Intravenous Drug Use: Signs, Effects, & Types

Intravenous (IV) drug use is a dangerous but widely used method of taking various substances. Though the effects of intoxication vary widely depending on which type of drug is being used, many of the signs and risks of IV drug use are distinct to this specific route of administration. This page will discuss what injection drug use is, how it works, the signs of use, and the risks associated with injected drugs.

What Is Intravenous Drug Use?

Injecting drugs, also known as “intravenous drug use” or “IV drug use,” is a common way to use illicit drugs or misuse legal prescription drugs. “Intravenous” means “within a vein,” so IV drug use uses a needle to directly put the drug into a vein and the bloodstream.

Many people inject drugs because doing so allows for a more instantaneous delivery of the active substance into circulation, and a relatively more rapidly achieved and ultimately higher peak concentration of the substance, resulting in a quicker and more potent high.¹

But, using this more invasive, direct method of drug delivery into the bloodstream means that people who use IV drugs also take on additional risks that are associated with a variety of diseases and other health issues.¹

What Types of Drugs Are Used Intravenously?

Drugs that are most commonly injected include:²

• Cocaine.³
• Heroin and other opioids, including fentanyl, hydrocodone (Vicodin), oxycodone (OxyContin), or morphine.^4,5
• Methamphetamine.⁶
• Ketamine, PCP, and prescription stimulants like Adderall are also sometimes injected, although to a lesser extent.^2,7-9

How Does Intravenous Drug Use Work?

Intravenous drug use works by using a needle and syringe to inject a drug, in liquid form, directly into a person’s bloodstream through their vein.^5,9 While intravenous drug use is meant to deliver a drug into the vein, some people may miss the vein and instead inject the drug into fat or muscle (i.e., intramuscularly). Other people may purposely inject drugs just under the skin (i.e., subcutaneously) in a method called “skin popping.”¹⁰

When drugs are injected, it allows high concentrations of a substance to reach the brain within seconds.

What Are the Signs and Effects of Injecting Drugs?

Intravenous drug use is like smoking a drug in that it delivers high concentrations of a substance to the brain quickly, within seconds or just a few minutes.¹ This produces what is commonly referred to as a “rush”—an intense feeling of euphoria that may only last for a few minutes.

Although smoking and injecting drugs are highly efficient routes for delivering high concentrations of a drug to the brain quickly, they also result in greater reinforcing effects, which increases the likelihood of repeated use and addiction.^11,12

The effects of intoxication of a substance are specific to the substance used, however, some overt signs of injection drug use include:

• Bruising, track marks (visible scarring at the location of injection) or pitted skin (indentations resulting from deep scarring due to skin-popping)—After repeated punctures in the same site, your skin may scar. People who use injection drugs will often inject (and create scars), in multiple places along large veins. Thus, “tracks” of scars along the veins become visible with time. Bruising and pitted skin can also be caused by injection drug use. ^2,3
• Injection drug paraphernalia—Injection drug users use a variety of supplies, including needles, syringes, spoons, cotton, water (for dissolving drugs prior to injection), and tourniquets.^2,13

Health Risks Associated With Intravenous Drug Use

There are multiple long-term health risks associated with injecting drugs. Intravenous drug use increases the likelihood of developing an addiction compared with other routes of administration, such as snorting a powder or swallowing a pill.¹¹

People who inject drugs put themselves at a higher risk for:²

• Contracting HIV/AIDS, hepatitis B, hepatitis C, and other blood-borne or infectious diseases.^3,15
• Vascular injuries such as scarred or collapsed veins.³
• Skin infections, including wound botulism.^14,15
• Chronic blood infections and increased risk of thrombosis due to blood clots.¹⁴
• Bone infections.¹⁴
• Heart infections including infective endocarditis, which is the most common cardiac complication associated with injection drug use .^14,15
• Lung infections, including pneumonia and tuberculosis.^1,3
• Other rare but serious lung complications may include septic pulmonary embolism, pulmonary hypertension, emphysema, pulmonary edema, pneumothorax, and pneumomediastinum.¹
• Needle embolization is a rare complication that can occur when a piece of the needle breaks off and escapes into the vascular system. Damage and infection to the veins and heart may occur as a result.¹

While some of the risks are due to trauma associated with repeated puncturing, most of the potential long-term consequences are associated with infection. When people who inject drugs have access to clean needles or can be educated about proper injection techniques, some infections can be avoided.¹⁷

Injecting dissolved prescription medications presents a unique issue as these typically come in the form of pills that contain ingredients that can be difficult to dissolve.¹⁷ This increases the risk of skin abscesses, thrombus formation (i.e., blood clots that can block veins or arteries), and foreign body granulomatosis, a rare disorder that occurs when insoluble binding agents used in pills become trapped in the pulmonary vasculature.^2,17

People who inject drugs are also at a higher risk for other risky behaviors. Engagement in risky sexual behavior is a common result of IV drug use, which further increases the risk of STDs.¹⁸

In addition to the above, the risk of overdose is higher for those who use intravenous drugs.^17,19 In the case of opioid injection drug use, harm reduction measures such as fentanyl test strips and the availability of the overdose-reversing drug naloxone can effectively reduce the number of fatal overdoses.¹⁷

Of the many ways that drugs are taken, injecting drugs is a particularly risky form of drug use that should be avoided.

Find Treatment for Intravenous Drug Use

If you need help with your own drug or alcohol use or are helping a loved one with addiction, Desert Hope offers multiple levels of addiction treatment and employs evidence-based therapies. The experienced team at Desert Hope is ready to help you achieve sobriety and long-term recovery.

Whether a short-term drug detox, a month-long rehab program, or a long-term addiction treatment is right for you, patients can remain in personalized treatment for the length of time that works best for them.

Call us at to verify your insurance coverage or learn about the many ways to pay for rehab. You can also start the admissions process by easily . Please don’t wait, reach out for help today.

FAQs About Intravenous Drug Use