Intravenous drug user
Intravenous drug users (IVDU) (also known as intravenous drug abusers (IVDA)) are patients who self-inject recreational drugs, most commonly heroin, although many other agents are frequently injected, including cocaine, prescription opioids and methamphetamine.
Intravenous drug users form part of a larger population of persons who use drugs (PWUD) 3.
Intravenous drug users may present due to a variety of complications 4:
- at/close to the injection site
- remote from the injection site
- chronic disease: multiple comorbidities are common 4
- vascular: serial venous thromboembolism, venous ulcers, peripheral vascular disease (PVD)
- limb amputation: due to vascular insufficiency, infections, personal neglect
- skin: chronic pruritus, soft tissue/wound infections, lower limb ulcers
- GI: nausea, constipation
- hepatic: viral hepatitis, cirrhosis, hepatocellular carcinoma
- pulmonary: early COPD, poorly-controlled asthma, TB, pneumonia
- dental : caries, dental abscesses, multiple extractions
- GU: STIs, poor fertility, erectile dysfunction
- pregnancy: multiple issues, including unplanned pregnancy, IUGR, fetal addiction syndromes, prematurity, maternal death
- related to the drug and/or excipients
- violent traumatic injuries
- mental illness: high prevalence, both due to, and as a cause, of IVDU 2
Intravenous drug users are also at increased risk of disease due to often having other risk factors for disease, including long term tobacco use, chronic alcohol excess, malnutrition, poor living conditions, etc. e.g. pneumonia 2.
- 1. Poowanawittayakom N, Dutta A, Stock S, Touray S, Ellison RT, Levitz SM. Reemergence of Intravenous Drug Use as Risk Factor for Candidemia, Massachusetts, USA. (2018) Emerging infectious diseases. doi:10.3201/eid2404.171807 - Pubmed
- 2. Cornford C, Close H. The physical health of people who inject drugs: complexities, challenges, and continuity. (2016) The British journal of general practice : the journal of the Royal College of General Practitioners. 66 (647): 286-7. doi:10.3399/bjgp16X685333 - Pubmed
- 3. Wurcel AG, Merchant EA, Clark RP, Stone DR. Emerging and Underrecognized Complications of Illicit Drug Use. (2015) Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 61 (12): 1840-9. doi:10.1093/cid/civ689 - Pubmed
- 4. Mitchell C, Dolan N, Dürsteler KM. Management of dependent use of illicit opioids. (2020) BMJ (Clinical research ed.). 368: m710. doi:10.1136/bmj.m710 - Pubmed