Author: Nikki Seay

Tracy was aiming for a vein, but she missed. Instead of entering her bloodstream, the heroin went directly into the fatty tissue around the vein. It hurt, but she figured it was no big deal.

She was wrong…

4 Dangers of Missing the Vein With IV Drug Use

Injecting a drug (often called “shooting up”) means using a needle to deliver drugs like heroin, cocaine, and methamphetamine directly into a vein. When the needle fails to reach its target, this is called a “missed shot.”

A “missed shot” happens when a needle either: 1) doesn’t enter the vein properly, 2) enters the vein then slips out again, or 3) enters the vein and goes all the way through to the opposite side of the vein.

During IV drug use, when the needle slips or punctures the vein, it causes fluid to enter the tissue around the injection site. This often leads to infection, and from there, things can quickly go downhill. People can experience abscesses, cellulitis, vein collapse, and other complications.

Let’s take a look at four serious problems that can develop if IV drug users miss the vein.

#1 Abscesses

When a missed shot gets infected, you may get an abscess at the injection site. Your body is trying to fight the infection, so it sends cells to the damaged tissue to repair it. This causes the area to become swollen and fill with pus. (Pus is a mix of white blood cells that are sent to fight the infection, plus germs and dead tissue.)

Side effects of an abscess include:

• Redness of the skin
• Smooth swelling under the skin
• Pain in the infected area
• Warmth of the skin in that area
• A build-up of pus in the area

Because of the infection, you may also experience a fever and chills. Here’s how some people have described the abscess experience:

#2 Cellulitis

A missed shot can also lead to cellulitis. This is a deep, bacterial skin infection. It can occur when a break in the skin allows bacteria to invade (which happens when drugs are injected outside a vein). And it can be very serious.

Common symptoms of cellulitis include:

• Pain
• Tenderness
• Swollen skin
• Redness of the skin
• Bruising
• Blisters
• Fever
• Headache
• Weakness
• Chills

The pain and other symptoms start at the injection site, but the infection can spread quickly throughout the body. It can cause damage to tissue and tissue death. If you get cellulitis repeatedly, this can cause damage to your lymphatic drainage system and cause ongoing swelling of the affected arm or leg.

And the infection can enter your bloodstream, lymph nodes, bones, heart, or nervous system. At that point, it can become life-threatening. Complications from cellulitis can lead to amputation or even death. When you factor in the complications from addiction, it’s easy to see how things can spiral.

#3 Vein Collapse

Repeated missed shots can also cause your veins to collapse.

Here’s how it happens:

1. The injection causes damage to the lining of the vein.
2. Clots form around the damaged site.
3. The clots harden into scar tissue.
4. These clots narrow the vein, which restricts blood flow and causes future clots to form more quickly.
5. Eventually, the sides of the vein heal together (the vein “collapses.). There’s so much scar tissue that it draws the sides together and shuts off the vein.

Once a vein collapses, blood can no longer flow through it. Sometimes a collapsed vein can heal, but the damage can be severe enough that the collapse is permanent. In some cases, this can cause circulation problems.

#4 Substance Complications

In addition to the damage caused by the needle, the drugs themselves can irritate the vein or cause other issues. For example, research has shown that the acidity in heroin can damage veins. Researchers found that some batches of heroin have a pH level as low as 2.6 – which means the heroin is very acidic. (In comparison, lemon juice and vinegar both have a pH of 2.) Imagine the irritation your veins would experience with something that acidic flowing through them. With repeated exposure to such high pH levels, veins can develop life-threatening infections.

It’s also worth mentioning that, when people inject heroin that is mixed with cocaine, the cocaine actually numbs the injection area. That means you aren’t able to feel the typical pain associated with missing the vein. And when you can’t feel it, you don’t know there’s a problem.

IV Drug Users Can Expect Complications

Are complications from missed shots a common problem? Are you likely to experience one of these issues? Well, over half (56%) of people who inject drugs admit they’ve missed a vein. And one in six intravenous drug users reports experiencing a missed shot more than four times every month.

So, yes, IV drug use problems are common, and the risks are high.