Harm Reduction I.M. Injection complications

adder · Oct 30, 2012

After I had finally stopped using methadone (September 7), I have eventually started injecting codeine i.m. just to ease persisting withdrawal effects (terrible depression, anxiety, and sweating). They kept me away from my friends and I needed interaction with people so much.

It's been one week but in the end I quickly had to inject into muscles I had injected before (I didn't inject into the same spots but some muscles aren't that big in my case right now). I am thin and my immunity is very low at the moment. So I hit some veins, this caused bruises. I imagine there are clots under my skin. Is there anything I can help my muscles here?

I did i.m. injections in the past and that definitely had some impact on my muscles like adhesions causing inability to inject in some places. It's certain I damaged my muscles meaning I got adhesions from these recent injections. There are spots where my muscles are hard.

Although I know about possible complications in theory, I have never encountered them or seen in other people.

What would be some visible and/or noticeable (e.g. feeling by touching muscles and applying some pressure with fingers) signs of something more serious like abscess, subcutaneous tissue atrophy, or fibrosis to name a few serious problems? What are chronic effects resulting from this? When I finally got off this methadone shit and I had wanted to do it for a long time, I could cause. irreversible changes. I may be paranoid, I can't be objective here. But if I'm about to lose the last chance to get my life back, then paradoxically I now have no reason to live any more and being on methadone was safer. I don't want to die now, it's possible I finally met a girl who seems to be someone I could start a serious relationship, my life could get back on track. If it's all to fall apart, I'm out of ideas.

I need help, even just a few words. I'm sorry I'm so effusive but I was in the "nowhere" land for 3 years because of methadone addiction.

Please don't tell me I was stupid or reckless as I'm not needed to be told that. I simply couldn't control problems of biological nature being a result of quitting methadone. 10 lines about what happened after if you care to read:

NSFW:

Interested in other research studies? Find more drug studies.

MartinFn · Oct 30, 2012

Good luck bro, you need it..

I just chime to wish you good luck..I've read a lot of your posts, in the ultimate potentiation thread mostly, and i know that you're a person with solid knowledge of chemistry, and i remember you mentioned a lot of times, the problems you have with methadone and clonazepam (i think..).
Well, i think that i know about how you feel, i'm a chronic pain patient,(and junkie) and the 100mcg/hr fent patches every 48hrs, seems that can't cover all the fuckin pain..
Anyway, i don't wanna rambl, just wanna wish you get rid of meth, and i wish this can be done, as easy as it gets..Bye fellow, and be strong..

MartinFn

Kenny7822 · Oct 30, 2012

Were you injecting codeine pills and if you were did you at least micron filter them? Either way you need to get to a hospital before something really serious happens.

NeighborhoodThreat · Oct 30, 2012

Stick to dosing the codeine orally man. That sucks that your doctor took a leave of absence and pretty much left you stuck.

How long until your doctor returns? Can't you just talk to another doctor about stepping down your dosage? I.M. codeine injection is very very dangerous man. Codeine is not meant to be injected.

adder · Oct 30, 2012

Thank you a lot all for replies. It means a lot for my mind which plays shadow games with me.

EDIT: Sorry if this fits more into my blog. I'm in the process of becoming me again and before getting addicted I was a sociable and talkative person. It's like I have too much to say and too little time.

@ MartinFn

I have got rid of methadone already. I poured it into a toilet bowl, this is where its place is. This shit ruined a lot in my life, probably even more than morphine, heroin, or any other opioid, although I took methadone p.o. and intravenous injections throughout the years caused such adhesions on median cubital vein that nurses have problems getting there right and those more professional take blood from deeper veins (well, I had a lot of venipunctures in the last 3 years too and to be honest my shots were better hit than those venipunctures; I have met 2 nurses in my life being able to take a lot of blood without leaving me with a bruise).

Well, the whole situation with this codeine i.m. administration gets even more unbelievable (how could I be so irresponsible?) - I did a lot of intramuscular and intravenous injections for my family members so they didn't have to go to a clinic just to get a shot. And you know that not only watery solutions are meant for i.m. but also oily ones and suspensions.

And yes, I'm also addicted to clonazepam, I'm at 3mg right now but I often forget to take it, seriously. I get nothing from it and the only reasons I still take it are 1) too little time has passed since I quit methadone so I wouldn't bear it and 2) fear of having an epileptic fit.

@ Kenny7822

Yes, a person with a good knowledge of what any type of injection can cause when something is not done as in the unwritten rules (unwritten for addicts of course, it's clear pills are made for oral consumption), injected codeine phosphate extracted from pills. I didn't use micron filters (just as I hadn't in the past as my problem with opioids started with codeine too, first p.o., then i.m.), I used cotton (I would have to order micron filters and I know of no Polish source, besides I was too disoriented and panicked to even let this one sentence come out of my subconscious - "you know pills injected i.m. are worse than pills injected i.v. plus cotton isn't really safe as there are bacteria in it and it's not enough as a filter to stop bacteria". I used boiling water to disinfect glass and I used either water for injection or 0.9% NaCl solution.

@ NeighborhoodThreat
I have a visit next Thursday... Like I wrote, I respect this person as a psychiatrist. But there are some things I think he could have done in a different way. He prescribed me sedative antidepressant drugs so I could sleep because sleeping was possible during the first weeks of withdrawal only when I got exhausted from being awake. First, it was mianserin but it made me very angry and I started having suicide thoughts (first time in my life for real, I realized thoughts I had had in the past weren't really suicidal ideation), then he decided to go with amitriptyline as I was in deep depression, but it was even worse for me (I got bilirubin levels above normal with ideal AspAT and AlAT so I was diagnosed with Gilbert syndrome), my eyes were yellow, I had dilated pupils, and I felt "dirty", it wasn't definitely how an antidepressant should act bringing the right antidepressant effects.

I didn't inject codeine any more after my first post. I used it per rectum in the morning as I knew it'd be impossible to shoot it i.m. After I saw how I look from these injections, I guess I "sobered" a bit. I read quite a lot about administration of opioids that are pro-drugs and their action is mainly by toxication mechanism. For codeine i.m. is actually equal to p.r., the only difference is Cmax is lower in case of p.r. and the effects start a bit later, and there's no rush (e.g. you can get some sweat on your face after codeine i.m. injection, something like taking opium), it's of gradual nature.

@ pontifex01
I guess zolpidem is a bit different story from codeine. It's really harsh and it's not only when you inject i.m. a solution made from pills but it would also be harming to veins even in a form of lab pure powder. I'm not saying my muscles are fine. But I had a really panicking moment last night when I looked at all these bruises and felt my muscles are hard in many places. I'm just achy but let me be honest - sometimes I simply should have take out the needle seeing I couldn't administer normally, I pushed it too far.

I don't know if tapering down is a good idea as it wasn't much of a binge and I've been through much worse, codeine withdrawal is a walk in the park in comparison. It's just me being weakened by methadone. I have already quit it but the main withdrawal effects may last up to 3 months and it's been only almost 2 months. I also suffer from hypothyroidism. However, after quitting methadone and going through some infection that was misdiagnosed by 3 physicians (incl. one otolaryngologist) my TSH levels dropped to the point of below normal and indeed I had clinical symptoms of hyperthyroidism (mixed up with antidepressants side effects...). I can thank two GPs for getting fungi and candida on my tonsils as a result of 20 days of taking antibiotics which weren't needed at all. Thus, I can't really tell for sure if persisting sweating is really still because of stopping methadone.

Luckily I'm seeing my endocrinologist tomorrow and I know I need to be honest about my opioid use. You should know that addicts, especially addicts taking heroin/morphine, are much more stigmatized in Poland than in Western Europe. Morphine-type addiction wasn't really widely known here until early 1990s and powdered heroin wasn't really available until 1990s too, earlier people used the infamous Polish kompot in vast majority but they were considered underclass. And even now although it's 21st century most people think the same way about people who used/use heroin ("he/she just has to be infected with HIV and HCV", "a heroinist is a dirty person with skin colour changes just like alcoholics", "all heroinists are thieves").

Concerning going to a hospital, this doesn't work that way in Poland. If you aren't dying right in the moment you're at hospital, you will be sent to a GP who then may give (but doesn't have to) a referral for a specialist who will most likely have problems with proper diagnosis and will be afraid to give a referral to hospital. Also, GPs have a limited amount of laboratory orders etc. per one month and they're hesitant to use them. Luckily I could buy an unlimited access to some specialists in a private medical care company, otherwise I would still have to wait to see an endocrinologist (it's 2-3 months of waiting normally). To sum it up, nobody would look at my muscles in a hospital because I'm not about to die in like minutes (there are news from time to time like "a man/woman died and should have been under specialist's supervision in a hospital"). Poland is a member of the EU but our law is flawed, it doesn't serve normal people, it serves politicians and influential people. I must recover by myself (if I fucked something, I won't know about it until it shows...).

I would go cold turkey without thinking but I've got an exam on Monday + I need to write a few source codes. If the withdrawal is too strong to think and do my duties, I will taper down with tramadol. It'll be safer because I never enjoyed it as a forget-the-problems and stop-the-anxiety drug. Also, maybe the SNRI component of tramadol will help me with depression a bit until I see my psychiatrist. I can pray to God I may get a chance to fix my life now that I not only understood my problem but also finally dropped methadone (interestingly I realized I'm not a religious agnostic when I stopped methadone, earlier I even considered myself an atheist or not caring about higher power presence at all).

Kenny7822 · Oct 30, 2012

You injected codeine pills without a micron filter, that is extremely dangerous and you need to get to a hospital right now. If you don't believe me, read pontifex01's thread that he posted above. You shouldn't be even posting on here go now. I'm 99% sure you will develop and abcess or an infection of some sort and that's not even the worst that could happen.

I'm sorry I seem like I am preaching to you but you very well could die from this and I'm not exagerating. pontifex01 almost died from this same exact thing. Only difference is he injected a different type of pill.

I don't know how the hospitals are run in Poland but if they are really like you say they are then go to a different country or something... I'm serious you could die or lose a limb.

Anyway, I am concerned about your well being so please update this thread and let us know how things are going as time passes.

FlippingTop · Oct 30, 2012

Man you NEED to go to the hospital.

You NEED medical attention.

Don't misread pontifex's post, he isn't talking about how well and dandy things were.

Concerning going to a hospital, this doesn't work that way in Poland. If you aren't dying right in the moment you're at hospital, you will be sent to a GP who then may give (but doesn't have to) a referral for a specialist who will most likely have problems with proper diagnosis and will be afraid to give a referral to hospital. Also, GPs have a limited amount of laboratory orders etc. per one month and they're hesitant to use them. Luckily I could buy an unlimited access to some specialists in a private medical care company, otherwise I would still have to wait to see an endocrinologist (it's 2-3 months of waiting normally). To sum it up, nobody would look at my muscles in a hospital because I'm not about to die in like minutes (there are news from time to time like "a man/woman died and should have been under specialist's supervision in a hospital").

Go to A+E and tell them you have been injecting pills without a filter and these are the side effects thus far.

'worst' thing that happens is you are released and return home.

adder · Oct 31, 2012

I even wonder if they would do any tests... Some physician would probably just take a look in an outpatient department. Not that I don't feel any need to know what I could have done to myself, I simply had so many unpleasant situations that discouraged me. I was to go to a hospital for a few days for a few tests as the endocrinologist suspected adrenal insufficiency or even pituitary gland insufficiency. I postponed it once and the second time I simply got myself out from the queue.

My temperature is 36.9 Celsius degrees (I'm still sick a bit, codeine stopped coughing, besides codeine always put some 0.2-0.3 to my body temp), my muscles feel less hard. The pain isn't so bad that I can't move, I sure am feeling it when I apply pressure onto the site of administration, there's no reddening and bruises are smaller. I just feel weak but it's nothing new. I've felt weak since I quit methadone. I didn't hit any big nerve like sciatic nerve or axillary nerve. My skin simply can't look healthy as I have to take fluconazole (after wrong diagnosis and treatment with amoxicilin and cephadroxil) + I still have some colouring from beta-carotene stored in tissues (I like carrot juice). I checked my lymph nodes, both armpits and groins, they aren't bigger than normally.

I would use ketoprofen orally but I guess my liver is already overloaded with various drugs (fluconazole definitely extends effects from codeine - it's been 19 hours since I took 300mg p.r., I'm not sweating yet and my pupils are still constricted, my heart got uneasy. My hands shake when I raise them so they form a 90 degrees angle with my torso but that's another thing and was present before, probably connected with hyperthyroidism symptoms.

I will update information. Well, unless I no longer can.

Don't misread pontifex's post, he isn't talking about how well and dandy things were.

I didn't mean to and I didn't. I know sepsis is a serious condition that may be fatal if not treated right away. I am well aware of my recklessness but I can't really find any symptom that would add to symptoms I used to have years ago when I was starting to dig my opioid grave I luckily don't occupy now (I started with codeine and I didn't have pure powder like one used in e.g. some academy of medicine right away).

I know my hesitation seems driven by some stupid reasons, if I read a post like my starting post in the thread, I would recommend doing the very same thing. It's much easier to suggest something to someone than to do it yourself when you find yourself in the same position. I started the thread crying totally depressed although under the influence of an opioid, something that always took care of things like emotions and feelings I couldn't cope with. There was a sense of guilt, shame, and feeling I'm useless because I'm a fucking junkie who lost to codeine being so close to the end of theoretical 3-month period of recovering from methadone discontinuation. I also feel stupid that I was simply like "I need to cure myself right now and that's it". It's a constant roller coaster that drove me to other stupid things. I'm ashamed to go to the casualty department where people find themselves when something serious happens to them and their actions had no impact on their state, this is why it's more convenient for me to observe it all myself and see if it doesn't resolve itself with time. There would be a reason for my muscles to be hard even if I had used micron filters, just because I overdid it (and definitely didn't even think for a second to cure with a stronger opioid though morphine would come in ampoules). I'm not in an unexpected pain and if you really saw the whole process, you'd probably say "how come you could still inject on the following day?".

adder · Oct 31, 2012

If it's possible to push it through privately, what kind of tests should a physician give laboratory orders for, so I don't find out something is wrong in a month? There are a lot of quacks at hospitals who probably have never seen anyone having injected oneself in virtually all muscles used for i.m. injection. My knowledge about anatomy is superficial.

adder · Oct 31, 2012

I went to hospital but unfortunately a physician just took a look at it (after a quite long talk about what the casualty department is for...) and told me that he can't do a USG because he sees no reasons... "Well, you will feel hardness and some pain, this happens with most drugs injected intramuscularly. Besides you said you filtered it and it wasn't a suspension, this should resolve itself, it just needs time". Generally, it was a very unpleasant experience and not helping at all. The guy also saw no reason for sepsis possibility because the last time I injected was Monday (well, but the shit that was there beside codeine can still be absorbed and cause an abcess, right?...).

I mentioned going to a doctor privately. And that was what I did. First of all, I was told to show up at night in the hospital if I'm feeling worse. That should force a doctor having night duty to examine me because he/she will know that there is no other place at such time where I could get any type of help (he/she could even just be afraid of legal problems). I was asked about various things. In the end I was told to buy pills with aluminium acetotartrate and put cold compresses so anything left in the muscles is slower absorbed and that should help my organism cope with the situation. It was too late when I arrived at the private clinic to do any tests as laboratories were already closed. This unfortunately means I won't be able to do a USG privately until Monday. $:\$

I don't know if I'm right here but maybe it all looked like this because I told that I suffer from Gilbert's syndrome, take clonazepam daily, and take fluconazole for these fungi and candida. I also told about this strange infection I had, 3 wrong diagnoses, and a 20-day treatment with antibiotics.

I also told her that I didn't stop codeine but took it p.r. yesterday. She asked if I am under medical care concerning my opioid addiction. I told her how different things left me without my doctor for 2 weeks. I talked with my therapist (with my mum, well, this is also to make her realize why I sometimes can't say "no", I wanted a professionalist to explain her some mechanisms because she doesn't believe me and it's no wonder why). He said that his opinion is this curing with codeine isn't really that dangerous as it's far from morphine or heroin and it's justified in some way that I took it several times throughout last 1.5 weeks. He even said that I should not have pricks of conscience as in theory a 3-month period after methadone discontinuation hasn't passed. Of course again I heard that I should take as little as possible and stay away from needles because this acts as a catalyst reminding me of past drug usage and he sees that I care a lot about my studies and stuck to a concrete plan so if I manage to get through these hard times, he thinks that no centre for addicts will be needed as I do the very same things in a more natural way attending group therapy and reviving my social life.

Well, I think that this 3-year methadone addiction and now these reckless i.m. injections will help me even more in recovering from this mental roller coaster. I definitely don't think about possibility of taking stronger opioids. I wanted to switch codeine to tramadol until Thursday (I will see my doctor then). This is the only opioid from the whole lot I took that causes nausea, headache, "dirty" feeling similar to some S(N)RIs and uneasy heart. I guess it won't be high-seeking behaviour if I ask him whether temporary Suboxone program could be a solution as I wouldn't take anything else, I wouldn't feel as if I had my mind in the clouds, and I would get an antidepressant boost totally different from all these dirty feeling TCAs, (S)(N)(D)RIs, or NaSSAs).

I want to thank you all again for your input in this thread and giving me a kick to go out and seek medical help. Also, I want to apologize for posting digressions that should rather go into a blog or a different thread; it's all because all these things are inextricably connected. Feel free to leave only what you think would be a good warning for other people (whatever the reason is they want to i.m. something).

Swimmingdancer · Nov 1, 2012

adder said:
I don't know if I'm right here but maybe it all looked like this because I told that I suffer from Gilbert's syndrome, take clonazepam daily, and take fluconazole for these fungi and candida. I also told about this strange infection I had, 3 wrong diagnoses, and a 20-day treatment with antibiotics.

The anti-fungals and anti-biotics are seriously hard on your system. There are way better and healthier options for fungus/candida than fluconazole and fluconazole doesn't solve the problem, it will just come back. I have some advice about the GS too (which is probably related). I don't mean to go off topic so please PM me if you'd like more info.

Hope you are ok

Kenny7822 · Nov 8, 2012

Hey, Adder, I noticed you haven't posted in a while. How's everything going?

adder · Nov 9, 2012

I'm sorry I didn't update it in the thread. I haven't had much time lately (university, seeing doctors, and perfect timing for falling for a girl). I can't visit Bluelight as often as I used to (and I can't focus on improving my chemistry knowledge, I guess it's going to be like this while studying IT..., but I think some physical workout will be much better than breathing in some lab atmosphere

).

I am fine. Luckily it slowly resolved itself with the help of cold compresses with aluminium acetotartrate. I lost some weight, it all definitely did nothing good for my health but I will recover. I am thankful to God for giving me one more chance to settle down. And I won't be lying that only awareness of this girl's presence and seeing her everyday helps me a lot with my mood and attitude to life. So as I thought I had lost a few years on studying chemistry which gave me nothing in the end, now I look back much rarer and take my life as it is. If it all hadn't happened, I wouldn't eventually be where I am now.

I finally saw my psychiatrist to do something about this stupid codeine comeback. I told him about this situation. He said he thought I was wiser, well, I thought too... But I guess it made sense for him why I got into this, it wasn't just a thought like "I need to cure myself, I don't want to go into strong opioids, so codeine is at hand). He said it's good I have some social life and I'm doing good at university. At the beginning he suggested that placing me in the ward would be the best option as I would be under medical supervision during the withdrawal but I explained him that it's not a matter of me being afraid of withdrawal from codeine, it's just that I can't afford losing even just one week at the university right now. He was opened for suggestions which kind of stroke me but he probably sees my thinking is different from that when I was on methadone and wanted to get on the programme desperately for no apparent reason. I told him I tried substituting codeine with tramadol but I mostly felt side effects similar to those from some antidepressants and there was rather little opioid action. I mentioned I used to use dihydrocodeine during withdrawals from stronger opioids. Well, the best option after spending a week or two in the hospital is tapering down codeine, as he said, but I explained him that even now I can hardly get it OTC because pharmacists already know me well... And there's no codeine only medication in Poland so he could prescribe it. As for dihydrocodeine there are only extended-release pills, but there's a special type of prescription here for strong opioids and some other meds (they look the same but they're purple). DHC Continus is rarely used in cancer, doctors rather go from stronger NSAIDs straight to XR morphine pills (it's terrible here, nothing in between, no hydrocodone, well, long story how pain is managed here), so I guess no chemist's would even have it in stock and would have to order it. Another problem is he can't use purple prescriptions at the clinic, meds needing such prescriptions are simply used at the ward.

Eventually I had to go with the only possible solution, i.e. tramadol. 100mg q.i.d. I think it's not a bad solution, I don't feel an urge to take tramadol, I never felt, so I guess I won't even take 400mg / day in total and I will taper down quicker than he planned. That's it so it doesn't go totally off-topic.

Again, thank you all who helped me when I struggled with this at the very beginning and big thanks for remembering I posted this thread!

Harm Reduction I.M. Injection complications

adder

Bluelighter

MartinFn

Bluelighter

Kenny7822

Bluelighter

NeighborhoodThreat

Bluelight Crew

adder

Bluelighter

Kenny7822

Bluelighter

FlippingTop

Bluelighter

adder

Bluelighter

adder

Bluelighter

adder

Bluelighter

Swimmingdancer

Bluelight Crew

Kenny7822

Bluelighter

adder

Bluelighter