The Pharmaceutical Journal
Vol 279 No 7471 p353
29 September 2007

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• Retention fees (12)
• CPD (2)
• The profession (2)
• Drug misuse
• Community pharmacy

Letters to the Editor

Drug misuse

Injecting technique

From Mr R. I. Dunkley, MRPharmS

Jeremy Clitherow makes a valuable point in his article, “Pharmacy has a role in averting the abuse of steroids” (Community Pharmacist, September 2007, pS3 (PDF 300K)), when he wrote about “illicit injections and all that goes with them”. I would like to raise an equally valuable point about the actual act of intravenous injection in substance misuse.

In the past three months, six addicts under my care have died because of faulty injection technique. They have died not because of overdose, but because they have, in the act of injection, created emboli. I have a dozen more substance misuse patients on warfarin or Clexane who are are in the “waiting room of premature death”.

Repeated insult to the vein results in that vein shutting down and the addict using another site, with increasingly risky consequences, ie, the production of clots or emboli, or transmission of blood-borne viruses.¹

I recently attended a conference in London about crack cocaine run by the Royal College of General Practitioners and led by crack cocaine users. These people inject repeatedly, but not one of them had any problem with circulation, because they rotated their injection sites and allowed their veins to recover before using them again, ie, they had good injection technique.

Should we not inform opiate and cocaine users how to inject safely? If pharmacists who deal with substance misuse patients could do this, then perhaps we could lessen the death toll of our addicts and lessen the burden of these patients on the NHS.

Bob Dunkley
Leeds

Reference

1. Derricot J, Preston A, Hunt N. The safer injecting briefing. Liverpool; HIT: 1999.

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