Safer injection guide: Difference between revisions

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* '''Substances'''

** [[Hydroxyzine]] (brand name Atarax, and Vistaril) - "The drug is not recommended for {{abbr|SC|subcutaneous}}, {{abbr|IA|intra-articular}}, or {{abbr|SC|subcutaneous}} administration because of adverse reactions that have occurred after its administration via these routes."<ref>{{cite web |title=Hydroxyzine - an overview {{!}} ScienceDirect Topics |url=https://www.sciencedirect.com/topics/neuroscience/hydroxyzine |website=www.sciencedirect.com}}</ref><ref>https://go.drugbank.com/drugs/DB00557</ref>

** Impurities in street drugs that often are taken intravenously (see [https://en.wikipedia.org/wiki/Clandestine_chemistry#Psychoactive_substances Clandestine chemistry#Psychoactive substances (Wikipedia)] for all substances that are dangerous to consume, regardless of routes of administration): [[Black tar heroin]]. Illicitly produced [[desomorphine]] (Crocodile). MPTP may be accidentally produced during the manufacture of [[MPPP]]. [[MPP+|1-Methyl-4-phenylpyridinium]] (MPP<sup>+</sup>), a metabolite of MPTP, causes rapid onset of irreversible symptoms similar to Parkinson's disease.<ref>{{cite journal |last1=Davis |first1=Glenn C. |last2=Williams |first2=Adrian C. |last3=Markey |first3=Sanford P. |last4=Ebert |first4=Michael H. |last5=Caine |first5=Eric D. |last6=Reichert |first6=Cheryl M. |last7=Kopin |first7=Irwin J. |title=Chronic parkinsonism secondary to intravenous injection of meperidine analogues |journal=Psychiatry Research |date=December 1979 |volume=1 |issue=3 |pages=249–254 |doi=10.1016/0165-1781(79)90006-4 |pmid=298352 |s2cid=44304872 }}</ref><ref name="Surprising Clue to Parkinsons">{{cite magazine |url=http://www.time.com/time/magazine/article/0,9171,1101850408-141542,00.html |archive-url=https://web.archive.org/web/20070211030319/http://www.time.com/time/magazine/article/0,9171,1101850408-141542,00.html |url-status=dead |archive-date=February 11, 2007 |title=Surprising Clue to Parkinson's |magazine=[[Time (magazine)|Time]]|access-date= 2010-05-13| date=2001-06-24 | first=Claudia | last=Wallis}}</ref>

** Impurities in street drugs that often are taken intravenously (see [https://en.wikipedia.org/wiki/Clandestine_chemistry#Psychoactive_substances Clandestine chemistry#Psychoactive substances (Wikipedia)] for all substances that are dangerous to consume, regardless of routes of administration):

*** [[Black tar heroin]].

*** Illicitly produced [[desomorphine]] (Crocodile).

*** MPTP may be accidentally produced during the manufacture of [[MPPP]]. [[MPP+|1-Methyl-4-phenylpyridinium]] (MPP<sup>+</sup>), a metabolite of MPTP, causes rapid onset of irreversible symptoms similar to Parkinson's disease.<ref>{{cite journal |last1=Davis |first1=Glenn C. |last2=Williams |first2=Adrian C. |last3=Markey |first3=Sanford P. |last4=Ebert |first4=Michael H. |last5=Caine |first5=Eric D. |last6=Reichert |first6=Cheryl M. |last7=Kopin |first7=Irwin J. |title=Chronic parkinsonism secondary to intravenous injection of meperidine analogues |journal=Psychiatry Research |date=December 1979 |volume=1 |issue=3 |pages=249–254 |doi=10.1016/0165-1781(79)90006-4 |pmid=298352 |s2cid=44304872 }}</ref><ref name="Surprising Clue to Parkinsons">{{cite magazine |url=http://www.time.com/time/magazine/article/0,9171,1101850408-141542,00.html |archive-url=https://web.archive.org/web/20070211030319/http://www.time.com/time/magazine/article/0,9171,1101850408-141542,00.html |url-status=dead |archive-date=February 11, 2007 |title=Surprising Clue to Parkinson's |magazine=[[Time (magazine)|Time]]|access-date= 2010-05-13| date=2001-06-24 | first=Claudia | last=Wallis}}</ref>

** Eye drops that contain medicines (e.g. the deliriant tropicamide only used for ocular administration) can be deadly when injected. Use eye drops without medicine (they are frequently shared by needle exchange programs) as solution to dissolve substances.

*'''Increased risk of [[Drug overdose|overdose]]''' - This risk is especially present with [[opiates]] such as [[heroin]]. If one is injecting opiates, it is important to have [[naloxone]] available, if possible, as this can reverse the effects of an opiate [[drug overdose]] if administered quickly.<ref>Overdose Prevention For Injection Drug Users (drugpolicy.org) | http://www.drugpolicy.org/resource/overdose-prevention-injection-drug-users</ref> The risk of fatal overdoses rise sharply after a period of cessation and relapse, largely because of reduced tolerance.<ref>Why Heroin Relapse Often Ends In Death - Lauren F Friedman (Business Insider) | http://www.businessinsider.com.au/philip-seymour-hoffman-overdose-2014-2</ref> To account for this lack of tolerance, it is safer to only dose a small fraction of one's usual [[dosage]] if relapsing after an extended break. It has also been found that the environment one is in can play a role fatal overdosing. In one scientific study, rats were significantly more likely to die after receiving their dose in an environment not associated with the drug in contrast to a familiar environment.<ref>{{cite journal | vauthors=((Siegel, S.)), ((Hinson, R. E.)), ((Krank, M. D.)), ((McCully, J.)) | journal=Science | title=Heroin “Overdose” Death: Contribution of Drug-Associated Environmental Cues | volume=216 | issue=4544 | pages=436–437 | date=23 April 1982 | url=https://www.science.org/doi/10.1126/science.7200260 | issn=0036-8075 | doi=10.1126/science.7200260}}</ref> Other drugs are conditionally intramuscularly self-injected to prevent intravenous complications that can be prevented in a hospital setting. For example, [[ketamine]] taken intravenously quicker than 1.5 minute can cause breathing depression for short time (up to a minute).<ref>Ketamine: Dreams and Realities, p276</ref>

@@ Line 45: / Line 45: @@
 * '''Substances'''
 ** [[Hydroxyzine]] (brand name Atarax, and Vistaril) - "The drug is not recommended for {{abbr|SC|subcutaneous}}, {{abbr|IA|intra-articular}}, or {{abbr|SC|subcutaneous}} administration because of adverse reactions that have occurred after its administration via these routes."<ref>{{cite web |title=Hydroxyzine - an overview {{!}} ScienceDirect Topics |url=https://www.sciencedirect.com/topics/neuroscience/hydroxyzine |website=www.sciencedirect.com}}</ref><ref>https://go.drugbank.com/drugs/DB00557</ref><!-- Added to: Routes of administration, Safer injection guide -->
-** Impurities in street drugs that often are taken intravenously (see [https://en.wikipedia.org/wiki/Clandestine_chemistry#Psychoactive_substances Clandestine chemistry#Psychoactive substances (Wikipedia)] for all substances that are dangerous to consume, regardless of routes of administration): [[Black tar heroin]]. Illicitly produced [[desomorphine]] (Crocodile). MPTP may be accidentally produced during the manufacture of [[MPPP]]. [[MPP+|1-Methyl-4-phenylpyridinium]] (MPP<sup>+</sup>), a metabolite of MPTP, causes rapid onset of irreversible symptoms similar to Parkinson's disease.<ref>{{cite journal |last1=Davis |first1=Glenn C. |last2=Williams |first2=Adrian C. |last3=Markey |first3=Sanford P. |last4=Ebert |first4=Michael H. |last5=Caine |first5=Eric D. |last6=Reichert |first6=Cheryl M. |last7=Kopin |first7=Irwin J. |title=Chronic parkinsonism secondary to intravenous injection of meperidine analogues |journal=Psychiatry Research |date=December 1979 |volume=1 |issue=3 |pages=249–254 |doi=10.1016/0165-1781(79)90006-4 |pmid=298352 |s2cid=44304872 }}</ref><ref name="Surprising Clue to Parkinsons">{{cite magazine |url=http://www.time.com/time/magazine/article/0,9171,1101850408-141542,00.html |archive-url=https://web.archive.org/web/20070211030319/http://www.time.com/time/magazine/article/0,9171,1101850408-141542,00.html |url-status=dead |archive-date=February 11, 2007 |title=Surprising Clue to Parkinson's |magazine=[[Time (magazine)|Time]]|access-date= 2010-05-13| date=2001-06-24 | first=Claudia | last=Wallis}}</ref>
+** Impurities in street drugs that often are taken intravenously (see [https://en.wikipedia.org/wiki/Clandestine_chemistry#Psychoactive_substances Clandestine chemistry#Psychoactive substances (Wikipedia)] for all substances that are dangerous to consume, regardless of routes of administration):
+*** [[Black tar heroin]].
+*** Illicitly produced [[desomorphine]] (Crocodile).
+*** MPTP may be accidentally produced during the manufacture of [[MPPP]]. [[MPP+|1-Methyl-4-phenylpyridinium]] (MPP<sup>+</sup>), a metabolite of MPTP, causes rapid onset of irreversible symptoms similar to Parkinson's disease.<ref>{{cite journal |last1=Davis |first1=Glenn C. |last2=Williams |first2=Adrian C. |last3=Markey |first3=Sanford P. |last4=Ebert |first4=Michael H. |last5=Caine |first5=Eric D. |last6=Reichert |first6=Cheryl M. |last7=Kopin |first7=Irwin J. |title=Chronic parkinsonism secondary to intravenous injection of meperidine analogues |journal=Psychiatry Research |date=December 1979 |volume=1 |issue=3 |pages=249–254 |doi=10.1016/0165-1781(79)90006-4 |pmid=298352 |s2cid=44304872 }}</ref><ref name="Surprising Clue to Parkinsons">{{cite magazine |url=http://www.time.com/time/magazine/article/0,9171,1101850408-141542,00.html |archive-url=https://web.archive.org/web/20070211030319/http://www.time.com/time/magazine/article/0,9171,1101850408-141542,00.html |url-status=dead |archive-date=February 11, 2007 |title=Surprising Clue to Parkinson's |magazine=[[Time (magazine)|Time]]|access-date= 2010-05-13| date=2001-06-24 | first=Claudia | last=Wallis}}</ref>
 ** Eye drops that contain medicines (e.g. the deliriant tropicamide only used for ocular administration) can be deadly when injected. Use eye drops without medicine (they are frequently shared by needle exchange programs) as solution to dissolve substances.
 *'''Increased risk of [[Drug overdose|overdose]]''' - This risk is especially present with [[opiates]] such as [[heroin]]. If one is injecting opiates, it is important to have [[naloxone]] available, if possible, as this can reverse the effects of an opiate [[drug overdose]] if administered quickly.<ref>Overdose Prevention For Injection Drug Users (drugpolicy.org) | http://www.drugpolicy.org/resource/overdose-prevention-injection-drug-users</ref> The risk of fatal overdoses rise sharply after a period of cessation and relapse, largely because of reduced tolerance.<ref>Why Heroin Relapse Often Ends In Death - Lauren F Friedman (Business Insider) | http://www.businessinsider.com.au/philip-seymour-hoffman-overdose-2014-2</ref> To account for this lack of tolerance, it is safer to only dose a small fraction of one's usual [[dosage]] if relapsing after an extended break. It has also been found that the environment one is in can play a role fatal overdosing. In one scientific study, rats were significantly more likely to die after receiving their dose in an environment not associated with the drug in contrast to a familiar environment.<ref>{{cite journal | vauthors=((Siegel, S.)), ((Hinson, R. E.)), ((Krank, M. D.)), ((McCully, J.)) | journal=Science | title=Heroin “Overdose” Death: Contribution of Drug-Associated Environmental Cues | volume=216 | issue=4544 | pages=436–437 | date=23 April 1982 | url=https://www.science.org/doi/10.1126/science.7200260 | issn=0036-8075 | doi=10.1126/science.7200260}}</ref> Other drugs are conditionally intramuscularly self-injected to prevent intravenous complications that can be prevented in a hospital setting. For example, [[ketamine]] taken intravenously quicker than 1.5 minute can cause breathing depression for short time (up to a minute).<ref>Ketamine: Dreams and Realities, p276</ref>