Harm Reduction Avoiding the Liver? Questions of first pass metabolism, IV / IM / Rectal admin. To prevent liver damage?

[neversickanymore]

Opioid Drugs in Patients With Liver Disease: A Systematic Review

The liver, one of the most important organs of the body, is known to be responsible for several functions. The functional contribution of the liver to the metabolism of carbohydrates, protein, drugs and toxins, fats and cholesterol and many other biological ...

www.ncbi.nlm.nih.gov

 

[evo4ever]

IV/IM avoids "first pass" metabolism, note "first pass" is key, eventually the drug will come into contact with the liver after a few round trips in the blood stream. Heroin for instance is mostly metabolized into 6-MAM and Morphine in the brain its self by isozymes.

 

[Jabberwocky]

Hopefully there's a less severe explanation, but yeah I'd definitely get checked for hep c soon.

I never did find how exactly how I got it, or even who I got it from (though I can certainly guess..). I mean obviously I got it through IV injecting, but prior to being infected I had never shared a needle. So it had to have been through shared spoons or other equipment.

My point is, hep c can be contracted even without an obvious point of exposure. If you inject at all, and you have elevated liver results, it's worth assuming that hep c could be the reason.

Fortunately Hep c is not a very scary disease anymore. When I contracted it (from sharing a spoon) the only cure was interferon which made most people suicidily depressed and needed I think 12 months of treatment. These days there is a really simple treatment of pills that has a close to 100 % cure rate. In any case, it takes years from infection to damage to your liver - its a slow disease. I was very lucky I was in the 25 % of people whose bodies spontaneously clear the infection without treatment. Was terrifying diagnosis at the time though - made me realise how potentialy close to HIV I'd been (even though you need something like 100 times more blood shared for an HIV infection compared to Hep C where an infintesimal amount is enough for transmission.

 

[JessFR]

Fortunately Hep c is not a very scary disease anymore. When I contracted it (from sharing a spoon) the only cure was interferon which made most people suicidily depressed and needed I think 12 months of treatment. These days there is a really simple treatment of pills that has a close to 100 % cure rate. In any case, it takes years from infection to damage to your liver - its a slow disease. I was very lucky I was in the 25 % of people whose bodies spontaneously clear the infection without treatment. Was terrifying diagnosis at the time though - made me realise how potentialy close to HIV I'd been (even though you need something like 100 times more blood shared for an HIV infection compared to Hep C where an infintesimal amount is enough for transmission.

I know, I fortunately had my hep c infection cured using the amazing new drugs.

The only issue is they're very expensive if you don't have access to good health care, which I fortunately do.

Interestingly, I had exactly the same kinda psychological reaction you describe, after I found out I had Hep C.. I couldn't help think about just how easily I could get hiv or something.

It didn't make me stop using. I kept using for years more. But it was definitely a bit of a wake up call.

Hep c still shouldn't be underestimated though. It can and does kill people. It's a lot less common now, but it can still kill you in the long run if you ignore it. Which sadly I've known people who have.

 

[Jabberwocky]

Hep c still shouldn't be underestimated though. It can and does kill people. It's a lot less common now, but it can still kill you in the long run if you ignore it. Which sadly I've known people who have.

Yep. Every IV user should get tested annually I reckon. I still get tested regularly just to double check I have not become re-infected (if that is even possible).

 

[JessFR]

Yep. Every IV user should get tested annually I reckon. I still get tested regularly just to double check I have not become re-infected (if that is even possible).

It is possible unfortunately.
And yes I completely agree.