IV DRUGS

 

And Your Veins

The anatomy of a vein

Veins have three layers (Cleveland Clinic, 2022): 

1. Tunica Adventitia - The outer layer that gives structure and shape to your vein.
2. Tunica Media -  The middle layer contains smooth muscle cells that allow the vein to get wider or narrower, facilitating blood flow.
3. Tunica Intima—This layer comprises a thin layer of smooth and slippery endothelial cells, facilitating blood flow.

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The tunica intima is the thinnest layer, and it protects the blood from coming in contact with underlying tissues.

IV drugs can affect the tunica intima in a number of ways. Some IV drugs can directly damage the endothelial cells of the tunica intima, leading to inflammation and narrowing of the vein. Other IV drugs can increase the risk of blood clots, which can damage the tunica intima and lead to vein occlusion.(Tunica Intima - an Overview | ScienceDirect Topics, n.d.)

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Here are some specific examples of how IV drugs can affect the tunica intima:

• Cocaine: Cocaine can cause vasoconstriction, which narrows the veins and can damage the tunica intima. Cocaine can also cause inflammation and injury to the endothelial cells of the tunica intima.
• Heroin: Heroin can cause vasoconstriction and inflammation of the tunica intima. Heroin can also increase the risk of blood clots, which can damage the tunica intima and lead to vein occlusion.
• Methamphetamine: Methamphetamine can cause vasoconstriction, inflammation, and injury to the endothelial cells of the tunica intima. Methamphetamine can also increase the risk of blood clots, which can damage the tunica intima and lead to vein occlusion.

1. Deep vein thrombosis (DVT): DVT is a blood clot that forms in a deep vein, usually in the leg. DVT can be life-threatening if the blood clot breaks off and travels to the lungs.
2. Pulmonary embolism (PE): A PE is a blood clot that travels to the lungs and blocks a blood vessel. PE can be fatal.
3. Venous insufficiency: Venous insufficiency is a condition in which the veins are unable to effectively return blood to the heart. This can lead to swelling, pain, and skin changes in the legs.

Any breach in the tunica intima can activate your clotting factors which contribute to the beginning of the above situation.

If you are using IV drugs, it is crucial to be aware of the potential risks to your vein health. If you have any concerns, please talk to your doctor.

Intravenous (IV) drug use can strip a vein by damaging the inner lining of the vein and causing it to collapse. This can happen in several ways:

1. Irritation: The chemicals in IV drugs can irritate the vein's inner lining, causing it to become inflamed and swollen. This swelling can narrow or even block the vein.
2. Scarring: Over time, repeated injections can cause the inner lining of the vein to scar. This scarring can make the vein more prone to collapse.
3. Infection: IV drug users are at an increased risk of developing infections, including hepatitis B and C. These infections can damage the veins and make them more likely to collapse.

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 There are a number of things you can do to reduce the risk of vein damage from IV drug use:

1. Use a clean needle and syringe for every injection.
2. Don't share needles or other injection equipment with anyone.
3. Rotate injection sites to prevent damage to the same vein.
   
4. Clean the injection site with soap and water before injecting.
5. Inject slowly and carefully.

If you miss a vein, don't try to inject again in the same spot.

Seek medical attention if you experience any problems with your veins, such as pain, swelling, or redness.

References

Cleveland Clinic. (2022, June 19). Veins: Anatomy and Function. Cleveland Clinic. https://my.clevelandclinic.org/health/body/23360-veins

 

 Tunica Intima - an overview | ScienceDirect Topics. (n.d.). Www.sciencedirect.com. Retrieved October 11, 2023, from https://www.sciencedirect.com/topics/agricultural-and-biological-sciences/tunica-intima#:~:text=An%20intact%20endothelial%20layer%20is%20critical%20for

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The Need for Take Home

 

Naloxone Programs

 

Naloxone is a medication that can rapidly reverse the effects of an opioid overdose. It is an opioid antagonist, which means that it binds to opioid receptors and blocks the effects of other opioids. This allows a person to breathe again and reverses the overdose.

Naloxone is not a controlled substance and has no potential for abuse. It can be administered by minimally trained laypeople, which makes it ideal for treating overdose in people who have been prescribed opioid pain medication and in people who use heroin and other opioids.

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• Naloxone works by knocking opioids off of opioid receptors in the brain. This allows a person to breathe again and reverses the overdose. Naloxone only works if a person has opioids in their system; it has no effect if opioids are absent.
• Naloxone may be injected in a muscle, vein, under the skin, or sprayed into the nose. Naloxone that is injected comes in a lower concentration (0.4mg/1ml) than naloxone that is sprayed up the nose (1mg/1ml). It is a temporary drug that wears off in 30-90 minutes.

Opioid overdoses are a major public health problem. Many people who die from opioid overdose fail to receive proper medical attention because their peers and witnesses delay or do not call 911 for fear of police involvement. Naloxone is a safe and effective medication that can reverse an opioid overdose. However, in most jurisdictions, naloxone is only available in hospital settings and carried by emergency medical personnel. As a result, it is often not available to people experiencing overdose until they have already suffered severe harm. Take-home naloxone programs have been established in approximately 200 communities throughout the United States to expand naloxone access to people who use drugs and their loved ones. These programs provide comprehensive training on overdose prevention, recognition, and response in addition to prescribing and dispensing naloxone. Fatal overdose is the leading cause of death for people in the U.S. under 50 years old. Providing overdose prevention, recognition, and response education to people who use drugs, their neighbors, friends, families, and the service providers who work with them is a harm reduction intervention that saves lives.

References

Opioid Overdose Basics - Harm Reduction Coalition. (2019). Harmreduction.org. https://harmreduction.org/issues/overdose-prevention/overview/overdose-basics/

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Opioid Overdose Basics

• An overdose is when a toxic amount of a drug, or combination of drugs overwhelms the body. Opioid overdoses happen when there are so many opioids or a combination of opioids and other drugs in the body that the victim is not responsive to stimulation and/or breathing is inadequate.

• Opioids fit into specific receptors that also affect the drive to breathe. If someone can not breathe or is not breathing enough, the oxygen levels in the blood decrease, and the lips and fingers turn blue- this is called cyanosis. This oxygen starvation eventually stops other vital organs like the heart, and then the brain. This leads to unconsciousness, coma, and then death.

• Brain damage starts to occur after 3-5 minutes without oxygen, followed by death. Fortunately, this process is rarely instantaneous; people slowly stop breathing which usually happens minutes to hours after the drug is used. While people have been “found dead with a needle in their arm,” more often there is time to intervene between when an overdose starts and before a victim dies.

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  Heroin, prescription opioids, and other downers such as alcohol and benzodiazepines are a particularly dangerous combo since they all affect the body’s central nervous system, which slows breathing, blood pressure, and heart rate, and in turn, reduces body temperature.

• In a stimulant overdose, drugs like speed, cocaine, and ecstasy raise the heart rate, blood pressure, and body temperature, and speed up breathing. This can lead to a seizure, stroke, heart attack, or death.

How to help someone who is overdosing:

1. Call 911 immediately.
2. If the person is unconscious, roll them onto their side to prevent choking.
3. Check their breathing and pulse. If they are not breathing, give CPR.
4. If you have Narcan, administer it according to the package instructions.

Stay with the person until help arrives.

References

 Opioid Overdose Basics - Harm Reduction Coalition. (2019). Harmreduction.org. https://harmreduction.org/issues/overdose-prevention/overview/overdose-basics/

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