heroin and Vascular-Diseases

Topics: Female; Heroin; Heroin Dependence; Humans; Male; Narcotics; Substance Abuse, Intravenous; Vascular Diseases

The loss of functioning veins (venous sclerosis) is a root cause of suffering for long-term heroin injectors. In addition to perpetual frustration and loss of pleasure/esteem, venous sclerosis leads to myriad medical consequences including skin infections, for example, abscess, and possibly elevated HIV/HCV risks due to injection into larger jugular and femoral veins. The etiology of venous sclerosis is unknown and users' perceptions of cause/meaning unexplored. This commentary stems from our hypothesis that venous sclerosis is causally related to heroin acidity, which varies by heroin source-form and preparation. We report pilot study data on first ever in vivo measurements of heroin pH and as well as qualitative data on users' concerns and perceptions regarding the caustic nature of heroin and its effects. Heroin pH testing in natural settings is feasible and a useful tool for further research. Our preliminary findings, for example, that different heroin source-forms and preparations have a two log difference in acidity, have potentially broad, vital and readily implementable harm reduction implications.

Topics: Acids; Adult; Biomedical Research; Female; Heroin; Heroin Dependence; Humans; Hydrogen-Ion Concentration; Male; Middle Aged; Narcotics; Pilot Projects; Sclerosis; Substance Abuse, Intravenous; Vascular Diseases; Veins

Topics: Female; Heroin; Heroin Dependence; Humans; Male; Narcotics; Substance Abuse, Intravenous; Vascular Diseases

Vascular complications resulting from drug abuse constitute a widespread and common clinical problem. A 3-year experience with 32 vascular complications (13 arterial, 19 venous) related to intravenous drug abuse is reported. Fourteen (48%) of the 29 patients in this series presented with septic vascular complications. These infections were a major cause of morbidity and mortality, resulting in two hospital deaths and a disrupted arterial repair. In addition, intra-arterial drug injection caused digital gangrene in two patients. Early recognition, diagnostic arteriography and venography, and planned therapeutic interventions are possible if a high level of suspicion is maintained.

Topics: Adult; Arteries; Cocaine; Heroin; Humans; Injections, Intra-Arterial; Injections, Intravenous; Male; Substance-Related Disorders; Vascular Diseases

Topics: Aneurysm, Infected; Arterial Occlusive Diseases; Cardiomegaly; Edema; Endocarditis, Bacterial; Hand; Heroin; Humans; Injections, Intra-Arterial; Injections, Intravenous; Ischemia; Lung Diseases; Lymphadenitis; Pneumonia; Pneumonia, Aspiration; Pulmonary Edema; Pulmonary Embolism; Substance-Related Disorders; Tuberculosis, Pulmonary; Vascular Diseases; Venous Insufficiency

Topics: Adult; Amphetamine; Amputation, Surgical; Aneurysm; Angiography; Arm; Arteries; Barbiturates; Blood Vessels; Candidiasis; Codeine; Endocarditis, Bacterial; Female; Heparin; Heroin; Humans; Injections, Intra-Arterial; Ischemia; Leg; Male; Methylphenidate; Substance-Related Disorders; Vascular Diseases; Vasodilator Agents; Veins

Topics: Adult; Aneurysm; Aneurysm, Infected; Endocarditis, Bacterial; Female; Heroin; Humans; Hypertension, Pulmonary; Injections, Intravenous; Lung Diseases; Male; Methylphenidate; Middle Aged; Pneumonia; Pneumonia, Aspiration; Pulmonary Edema; Pulmonary Embolism; Radiography; Substance-Related Disorders; Thrombophlebitis; Thrombosis; Tuberculosis, Pulmonary; Vascular Diseases