Intravenous drug user
- Radiopaedia Events Pty Ltd, Speaker fees (past)
- Integral Diagnostics, Shareholder (ongoing)
- Micro-X Ltd, Shareholder (ongoing)
Updates to Article Attributes
Intravenous drug users (IVDU) (also, also known as intravenous drug abusers (IVDA)), are patients who self-inject inject recreational drugs, most commonly heroin, although many other agents are frequently injected, including cocaine, prescription opioids and methamphetamine.
Terminology
Intravenous drug users form part of a larger population of persons who use drugs (PWUD) 3.
Clinical presentation
Intravenous drug users may present due to a variety of complications 4:
-
at/close to the injection site
-
vascular
haemorrhage/haematoma
-
arterial
thromboembolism
-
venous
-
soft tissue infections
tissue necrosis
-
-
remote from the injection site
-
infections
specific: infective endocarditis, HIV/AIDS, hepatitis B/C, pulmonary septic emboli, osteomyelitis, etc.
non-specific: sepsis
-
-
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/ wound infections, lower limb ulcersGI: nausea, constipation
hepatic: viral hepatitis, cirrhosis, hepatocellular carcinoma
pulmonary: early COPD, poorly-controlled asthma,
TBtuberculosis, pneumoniadental : caries, dental
abscessesabscess, multiple extractionsGU: STIs, poor fertility, erectile dysfunction
pregnancy: multiple issues, including unplanned pregnancy,
IUGRintrauterine growth restriction, fetal addiction syndromes, prematurity, maternal death
-
related to the drug and/or excipients
-
non-specific
overdose
allergic reactions including anaphylaxis
-
specific
hypogonadism in heroin use 2
-
violent traumatic injuries
-
mental illness: high prevalence, both due to, and as a cause, of IVDU 2
general anxiety disorder
severe psychiatric disease: drug-induced psychosis, schizophrenia, bipolar disorder, personality disorders
alcohol, other substance addiction
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.
-<p><strong>Intravenous drug users</strong> (<strong>IVDU</strong>) (also known as <strong>intravenous drug abusers</strong> (<strong>IVDA</strong>)) are patients who self-inject <a href="/articles/recreational-drugs">recreational drugs</a>, most commonly heroin, although many other agents are frequently injected, including cocaine, prescription opioids and methamphetamine. </p><h4>Terminology</h4><p>Intravenous drug users form part of a larger population of <strong>persons who use drugs</strong> (<strong>PWUD</strong>) <sup>3</sup>.</p><h4>Clinical presentation</h4><p>Intravenous drug users may present due to a variety of complications <sup>4</sup>:</p><ul>-<li>at/close to the injection site<ul>-<li>vascular<ul>-<li>haemorrhage/<a href="/articles/haematoma">haematoma</a>-</li>-<li>arterial<ul>-<li>thromboembolism</li>-<li><a href="/articles/aneurysm">aneurysm</a></li>- +<p><strong>Intravenous drug users</strong> (<strong>IVDU</strong>), also known as <strong>intravenous drug abusers</strong> (<strong>IVDA</strong>), are patients who inject recreational drugs, most commonly heroin, although many other agents are frequently injected, including cocaine, prescription opioids and methamphetamine. </p><h4>Terminology</h4><p>Intravenous drug users form part of a larger population of <strong>persons who use drugs</strong> (<strong>PWUD</strong>) <sup>3</sup>.</p><h4>Clinical presentation</h4><p>Intravenous drug users may present due to a variety of complications <sup>4</sup>:</p><ul>
- +<li>
- +<p>at/close to the injection site</p>
- +<ul>
- +<li>
- +<p>vascular</p>
- +<ul>
- +<li><p>haemorrhage/<a href="/articles/haematoma">haematoma</a></p></li>
- +<li>
- +<p>arterial</p>
- +<ul>
- +<li><p>thromboembolism</p></li>
- +<li><p><a href="/articles/aneurysm">aneurysm</a></p></li>
-<li>venous<ul>-<li><a href="/articles/superficial-thrombophlebitis">superficial thrombophlebitis</a></li>-<a href="/articles/venous-thromboembolism">venous thromboembolism</a>: <a href="/articles/deep-vein-thrombosis">DVT</a>, <a href="/articles/pulmonary-embolism">PE</a>-</li>- +<p>venous</p>
- +<ul>
- +<li><p><a href="/articles/superficial-thrombophlebitis">superficial thrombophlebitis</a></p></li>
- +<li><p><a href="/articles/venous-thromboembolism">venous thromboembolism</a>: <a href="/articles/deep-vein-thrombosis">DVT</a>, <a href="/articles/pulmonary-embolism">PE</a></p></li>
-<li>soft tissue infections<ul>-<li><a href="/articles/cellulitis">cellulitis</a></li>-<li><a href="/articles/abscess">abscess</a></li>-<li><a href="/articles/necrotising-fasciitis">necrotising fasciitis</a></li>- +<li>
- +<p>soft tissue infections</p>
- +<ul>
- +<li><p><a href="/articles/cellulitis">cellulitis</a></p></li>
- +<li><p><a href="/articles/abscess">abscess</a></p></li>
- +<li><p><a href="/articles/necrotising-fasciitis">necrotising fasciitis</a></p></li>
-<li>tissue necrosis</li>- +<li><p>tissue necrosis</p></li>
-<li>remote from the injection site<ul><li>infections<ul>-<li>specific: <a href="/articles/infective-endocarditis">infective endocarditis</a>, <a href="/articles/hivaids">HIV/AIDS</a>, hepatitis <a href="/articles/hepatitis-b-virus-1">B</a>/<a href="/articles/hepatitis-c-virus">C</a>, <a href="/articles/septic-pulmonary-emboli">pulmonary septic emboli</a>, <a href="/articles/osteomyelitis">osteomyelitis</a>, etc.</li>-<li>non-specific: <a href="/articles/sepsis">sepsis</a>-</li>- +<li>
- +<p>remote from the injection site</p>
- +<ul><li>
- +<p>infections</p>
- +<ul>
- +<li><p>specific: <a href="/articles/infective-endocarditis">infective endocarditis</a>, <a href="/articles/hivaids">HIV/AIDS</a>, hepatitis <a href="/articles/hepatitis-b-virus-1">B</a>/<a href="/articles/hepatitis-c-virus">C</a>, <a href="/articles/septic-pulmonary-emboli">pulmonary septic emboli</a>, <a href="/articles/osteomyelitis">osteomyelitis</a>, etc.</p></li>
- +<li><p>non-specific: <a href="/articles/sepsis">sepsis</a></p></li>
-<li>chronic disease: multiple comorbidities are common <sup>4</sup><ul>-<li>vascular: serial venous thromboembolism, venous ulcers, <a href="/articles/peripheral-arterial-disease">peripheral vascular disease (PVD)</a>-</li>-<a href="/articles/amputation-generic">limb amputation</a>: due to vascular insufficiency, infections, personal neglect</li>-<li>skin: chronic pruritus, soft tissue/wound infections, lower limb ulcers</li>-<li>GI: nausea, constipation</li>-<li>hepatic: <a href="/articles/viral-hepatitis">viral hepatitis</a>, <a href="/articles/cirrhosis">cirrhosis</a>, <a href="/articles/hepatocellular-carcinoma">hepatocellular carcinoma</a>-</li>-<li>pulmonary: early <a href="/articles/chronic-obstructive-pulmonary-disease-1">COPD</a>, poorly-controlled <a href="/articles/asthma-1">asthma</a>, <a href="/articles/tuberculosis-pulmonary-manifestations-1">TB</a>, <a href="/articles/pneumonia">pneumonia</a>-</li>-<li>dental : <a href="/articles/dental-caries">caries</a>, <a href="/articles/dental-abscess">dental abscesses</a>, multiple extractions</li>-<li>GU: <a href="/articles/sexually-transmitted-infection-sti">STIs</a>, poor fertility, <a href="/articles/erectile-dysfunction">erectile dysfunction</a>-</li>-<li>pregnancy: multiple issues, including unplanned pregnancy, <a href="/articles/intrauterine-growth-restriction">IUGR</a>, <a href="/articles/fetal-addiction-syndrome">fetal addiction syndromes</a>, <a href="/articles/premature-birth">prematurity</a>, maternal death</li>- +<p>chronic disease: multiple comorbidities are common <sup>4</sup></p>
- +<ul>
- +<li><p>vascular: serial venous thromboembolism, venous ulcers, <a href="/articles/peripheral-arterial-disease">peripheral vascular disease (PVD)</a></p></li>
- +<li><p><a href="/articles/amputation-generic">limb amputation</a>: due to vascular insufficiency, infections, personal neglect</p></li>
- +<li><p>skin: chronic pruritus, soft tissue / wound infections, lower limb ulcers</p></li>
- +<li><p>GI: nausea, constipation</p></li>
- +<li><p>hepatic: <a href="/articles/viral-hepatitis">viral hepatitis</a>, <a href="/articles/cirrhosis">cirrhosis</a>, <a href="/articles/hepatocellular-carcinoma">hepatocellular carcinoma</a></p></li>
- +<li><p>pulmonary: early <a href="/articles/chronic-obstructive-pulmonary-disease-1">COPD</a>, poorly-controlled <a href="/articles/asthma-1">asthma</a>, <a href="/articles/tuberculosis-pulmonary-manifestations-1">tuberculosis</a>, <a href="/articles/pneumonia">pneumonia</a></p></li>
- +<li><p>dental : <a href="/articles/dental-caries">caries</a>, <a href="/articles/dental-abscess">dental abscess</a>, multiple extractions</p></li>
- +<li><p>GU: <a href="/articles/sexually-transmitted-infection-sti">STIs</a>, poor fertility, <a href="/articles/erectile-dysfunction">erectile dysfunction</a></p></li>
- +<li><p>pregnancy: multiple issues, including unplanned pregnancy, <a href="/articles/intrauterine-growth-restriction">intrauterine growth restriction</a>, <a href="/articles/fetal-addiction-syndrome">fetal addiction syndromes</a>, <a href="/articles/premature-birth">prematurity</a>, maternal death</p></li>
-<li>related to the drug and/or excipients<ul>-<li>non-specific<ul>-<li>overdose</li>-<li>allergic reactions including <a href="/articles/anaphylaxis">anaphylaxis</a>-</li>-<li><a href="/articles/acute-respiratory-distress-syndrome-1">ARDS</a></li>- +<li>
- +<p>related to the drug and/or excipients</p>
- +<ul>
- +<li>
- +<p>non-specific</p>
- +<ul>
- +<li><p>overdose</p></li>
- +<li><p>allergic reactions including <a href="/articles/anaphylaxis">anaphylaxis</a></p></li>
- +<li><p><a href="/articles/acute-respiratory-distress-syndrome-1">ARDS</a></p></li>
-<li>specific<ul><li>hypogonadism in heroin use <sup>2</sup>-</li></ul>- +<li>
- +<p>specific</p>
- +<ul><li><p>hypogonadism in heroin use <sup>2</sup></p></li></ul>
-<li>violent traumatic injuries</li>-<li>mental illness: high prevalence, both due to, and as a cause, of IVDU <sup>2</sup><ul>-<li><a href="/articles/major-depressive-disorder">depression</a></li>-<li>general anxiety disorder</li>- +<li><p>violent traumatic injuries</p></li>
-<a href="/articles/post-traumatic-stress-disorder">post-traumatic stress disorder (PTSD)</a> <sup>4</sup>-</li>-<li>-<a href="/articles/self-harm">self-harm</a> and <a href="/articles/suicide">suicide</a>-</li>-<li>severe psychiatric disease: drug-induced psychosis, <a href="/articles/schizophrenia">schizophrenia</a>, bipolar disorder, personality disorders</li>-<li>alcohol, other substance addiction</li>- +<p>mental illness: high prevalence, both due to, and as a cause, of IVDU <sup>2</sup></p>
- +<ul>
- +<li><p><a href="/articles/major-depressive-disorder">depression</a></p></li>
- +<li><p>general anxiety disorder</p></li>
- +<li><p><a href="/articles/post-traumatic-stress-disorder">post-traumatic stress disorder (PTSD)</a> <sup>4</sup></p></li>
- +<li><p><a href="/articles/self-harm">self-harm</a> and <a href="/articles/suicide">suicide</a></p></li>
- +<li><p>severe psychiatric disease: drug-induced psychosis, <a href="/articles/schizophrenia">schizophrenia</a>, bipolar disorder, personality disorders</p></li>
- +<li><p>alcohol, other substance addiction</p></li>
References changed:
- 1. Poowanawittayakom N, Dutta A, Stock S, Touray S, Ellison R, Levitz S. Reemergence of Intravenous Drug Use as Risk Factor for Candidemia, Massachusetts, USA. Emerg Infect Dis. 2018;24(4):631-7. <a href="https://doi.org/10.3201/eid2404.171807">doi:10.3201/eid2404.171807</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/29553923">Pubmed</a>
- 1. Poowanawittayakom N, Dutta A, Stock S, Touray S, Ellison R, Levitz S. Reemergence of Intravenous Drug Use as Risk Factor for Candidemia, Massachusetts, USA. Emerg Infect Dis. 2018;24(4). <a href="https://doi.org/10.3201/eid2404.171807">doi:10.3201/eid2404.171807</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/29553923">Pubmed</a>
Systems changed:
- Central Nervous System
- Musculoskeletal
- Chest
- Gastrointestinal
- Hepatobiliary
- Vascular
- Urogenital