Using IV drugs can lead to a variety of health risks. Learn about the risks involved in intravenous drug use, and find out where to go for help.

Using intravenous (IV) drugs can create a variety of health risks. Even in hospital settings, where IV drugs are routinely prescribed and used, these medications require additional monitoring and cannot normally be given outside of the hospital.

IV drugs enter the bloodstream more quickly, having a more immediate and severe effect. The most common street drugs that are used intravenously include:

These drugs are already risky when consumed, smoked or snorted. When injected, however, they can create severe and potentially life-threatening effects. The use of needles and the act of injecting substances into your body also creates a variety of risks, including infections, diseases and injuries. This overview covers the risks of IV drug use and how to find help for IV drug addiction.

Human Immunodeficiency Virus (HIV) Infection

Human immunodeficiency virus (HIV) is a potentially deadly virus that has no known cure. HIV is the virus that causes acquired immunodeficiency syndrome (AIDS), a chronic disease that slowly affects your immune system’s ability to fight infection.

HIV is only normally transmitted through anal or vaginal intercourse or by contaminated medical equipment. While medical equipment used in clinical settings normally goes through rigorous sterilization processes to prevent the spread of disease, medical equipment used outside of the health care system can easily spread infection. Sharing a needle that has been used by another person can create the risk of catching bloodborne illnesses like HIV.

Symptoms of HIV include flu-like symptoms that occur as the virus causes its initial infection. Symptoms can include:

  • Fever
  • Chills
  • Sweatiness
  • Fatigue
  • Sore throat

Following the initial infection, there is a period without symptoms. During this period, however, the disease of AIDS can be developing. AIDS symptoms can include:

  • Recurring fevers
  • Rapid weight loss
  • Diarrhea
  • Fatigue
  • Swollen lymph nodes
  • Pneumonia
  • Infected sores

There is no cure for AIDS, but there are many medications that can be used to slow the progression of the disease and provide relief from some symptoms.

The best way to avoid HIV and AIDS is to practice safe sex and avoid medical equipment and needles that have been used before. This includes makeshift tools, such as a rolled-up dollar bill used to snort drugs.

Hepatitis C (HCV) Infections

Hepatitis C virus (HCV) is another type of infection that is typically only transmitted through blood. HCV infection is 10 times more contagious than HIV, making it a greater concern for people who may be exposed to it. People who get hepatitis C from using drugs have almost always used a needle or medical equipment that has been used by another person.

Hepatitis C causes inflammation of the liver and creates symptoms that are connected to this liver inflammation. Symptoms of hepatitis C can include:

  • Dark yellow or brown urine
  • Fatigue
  • Fever
  • Yellowing of the eyes and skin
  • Confusion
  • Joint pain
  • Nausea or vomiting
  • Abdominal pain

Hepatitis C was an incurable, fatal disease as little as a decade ago. Now, modern medical research has provided medications in pill form that can offer a complete cure for hepatitis C in many people. However, there are other risks related to hepatitis C, so it is best to avoid getting it in the first place by practicing safe sex and avoiding already-used medical equipment.

Cotton Fever

Cotton fever is a slang term used to describe a temporary fever that sometimes occurs when using IV drugs that have been filtered through cotton. Cotton fever will cause an elevation in temperature and may cause some flu-like symptoms. These symptoms will normally go away by themselves and do not typically require advanced treatments.

The cause of cotton fever is not known, but there are several theories. The most commonly accepted theory is that there is a species of bacteria that tends to grow in cotton plants. The bacteria releases a toxin, and when fluid is filtered by the cotton, the toxin washes off. This toxin is thought to cause the symptoms of cotton fever, but it is not something that causes a lasting effect in the body.

Injection Injuries

Injection injuries are injuries caused by injecting a needle into your skin. Injection injuries can include:

  • Bleeding: Bleeding from an injection can range in severity. While a small amount of bleeding can cause a nasty bruise, severe bleeding can lead to a hematoma. A hematoma is a large accumulation of blood in the tissue, and it can impair circulation to a limb and even require amputation in severe cases. It is normally caused by accidentally piercing an artery instead of a vein.
  • Inflammation of the vein: Inflammation in a vein at the site of injection is called phlebitis. This causes a warm, painful, reddened vein that may feel like a rope under the skin. Phlebitis is not normally dangerous, but it can lead to complications like a blood clot developing in the vein.
  • Injection of drugs into tissues: When injecting a drug, it is possible to miss the vein and inject into the tissues around the vein. This is also called infiltration. Infiltrations will result in a raised, swollen area that will gradually subside. Infiltrations with saline are not dangerous, but some drugs may cause tissues to die, causing a large sore and other complications.
  • Infection: While IV drugs can lead to infections like HIV and hepatitis C, they can also cause infections at the injection site. These infections can be caused even when using brand new needles, and they can lead to complications like sepsis.
  • Scarring: Repeated use of a vein can cause scar tissue to form. This can lead to “track marks” caused by injecting into the same vein in different locations. Scarring of a vein can make it more difficult to use, eventually making it almost impossible to inject into. This can be a serious problem in the event of a medical emergency where IV medications are necessary, as health care personnel will find it difficult to provide the necessary medications.

Syringe Service Programs and Safe Injection Sites

Due to the various risks associated with IV drug use, many local or state governments have set up syringe service programs or safe injection sites to help reduce health impacts.

Syringe service programs can vary in how they are structured, but they typically provide clean syringes and needles to help people avoid reusing them and getting infections. Syringe service programs can reduce the risk of HIV and hepatitis C, but they are less likely to reduce the risk of injection injuries.

Safe injection sites are intended to be locations where people can go to use injectable drugs. These sites are designed to provide access to medical care if someone accidentally overdoses, and they help create a more sanitary environment for IV drug use. The sites may also provide syringe service programs.

There is some controversy about how well syringe service programs and safe injection sites work. Evidence shows that they help reduce risks connected with IV drug use, but some believe these programs are encouraging the use of illicit drugs.

Get Help Today

IV drugs are very strong, and converting to IV drug use is a sign of a more advanced addiction. IV drug use also indicates that someone is taking more risks to use drugs, potentially risking a lifelong infection that could be fatal. When addiction has progressed to this level of severity, professional treatment is often necessary.

If you or someone you love is struggling with IV drug use and addiction, The Recovery Village can help. Our organization is dedicated to helping people on their journey to a healthier, drug-free future. Contact us today to learn more about how our evidence-based addiction treatment programs can work well for your situation and recovery needs.

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Editor – Jonathan Strum
Jonathan Strum graduated from the University of Nebraska Omaha with a Bachelor's in Communication in 2017 and has been writing professionally ever since. Read more
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Medically Reviewed By – Benjamin Caleb Williams, RN
Benjamin Caleb Williams is a board-certified Emergency Nurse with several years of clinical experience, including supervisory roles within the ICU and ER settings. Read more

U.S. Centers for Disease Control and Prevention. “About HIV.” June 1, 2021. Accessed December 22, 2021.

University of California San Francisco. “AIDS Treatments.” 2021. Accessed December 22, 2021.

U.S. Centers for Disease Control and Prevention. “Hepatitis C.” July 28, 2020. Accessed December 22, 2021.

Franciscus, Alan. “Similarities and Differences between HIV and HCV.” HIV/HCV Coinfection, Indiana State Government, January 2015. Accessed December 22, 2021.

U.S. National Library of Medicine. “Hepatitis C.” MedlinePlus, September 29, 2021. Accessed December 22, 2021. “Treating Hepatitis C.” Accessed December 22, 2021.

Zerr, Ashley Michelle; Ku, Kimberly; Kara, Areeba. “Cotton Fever: A Condition Self-Diagnosed by IV Drug Users.” Journal of the American Board of Family Medicine, March 2016. Accessed December 22, 2021.

Dailiana, H.Z., Kotsaki, D., et al. “Injection injuries: seemingly minor inju[…]h major consequences.” Hippokratia, March 2008. Accessed December 22, 2021.

Gordon, Elana. “What’s The Evidence That Supervised Dr[…]on Sites Save Lives?” NPR, September 7, 2018. Accessed December 22, 2021.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.