Misc My Buddy's Second Self-Injection, Terrible Failure - Also, a few questions.

[Druidus]

Previously, I'd taught this person everything I could, once they came to me asking for help learning how to IV. I had them read a decent bit, and we talked a lot about it. But apparently, I didn't stress how dangerous missing a shot can be, or maybe didn't describe how it would feel accurately enough.

Regardless, I'd taught him with hydromorpone, and he went off and tried buproprion, of ALL things, for his second self-injection. He missed nearly one whole cc of liquid with 300mg of drug; due to panicking according to my friend, and not knowing what to watch for. The bruising was significant, there was serious discolouration and swelling, and also feelings of shooting electricity and numbness caused by differing positions of the arm. I advised him to go to the hospital; that it wasn't worth dying or losing an arm over. He went, and, luckily, was only experiencing vein irritation, nothing grave. Despite the hassle and medical record, I still think going to the hospital was the right thing to do. I've had to, a few times, for similarly non-serious stuff.

So I guess two questions: How do you teach someone what missing feels like if they don't know, and stress importance of avoiding such situations; especially if they know that getting a little in and then popping out will ruin a rush. He panicked, I think, to avoid that. Secondly, when do you, personally, go to the hospital for IV issues? I don't mean your advice to others, I mean what you do yourself.

A third: What was your first serious miss like? I missed a good .2 of cocaine, almost all of it, in the central vein going down one of my arms, I'm THINKING my left. I was convinced I was losing my arm, it was terrible, though in retrospect probably not as serious as recalled. The whole arm, basically, bruised and was numb then tingly for a couple days. I didn't go to the hospital to avoid a medical record as I require certain controlled substances and didn't want to jeopardize them at that point in life. I hoped, took benzos, smoked a bowl, and slept, hoping I'd be ok. Reckless, I suppose, but it just got better slowly after a few days looking awful.

 

[tricomb]

1) Show them pictures of IV complications. Show them our own IV Complications Megathread

2) I wouldn't think twice about going to the hospital, if there is ANY reason why you think you would need immediate medical attention, chances are you do and the clock is ticking, how long you wait could mean life or death, limb amputation or a clean bill of health.

3) I have been fortunate enough to have applied most harm reduction to my injection technique, I have only IV'd without a micron the first few times I IV'd, and have for the most part, rarely "had" to reuse a needle (REMEMBER you never HAVE to reuse it, you should plug it's contents instead instead of reusing a syringe) and have very good, easy to find veins. I think I've just been lucky though, a combination of intelligence/HR but mostly luck. EVEN WITH PERFECT INJECTION TECHNIQUE, there is still risk of complications with intravenous drug injection.

4) He tried to IV wellbutrin? WTF? I would have driven him to the hospital regardless of whether he was scared or not, you made the right decision. Never take chances with IV use. Sometimes you have to do the right thing even when you're friends are too scared of the proper authorities. If anything happened to your friend, and he died, not only would you have to live with that for the rest of your life, I'm pretty sure you could go to prison for knowingly not taking him to the hospital.

 

[Swimmingdancer]

So I guess two questions: How do you teach someone what missing feels like if they don't know, and stress importance of avoiding such situations; especially if they know that getting a little in and then popping out will ruin a rush. He panicked, I think, to avoid that.

Well his problems were probably greatly worsened by the fact that he was injecting bupropion. Not sure why he would do that anyway and it's not safe (and can easily cause seizures among other problems). It also requires a lot more preperation when injecting a pill that is not meant for injection: was he just crushing it up, putting it in water and injecting it? Regardless, it's very common for anyone injecting bupropion to have pain and/or burning and swelling. So I would strongly suggest your friend not inject it. Not everything is improved by injecting!

As for teaching someone how not to miss, if they are injecting something they should go slowly and if it hurts or burns or starts to swell or feel abnormal in any way they should stop and re-register to make sure blood still comes into the syringe.

Secondly, when do you, personally, go to the hospital for IV issues? I don't mean your advice to others, I mean what you do yourself.

Personally the only time I've ever been to the hospital in connection with drug use is when I overdosed. But I've always been good at educating myself about proper technique and how to recognize whether something serious is wrong or not. If there are needle exchanges or drug outreach centres etc in your area that would be my first step for anything that didn't seem life threatening. But that's just me, I do think you made the right decision in telling your friend to go to the hospital.

A third: What was your first serious miss like? I missed a good .2 of cocaine, almost all of it, in the central vein going down one of my arms, I'm THINKING my left. I was convinced I was losing my arm, it was terrible, though in retrospect probably not as serious as recalled. The whole arm, basically, bruised and was numb then tingly for a couple days. I didn't go to the hospital to avoid a medical record as I require certain controlled substances and didn't want to jeopardize them at that point in life. I hoped, took benzos, smoked a bowl, and slept, hoping I'd be ok. Reckless, I suppose, but it just got better slowly after a few days looking awful.

Mine wasn't that bad, but I was pretty experienced and knew right away that it was a miss and not that big a deal.

 

[daveykronick]

I have sought medical attention several times because of missed shots. The first time was when this idiot was shooting me up and was in a rush and missed a good 40-50 units of ER morphine. The pain was intense and it swelled up and turned red immediately. I went to the urgent care within like an hour and they gave me IV antibiotics and told me I made the right decision and I don't regret that at all.

Second time I had missed a few shots of black tar and my arms were bruised and a little swollen, not red but a little squishy so I thought I had an abscess. My paranoia got the best of me and I went to urgent care again. They released me without antibiotics after take a quick examination they said I was going to be okay but if I continued to miss I could eventually lose an arm, they recommend I seek treatment for my addiction. I kind of regretted that time but not really because of the peace of mind I got knowing I was safe.

The last time I went was because I used dirty cottons from the garbaged AND missed a little in my hand. This was AWFUL it swelled up tremendously and got very hot and red and was very painful. It was diagnosed as cellulits and I was given antibiotics. The antibiotics didn't work and it was getting more painful and red and hot so I went back in and they gave me different antibiotics and I was good to go a few days later. I don't regret that at all because if I didn't go in it would have turned into necrotitis and I would've lost my hand/arm or died. So, yes my medical record is completely fucked from all these IV drug related visits, plus a bunch of other drug related visits but I am alive and healthy and that's what really matters..

 

[Druidus]

That's how I ultimately see it, Davey. That peace of mind is just WORTH it.

And yeah, I know, buproprion is not a drug to be injecting, and I've advised him as such. Thing is, apparently it CAN provide something similar to the VERY beginning of a cocaine rush, though it quickly terminates in disappointment. Not even a high, really, just stimulation you might not even notice and a paltry and insignificant "rush". I suppose he was not thinking very logically.

 

[Swimmingdancer]

That's how I ultimately see it, Davey. That peace of mind is just WORTH it.

And yeah, I know, buproprion is not a drug to be injecting, and I've advised him as such. Thing is, apparently it CAN provide something similar to the VERY beginning of a cocaine rush, though it quickly terminates in disappointment. Not even a high, really, just stimulation you might not even notice and a paltry and insignificant "rush". I suppose he was not thinking very logically.

Yeah, some people get infatuated with the needle and want to do everything that way, or they assume that just because opioids are amazing when injected that everything else will be. But the harm from injecting bupropion far outweighs any tiny benefits.

An interesting study on bupropion abuse where participants were given bupropion or caffeine found that that caffeine actually had a higher potential for abuse since it resulted in more reports of pleasant feelings and a "high" than bupropion ;-)