morphine and chemical cocaine.
It has been noted that intravenous administration of drugs strengthens its effect, and - because drugs such as heroin and cocaine have been used to treat various diseases - many patients are given "hard" drug shots for illnesses such as alcoholism and depression.
At the time of Aleister Crowley, the culture of intravenous drugs already had small but loyal followers. Sir Arthur Conan Doyle writes that Sherlock Holmes used to inject cocaine to fill his mind among the cases.
Origin and initial use
The syringes and syringes in their current form were created by the French scientist Charles Pravaz in 1851, and became famous during the war and the following decade. However, the famous first attempt to inject drugs into the body was a 1667 attempt to inject a solution of opium into dogs, and some suspect that parenteral drug administration may work better based on the practice of rubbing opium and other drugs. become sores or cuts in the skin for the purpose of causing systemic uptake and early scientific understanding of lung function.
For much of the 1850s, the previously held belief that opiate and addiction dependence (often called "opium appetite", or, when relevant, "libido" or "codeine appetite") is due to the action of the drug on digestion. The system - like hunger or thirst - causes doctors to choose to inject morphine rather than administer it orally, in the hope that addiction will not develop. Of course, by c. 1870 or earlier, it was manifested that this was not the earliest case and title of morphine addicts as the current understood term is often given to Pravaz's wife, although habituation through oral ingestion of the drug is known. before this time, including Friedrich SertÃÆ'¼rner and his colleagues, followers, wives, and dogs. To some extent, it is also believed from the start that passing through the lungs will prevent opium addiction, as well as habituation to tobacco. Ethanol in its usual form is generally not injected and can be very damaging by most injection routes; in modern times, is used as an alternative or phenol potentiator (carbolic acid) in a procedure to erode damaged nerves.
In or immediately after 1851, drugs that have been discovered and extracted from their original plant and refined to water-soluble pure crystalline salts include morphine (1804 or late 1803), codeine (1832), narcotine/noscapine (1803-1805? ), papaverine (1814), cocaine (1855), caffeine (1819), quinine (1820), atropine (1831), scopolamine (aka hyoscine, aka laevo-duboisine) (1833?), hyoscyamine or laevo-atropine (1831) , a mixture of opium salts (1840s), chloral derivatives (1831 et seq.), ephedrine (1836?), nicotine (1828), and many others of all types, psychoactive and non-existent. Morphine is specifically used much more widely after the discovery of hypodermic syringe, and the practice of local anesthesia by infiltration is another step forward in medicine resulting from hypodermic needles, discovered at about the same time when it was determined that cocaine yielded benefits. numbness in the mucous membranes and eyes.
Various drugs are injected. Among the most popular in many countries are morphine, heroin, cocaine, amphetamine, and methamphetamine. Prescription drugs - including tablets, capsules, and even fluids and suppositories - are also sometimes injected. This applies especially to prescription opioids, as some opioid addicts have injected heroin. Injection preparations not intended for this purpose are particularly dangerous because of excipients (fillers), which can cause blood clots. Injecting codeine into the bloodstream is directly harmful because it causes rapid histamine release, which can lead to potentially fatal anaphylaxis and pulmonary edema. Dihydrocodeine, hydrocodone, nicocodeine, and other code-based products have similar risks. Codeine may be injected by intramuscular or subcutaneous route. The effect will not be instantaneous, but the dangerous and unpleasant massive release of histamine from intravenous injection of codeine is avoided. To minimize the amount of insoluble material in liquids prepared for injection, a cotton or synthetic fiber filter is usually used, such as a cotton tip or a small piece of cigarette filter.
Some manufacturers add naloxone narcotic antagonists or anticholinergic atropine and homatropin (lower than therapeutic doses) to their pills to prevent injections. Unlike naloxone, atropine does help morphine and other narcotics fight neuralgia. Atropine may be very problematic, and there is the possibility of reducing the atropine content from soluble tablets by placing them in ink with a drop of water on top, then preparing an injection of the rest of the pill. Canada and many other countries prohibit manufacturers from introducing secondary active ingredients for the above reasons; Their Talwin PX does not contain naloxone. However, as narcotic agonists, pentazocine and its relatives can cause withdrawal in those who are physically dependent on narcotics.
See also
- intravenous marijuana syndrome
- Lethal injection
References
External links
- Facts about illegal drugs include harm reduction strategies, detoxification and information for people affected by other illegal drug use
- Injection and care of safe blood vessels a very comprehensive and well-designed series of Chicago Recovery Alliance
- UN Office for Drugs & amp; Crime
Source of the article : Wikipedia
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