Bad injecting technique, lack of filtering, not rotating your sites, reusing needles and injecting too quickly are a few of the things that can lead to veins closing down. The only way to guarantee your veins stay in great shape is to use non-injecting methods like smoking, shafting, snorting or swallowing. But if you insist on injecting, here is a guide to which veins you should be use, especially if your favorite ones have gone - from the best ones to the most dangerous ones.
Best place to inject
The lower arm has plenty of veins between your elbow and wrist, which are the best ones to use. Remember to have several sites and rotate them.
Good technique, new fits each time and rotation your sites should prevent vein closure. Rotation of sites gives your veins time to heal from the needle tearing their fragile lining. Remember to use these veins on your other arm too when rotating sites. If it feels awkward, practise by injecting sterile water in between real hits till you get the hang of it.
If the veins on the inside of your arm have closed down, you can use the ones on the outside of your arm too. Just make sure you inject with the blood flow, ie toward the heart.
Second best place to inject
The upper arms tend to be the next best option, although they may be harder to find. Use a tourniquet but remember to release it before injecting, otherwise the extra blood pressure can cause vein damage.
Third best place to inject
The veins in the hands will usually be your third option. Although they may look prominent, they are smaller and more fragile. Use a very fine needle and be sure your mix is well filtered – a wheel filter is best. Veins in the fingers are very small so avoid these if possible. The artery usually lies just under the vein and it is very dangerous to accidentally inject into these. Remember to take off any rings or other jewellery that can restrict blood flow.
Most of us are either left or right-handed. If the veins have closed down in one arm, use the other arm instead. Even if this feels uncomfortable, practise using your other hand. The problem is that after your arms, all your injection sites involve much higher risks so stay with your arms where possible.
Injection sites not recommended
BREASTS - NOT RECOMMENDED
Injecting in the breasts is not a good idea. Even if the veins look prominent,
they are very fine and easily damaged. These veins are very close to the
milk ducts and these can very easily become infected. This can lead to abscesses
and a painful condition called mastitis.
ARMPITS - NOT RECOMMENDED
Injecting in the armpit is risky. All the veins, arteries and nerves are
close together around this joint with the usual risks of pain, nerve damage
or artery blockages further down the arm.
FEET - NOT RECOMMENDED
Injecting in your feet is quite dangerous. As the blood flow here is even
slower than in your legs, there’s a greater chance of missed hits
and abscesses, and slower healing. Infections rates are high due to more
bacteria on feet, especially if you wear shoes. The further you move away
from the heart, the smaller and more fragile the veins become. You don’t
get further away than the feet! The veins may look big as there is little
fat on your feet, but the veins are quite small with fragile walls.
PENIS - NOT RECOMMENDED
Injecting in the penis is dangerous, with problems like local infections
being highly likely. Another problem can be priapism – an erection
caused by the veins not reopening. This can last a long time and be extremely
painful. While this might sound interesting in the bedroom, take it from
us - a permanent boner becomes extremely painful!
Why does it happen? An erection is caused by the veins becoming smallerand restricting the flow of blood out of the penis. For the penis to return to its normal size, the veins must be able to re-open. If this is not possible because of damage, the erection will not subside. Some injectors mistakenly think that ‘groin’ injecting refers to injecting in the penis — it actually refers to another risky site — femoral injecting.
FEMORAL VEIN (GROIN)- TOO DANGEROUS!
Injecting into the femoral artery is very risky. The main issues involve
it being very close to the femoral artery and nerve. Hitting the nerve not
only causes intense pain but may cause paralysis as well. Injecting into
the artery can also be very painful and may cause blockages in blood vessels
further down the leg.
NECK - TOO DANGEROUS!
Injecting in the neck is extremely dangerous, as there are many arteries,
veins and nerves close together. Hitting an artery can result in strokes,
while hitting nerves is very painful and can cause paralysis.
Part of the risk arises from the fact that for self-injectors, injection in the neck requires the use of a mirror. This difficulty may lead injectors to ask others to attempt neck injection for them, thereby increasing the chances of both viral transmission and local injury, and removing all personal control over the process. It may also lay the injector open to at least a manslaughter charge if the person dies — even if they requested the injection.
The common complications of neck injecting may be similar to the usual vein problems, such as cellulitis and abscess formation, but have even more devastating effects. An abscess or cellulitis in the neck can cause dangerous pressure on nerves or obstruct the airway.
What else can go wrong? Accidental injection into an artery means the drug, and any other matter contained in the solution, will go directly to the brain, potentially causing a range of neurological problems, including strokes, weakening of the blood vessel wall (aneurysm) and nerve damage, including vocal chord paralysis.
INJECTING INTO ARTERIES - TOO DANGEROUS!
Usually injecting into an artery is by mistake - you would certainly never
want to do it on purpose! All drug injectors should be warned that they
should never inject into a blood vessel in which they can feel a pulse.
Arteries carry fresh blood from the heart around body. If you hit and block
this blood you run the risk of stopping the blood reaching your extemities,
like toes, feet, legs and fingers. No blood means these parts of your body
can die and drop off due to gangrene.
Pain is common with arterial injection, as the drug is taken to the small capillarires and absorbed by local tissue which is damaged by the drug.
Blood clots may also travel to the brain and possibly cause strokes. This usually does not happen at the time of injection, but some time later.
Veins, arteries and nerves run alongside one another in a tangled mess. Wherever there’s a vein there’s a possibility of injecting into an artery.
Although most arterial injections are accidental, occasionally people attempt arterial injection deliberately. The practice of deliberate arterial injection should be strongly discouraged.
For those who hit an artery by mistake or otherwise, advice should be to immediately withdraw the needle - do not complete the injection. Put strong pressure on the site for at least 15 minutes. Raise the affected limb if possible and use ice around the area to limit swelling. Seek medical advice.
Gentle massage over the next few days may help to remove toxins from the
area, but if any pain is experienced, it will only cause more damage.
Arterial injection can sometimes cause weakening of the artery wall (pseudoaneurysm)
or fungal infection of the artery wall (mycotic aneurysm). Both conditions
can lead to life-threatening arterial bleeding.
I only have these risky injections site left!
If the safer veins can't be used any more, talk to health professionals experienced in injecting drug use issues about your options. Ideally it would be best to look at some alternatives to injecting if your best veins have closed down. If you do continue to inject, remember that safer injecting technique will help to preserve the veins you do have left!
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