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How to Tell if Someone is Shooting Up

Signs of IV Drug Abuse

How to Tell if Someone is Shooting Up

Signs of IV Drug Abuse

Intravenous (IV) drugs are those injected directly into the body. While you might think that track marks will be easily visible on a friend’s or loved one’s arm, many people are able to hide the marks connected to substance abuse. Some people inject the skin between the toes and in other areas of the body that you can’t see. Some of the drugs used in this way include heroin and crystal meth.  If someone you love uses one of these drugs, it’s helpful to know the signs of shooting up and the dangers of addiction.

First Sign of Substance Abuse: Highs and Lows

A common sign that someone you know uses IV drugs is when that person experiences frequent highs and lows. You can think of this in the same you would the crash associated with caffeine or sugar. When you drink several cups of coffee or bottles of soda a day, the sugar and caffeine can leave you feeling wiry and jittery. Once those substances leave your system, though, you’ll feel a crushing sensation that might make you feel tired and worn out.

People who use IV drugs feel and act the same way through highs and lows. Some prefer injecting drugs to smoking or snorting substances because injecting produces a faster reaction. As the drugs go directly into the bloodstream, users feel the high much faster. The injection method can also produce a faster crash period because as the drugs leave, their pleasurable symptoms dissipate quickly too. Some of the signs you might notice during the crash period, also known as the cooling period, include:

Trouble concentrating or thinking

Issues with making decisions

Head nodding

Falling asleep in any spot or position 

Irritability any mood swings

Physical Symptoms of IV Drug Use

Injection Locations

Unless you have given yourself an injection before, you may have no idea what an injection site looks like. IV drug users can inject heroin and other drugs into different areas of the body, including the crook of an elbow, the sole of a foot, the vein that runs along the arm, and even in the leg or between the toes. 

Signs of an Injection Site

An injection site will typically have a small bruise that changes color over time. You may also see track marks in people who regularly use IV drugs. These marks will look like dark veins along the arm. You may see a darker area around the site of the injection, and then more lightly colored marks moving down the arm. 

Collapsed Veins

Another physical sign of intravenous drug use is one or more collapsed veins. The veins of the human body transport blood from one area to the next to keep the body healthy. If an individual keeps injecting substances into the same vein, that vein may eventually collapse and stop doing its necessary function of transporting blood. Though a collapsed vein is hard to see because it sits below the surface of the skin, a close look at the area should help you find it. 

Skin Infections

If you do not properly care for an injury, it can become infected. This is especially true in cases of ongoing IV drug use. As the same injection spot is used repeatedly, physical damage to the skin and veins occurs. Something as simple as wearing the same shirt or pants for several days in a row can cause an infection. The fabric rubbing against the skin and the bacteria on that fabric can also worsen the injection. Infections are also more likely to occur due to decreased personal hygiene like not showering or bathing regularly. 

Skin Popping

In addition to skin infections, IV drug use may also result in skin popping, but this only occurs among those who inject drugs into their muscles rather than their veins. Injections into the muscles cause lumps to form in the tissue beneath the skin. Those lumps will build up as scar tissue builds. The condition makes the lumps appear to pop or to puff out the skin. You can sometimes see these lumps on the arms and legs of IV drug users.

Soot Tattoos

You might notice soot beneath the skin too. Officially called a soot tattoo, the discoloration occurs because a flame is placed below the needle before injecting in order to cleanse it before putting it int heir skin. The soot that forms on the needle goes directly into the body and can leave behind a dark marks that becomes even darker over time. Some people get professional or amateur tattoos done as a way to hide those marks. 

Video: Spotting Signs of IV Drug Use

In the early stages of opioid use, it can be difficult to see the signs, especially if your son or daughter continues to function in his or her everyday life. As opioid use escalates, some fairly visible signs begin to emerge. Along with other more subtle warning signs, like changes in your son's or daughter's behavior or things you may notice around the house. 00:30 Tell-tell physical warning signs of opioid use, whether intravenous or not, our pinpoint pupils and nodding off. One of the most visible warning signs specific to IV use is "track marks," the scars and bruising that appear on the skin along the veins of someone who 00:49 frequently injects. The most common and frequent injection sites are along the inner arm, but some people also inject in their hands, feet, legs or even the groin. 01:02 IV substance use leaves behind other distinct clues as well, all of which 01:07 should raise a red flag: spoons or foil with burn marks; burns on fingers, which 01:14 are the result of preparing substances for injection; hidden or improperly disposed syringes, needles or syringe caps; glassine bags stamped with names 01:25 like "Superman," "Pitbull," and "Crazy Horse;" cotton balls, Q-tips or cigarette filters 01:32 used to remove impurities before injecting; rubber straps or bands or even missing shoelaces, commonly used as a tourniquet to help raise veins to the 01:43 surface of the skin prior to injection. Be on alert for any of these subtler signs, as well: 01:51 missing prescription pain medications; wearing long sleeves in warm weather; weight loss; avoiding family and social situations that would prevent use, like a 02:04 vacation or even a prolonged outing; spending excessive time locked in their bedroom or a bathroom alone; missing money or other items missing from home; 02:15 flu-like symptoms, which may actually be signs of withdrawal; receiving unusual packages in the mail, -- it's shockingly easy to have illicit drugs and 02:25 paraphernalia delivered right to one's home. One of the best ways to spot problems with substance use is to know who your 02:33 teen or young adult is spending time with. IV substance use, in particular, tends to be learned from and introduced by other friends and acquaintances. In 02:43 fact, it's not unusual to begin use with a significant other, particularly among young women. Once substance abuse is initiated, it may become a more solitary behavior as well. If you observe any of these warning 02:58 signs, keep watching to learn what you can do now to start helping your son or daughter

Other Possible Signs of IV Drug Use

It’s important that you consider all the other possible signs of addiction to meth or another IV drug. Those who use IV drugs will often wear clothing designed to hide infection sites.

Unseasonable Clothing

During the summer months, many people look forward to wearing tank tops and shorts to beat the heat. Those with an IV drug use issue frequently do not wear the same clothing because they risk showing signs addiction. They might wear long pants that reach down to their ankles and shirts with long sleeves that cover their arms even in the middle of a hot day.

Sudden Weight Loss

Sudden and quick weight loss is another sign of IV drug use. Drugs such as meth and heroin provide more energy than normal, resulting in staying up for hours and even days at a time during a binge. The extra energy received from the drugs burns calories resulting in losing a significant amount of weight. You might find that a close friend or family member suddenly lost a large amount of weight within a few months. Sometimes the weight loss can result in people looking like skin and bones and/or have heads that appear too large for their bodies.

Appetite Changes

Another sign to look for is a change in appetite, which often goes along with a change in sleep patterns.  Drugs can cause major changes in the way they eat and drink as well as sleep. They may only want to watch television or spend time with other people who also use. Addiction can also result in spending long hours awake and alert.

What Drugs Are Injected?

Although meth and heroin are among the more commonly abused injected drugs, they are far from the only ones. Some use cocaine in the form of crack cocaine or morphine. Some people also mix heroin with cocaine to make a substance called a speedball. Some of the other drugs taken intravenously include:

  • Bath salts
  • Steroids
  • Prescription drugs
  • PCP
  • Ketamine

Those who take prescription drugs intravenously often do so because they want to feel the full effects of the drug as quickly as possible. In the same way that doctors often recommend that patients take a prescription painkiller before they experience any pain because it can take up to an hour or more for the effects to kick in, shooting up the drug helps it kick in quickly and provides both pain reduction and a euphoric feeling.

Oxycodone, including both the name brand and the generic, is a common IV drug. Some also use ADHD medications as an injection, including Ritalin.

Some of the common signs of drug use include a loss of interest in activities and hobbies, a change in personality, constant thoughts of using and abusing drugs, and physical changes. When IV drug use occurs, you might notice that the eyes appear sunken and that bones show through the skin. It’s often hard to admit that there is a problem. Recognizing that an addiction is present is the first step on the road to recovery.

Drug Binges

More than 13 million people around the world use and abuse IV drugs and a large portion engages in something called a drug binge. A binge can last anywhere from a few days to a week. During drug binges, it’s common to stay awake the entire time. While some like to sit down and watch television or movies during a binge, others prefer to be physically active and to do things around the house. Some prefer to be alone and locked in their homes or apartments, and others like being around people.

During a drug binge, you may not see your loved one or have any way to reach that person. He or she may stop answering the phone and may ignore anyone who knocks on the door. You may worry so much that you call the police and ask them to perform a wellness check. The highs that occur during a drug binge can make a close friend seem like an entirely different person. A person binging can act in manic ways and have a hard time listening.

Health Risks and Dangers

Those who engage in IV drug use have an increased risk of developing other conditions later. A large number of people who use IV drugs end up with an HIV diagnosis because of dirty needles. While in the middle of a drug binge, people often are willing to do anything to get a fix and are more willing to take risks.

A dirty needle is one that is shared by two or more people. If someone infected with HIV uses a needle and then an uninfected person uses that same needle, that uninfected individual can contract the disease.

Anyone who uses drugs intravenously also has an increased risk of developing other conditions and diseases. One danger is that the drugs can cause memory problems. In fact, drugs can impact a person’s short-term and long-term memories. They may cause issues with a person remembering simple things, such as when to pick a child up from school or when to go to the grocery store. Long-term memory problems can make the individual forget the names of close friends.

In addition to HIV and sexually transmitted diseases, there is also a chance that IV drug use spreads other diseases as well. There are clean needle exchanges available for anyone who uses IV drugs. This is to ensure that clean or new needles are being used to avoid infections.

Video: How to Help a Loved One

We understand the fear, anxiety and uncertainty you're probably going through. Treatment and recovery from opioid use disorder are possible for 00:13 your son or daughter. Recovery is a journey and it takes time, but there are actions you can take now to keep your child safer while working to engage him or her in treatment. Note that whenever we refer to treatment we mean a 00:29 comprehensive clinical program addressing substance use disorder and other mitigating factors. A medical detox may be required, but it is not a substitute for treatment. If your son or daughter is misusing opioids have 00:44 naloxone sold under the brand name "Narcan" on hand and know how to use it. Available from most pharmacies, it can reverse opioid overdose and save lives. Encourage anyone that spends time with your child to do the same. In case of an 01:01 overdose, always call 911 whether or not you have naloxone to administer. Administer naloxone according to package specific directions. If breathing is labored or 01:15 non-existent, conduct rescue breathing. Once breathing resumes, place in the rescue position and provide comfort. A loved one overdosing is traumatic, but it 01:28 can also be an opportunity to engage or re-engage with needed treatment. You can find complete instructions on how to identify and respond to an overdose, including administering naloxone on our site. Helping your son or daughter engage 01:43 with a comprehensive treatment program, including medication, is the best course of action, but it can take time to get there, especially given wait lists and program availability. Taking some steps to reduce the risks to their life and health is a vital safeguard along the pathway there. 02:02 For someone struggling with a severe opioid disorder and still in active use, the immediate focus is on staying alive until they are willing and able to get help. Reducing the risks to your child means having an 02:17 open discussion about using safe injection practices, including sterile, never used or shared needles, and other items used for injection; not mixing substances; not using alone; and having naloxone on their person. They can also 02:32 consider going to safe injection sites. Understanding how to navigate current systems for accessing treatment can be overwhelming. This is one of the reasons we offer one-on-one assistance to parents. Our Parent Support Specialists 02:47 will help you create a personalized action plan for helping your child, including how to have a conversation about minimizing risks and engaging with treatment. They are here to listen, provide emotional support and help you 03:02 find the right answers for your family. When exploring the treatment options, consider medication-assisted treatment. The proper use of medications like Vivitrol, buprenorphine or methadone, combined with therapy, can help manage 03:16 cravings -- in turn reducing the risk of overdose and other health risks associated with IV use. Evidence-based treatments like this are often needed to overcome opioid addiction and maintain long-term recovery. Just as addiction 03:33 impacts the entire family, recovery is a journey taken together. You can stay involved and you can help your child change his or her behavior. It may be difficult to focus on your own well-being when your child is in crisis, 03:47 but self-care, which may include counseling or attending a support group, will help you and your family in so many ways, including strengthening your own resiliency. Taking care of yourself will better equip you to care for your child. 04:02 Remember that you can take steps to protect your child while he or she is still in active use, including having naloxone on hand and reviewing safer injection practices. Continue to work on engaging your son or daughter in a 04:17 comprehensive treatment program -- ideally one that includes the combined benefits of counseling and medication. Let us help you when you reach out to one of our Parent Support Specialists, they will lend 04:31 support and share information on approaches that have been demonstrated to help parents not only help their child, but help themselves as well. 04:41 Families can heal. Find the answers, support and guidance you need, here at drugfree.org.

What to Do if Someone is Shooting Up

If you worry that someone you love has an addiction to an IV drug such as heroin or meth, you should look for the physical signs of addiction. You may want to look around the house for other signs as well. They may have hidden paraphernalia around the house, including the small plastic bags and glass vials that once held the drugs. You may find dirty needles or the orange caps that sit on the ends of the needles around the house.

When it comes time to help a loved one, you may want to stage an intervention with other family members and friends. You can all talk about addiction and how it has impacted your lives. A treatment center can help too. Both inpatient and outpatient programs offer plans that include helping with detox and taking the first steps toward recovery. If you want to help a loved one struggling with a IV drug addiction, talking to a treatment center is your best course of action.

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