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Heroin Needle: Dangers of IM and IV Smack Injections

what is heroin shooting

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Shooting heroin is a common way of administering the drug among many users. It delivers the drug fast into the bloodstream to produce the desired results. However, it is associated with a number of complications and a higher risk of death when compared to other methods of using the drug.

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Table of Contents

What Does it Mean to Shoot Heroin?

“Shooting” or injecting heroin is a dangerous way of using an already dangerous drug. It involves injecting the drug intravenously using a syringe, which pushes the drug directly into the bloodstream.
People tend to enjoy shooting heroin because it releases the drug directly into the bloodstream, thereby causing a rapid onset of the desired “high” and euphoria. Users mostly make use of a lighter and a spoon for heroin cooking to liquefy the drug before shooting.

Intravenous and Intramuscular Smack Uses

Intravenous (IV) and intramuscular (IM) modes of using heroin are common but different. Intravenous use involves injecting the drug directly through a vein, usually in the front of the elbow, the groin, the leg, and neck. Intramuscular use involves injecting it into the muscle (usually the buttocks) from where it is absorbed into the bloodstream.
Intravenous use of the drug delivers it much faster into the bloodstream than other forms of use. This is why IV heroin makes users reach the most intense high, achieving peak effects within seven to eight seconds of shooting it.

However, this fast delivery of the drug into the bloodstream increases the risk of and reduces the onset time for toxicity from heroin injection.

Toxic effects of heroin typically peak within 10 minutes of intravenous use and 30 minutes of administering IM heroin.

What are the Health Risks of Shooting Heroin?

While shooting up heroin increases the risk of developing heroin overdoses or toxic symptoms, it also increases the risk of certain complications, particularly infections, resulting from shooting it.

There are four main ways heroin injections can cause infections:

  • Incorrect injection of the drug female drug addict hodling heroin syringe
  • Use of shared injected equipment
  • Unsterilized techniques
  • Injecting contaminated heroin

Diseases Associated with Incorrect Insertion of the Needle

Some users may incorrectly insert the heroin needle into a pulse or an artery. This is associated with a high risk of occluding the artery, causing gangrene of the part of the limb supplied by the artery. This is a serious complication because it may necessitate amputation of the limb.
The heroin injection sites chosen by the user may also increase one’s risk of incorrectly shooting the drug. For instance, attempting to take a heroin shot through the groin may lead to an incorrect insertion of the needle into the large artery or nerve which lie side by side with the vein. This could lead to abscesses and bleeding from damaging the artery.

Diseases Associated with Use of Shared Injection Equipment

Using shared equipment to inject the drug can transmit certain blood-borne infections, such as hepatitis C, hepatitis B, and HIV.

Hepatitis C and smack use

Hepatitis C is a virus which infects and damages the liver. It often presents with upper abdominal pain, yellowness of the eye, recurrent fever, and weight loss. However, most infected persons may not show any signs or symptoms until the lover has been badly damaged.
Hepatitis C is mostly spread by intravenous use, with more than 90% of the disease caused by injecting heroin and other intravenous substance use worldwide. In the United States, approximately 30,000 new cases of hepatitis C occur every year, with only about 2,000 manifesting symptoms.

Hepatitis B and dope injections

Hepatitis B is another virus which infects and damages the liver. It may also be transmitted by exposure to blood and body fluids of an infected person. Therefore, sharing needles for heroin shots poses a high risk of contracting the disease.

HIV and shared needles

HIV can be contracted by exposure to blood or genital fluids of an infected person. Using shared heroin needles, therefore, places an individual in contact with blood from an infected person. It can also be spread through sexual intercourse, blood transfusions, and vaginal birth.
About 30% of HIV infections worldwide (outside sub-Saharan Africa) are caused by using shared needles.
two heroin addicts sharing the syringe with smackOther diseases which can be transmitted via shared injection equipment include malaria and human T-lymphotropic virus (HTLV). HTLV is known to cause a type of cancer known as adult T-cell leukemia/lymphoma.
While overdose complications are mainly treated with replacement opioid therapy and psychotherapy in inpatient addiction treatment centers, these infections require intense antibiotic therapy.

Diseases Associated with Lack of Sterile Technique

Using unsterilized equipment to shoot up heroin may cause several infections. Sterile injection involves using injection equipment that has been heating at high temperatures to remove contaminants and germs. It also involves cleaning the heroin injection site with an antiseptic solution to prevent the introduction of bacteria and other germs from the skin into the bloodstream.
Many users engage in unsterilized practices of shooting the drug, inserting contaminated unsterile heroin needles into the veins in an unsterile environment.

Methicillin-Resistant Staphylococcus Aureus caused by non-sterility

One common bacterial agent spread due to use of unsterile techniques is methicillin-resistant Staphylococcus aureus (MRSA). Other infectious agents such as streptococci can also be spread in this way.
These bacteria commonly begin by infecting the tissues beneath the skin of the heroin injection site, causing cellulitis, furuncles (or boils), abscesses. The may then progress to infecting deeper tissues and bones, causing necrotizing fasciitis, septic arthritis, and osteomyelitis. The infection could spread into the blood, to different organs, leading to sepsis.
The bacteria may, consequently, seed into the heart, liver, and even brain, causing severe infections.

Group A Beta-hemolytic Streptococci (GABHS) and smack

Group A Streptococci can also be transmitted by shootingheroin drugs on dirty table the drug in unsterile conditions. It infects the body through direct contact with the skin or mucous membranes from contaminated objects, such as heroin needles.
Group A streptococci cause common infections, including on-invasive conditions such as scarlet fever and impetigo and invasive and severe infections such as bacteremia, toxic shock syndrome, and necrotizing fasciitis.

Diseases Caused by Heroin Contaminants

Contaminated heroin shots may cause several infections and diseases. In a hospital setting, medications for injection are injected in their pure and sterile forms. However, for drug users, substances may be mixed or cut (as with black tar and brown heroin) with other substances and micro-organisms which can cause infections.
What is heroin cut with? Some of these substances include caffeine, starch, sucrose, talcum powder, rat poison, laundry detergent, crushed painkillers, and baking soda. These substances are used to dilute the drug, but some of them can be dangerous.
Bacterial spores could contaminate some of these substances, causing certain infections, such as botulism and tetanus when the drug is shot up.

Botulism-contaminated heroin

Botulism is caused by Clostridium botulinum, which may occur in spores. These spores contaminate heroin and when injected can cause wounds at the heroin injection sites and botulism, which presents with weakness, blurred vision, weak muscles – manifesting as drooping eyelids, difficulty speaking, and difficulty swallowing.

Tetanus and smack needles

Tetanus is caused by Clostridium tetani, commonly found in the soil and rusty or dirty objects. Tetanus spores can also contaminate heroin, and this could take place at any point, from the production of the drug to its injection.
More than 15% of tetanus cases in the United States are caused by intravenous drug use, especially heroin injections. The disease presents with severe muscle spasms and convulsions.

Can Shooting Heroin Lead to Death?

One of the feared complications of injecting heroin is the risk of overdosing. This risk is increased with the intravenous use of the drug because it delivers it fast into the bloodstream. The presence of heroin track marks suggests that one may have become addicted to it, which may cause tolerance and a strong potential for toxicity.
faceless man in hoodOverdose on the drug is further potentiated by its long duration of stay in the body, as can be detected by heroin urine tests. Some overdose symptoms include disorientation, altered sensorium, convulsions, coma, and death. Substance abuse therapy is important at this stage to detoxify the individual and promote recovery.
Shooting up heroin may be the fastest way for users to experience the desired euphoric effects of the drug, this mode of using it comes with many severe complications, including severe blood-borne infections such as hepatitis B and HIV, skin infections and abscesses, and other infections such as tetanus. It is important for users to know that using heroin is dangerous to health, and intravenous use is associated with even higher health risks.

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Medically Reviewed By Michael Espelin APRN
Olivier George

About Author

Olivier George, Ph.D.

Olivier George is a medical writer and head manager of the rehab center in California. He spends a lot of time in collecting and analyzing the traditional approaches for substance abuse treatment and assessing their efficiency.


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