Shooting heroin question

Factual Questions
1

{Mods - I don’t use heroin, nor intend to. This isn’t seeking medical advise. It’s a question about human body physiology}

All I know about shooting heroin has been learned from movies and TV, in otherwards no real life knowledge. Having said that, it appears the optimal way is to wrap an elastic band around your arm, slap your forearm a few times to get a vein to rise the inject into that vein. Makes sense.

But another trope I see often (did again last night Behind Her Eyes) is to shoot between your toes so as to hide the track or injection sites. But there seems to be a world of difference between that as opposed to injecting it straight into a vein.

If one were to just randomly inject heroin into the body somewhere, is it still effective? And if so, why go through all of the trouble to find a vein?

2

If you do not shoot directly into a vein, you will not get as high and it will not kick in as fast. So, depends on what you mean by “still effective”. I mean, you can inject it under the skin or into a muscle or you could smoke it or snort it but this will not satisfy a connoisseur.

3

Direct venous injection is called “mainlining” in the argot. Or was when high school-aged me was seeing all the “drugs are bad” movies the school showed everyone.

The implication of that term borrowed from railroading is pretty clear. It’s the high speed express route to Highsville.

4

Well, let me ask this then, is shooting heroin into anywhere except a vein really as common as it is in the movies? I get that track marks in the crook of your arm are a dead giveaway, but aren’t there veins in your legs that would work just as well and wouldn’t show?

5

I have never used drugs that require injection (needle) recreationally (I have been in a hospital and they gave me stuff).

I have seen places that use blue light to make it harder or impossible for IV drug users to find a vein (although I am sure they could just chance it). To me this suggests finding a vein is critical to the process of getting high. If not, the blue lights would not matter.

6

IIRC, in his autobiography, Keith Richards said he didn’t use a vein. (And he certainly got hiigh.)

7

They are in fact injecting directly into a vein between the toes. Or trying to. The problem is that hardcore junkies will eventually destroy the accessible veins, then veins between the toes can eventually become candidates. It would help conceal needle tracks if you started this way, but the time they try toes usually junkies have already left tracks up and down their arms and everywhere else. They are resorting to veins in the toes as a last resort - hence the meme. A junkie shooting between the toes is a hardcore junkie indeed.

I’m currently in the process of reading the late Mark Lanegan’s really quite good biography Sing Backwards and Weep. He was the hardest of hardcore junkies for years and like most gradually destroyed his accessible veins. He was eventually reduced the trying to use mirrors to shoot into veins in his armpits, between his fingers and toes, whatever he could find. It was dangerous because the veins are so fine in places like fingers it can be difficult to tell if he was hitting vein or artery and hitting an artery was bad - no discernible high (the drugs traveled in the wrong direction) and almost immediate agonizing pain and severe swelling.

Lanegan got quite good at it and was often asked to inject others in tough spots because of that rather specialized skill.

8

Addicts will seek out any vein they can find to use. I’ve seen cases where the veins under the tongue were used, along with the dorsal vein of the penis, the femoral vein deep inside the inner thigh, the external jugular, and even caput medusae veins on the abdomen (caused generally by liver disease).

I had one unfortunate patient who injected into his brachial artery while trying to hit a deep vein, and ended up losing the arm.

9

Does it have to be in a vein? What if the person just jabbed themselves in their leg?

@ratatoskK suggested Keith Richards did not need a vein. If that is so, why do addicts try so hard for a vein? (really asking)

10

Yikes! Am I right in guessing that that was extremely risky? Damage to the jugular is kind of associated with death.

11

I’m a little surprised Richards didn’t inject into veins, but part of it may be Richards was as rich as Croesus and could afford to “waste” heroin. For less well-heeled junkies, anything less than injecting into veins was a “waste” because of the much superior quality of the high relative to drug volume used. Something like smoking heroin for example was far too wasteful of material to appeal to most established addicts (I’ve heard this straight from the mouth of an ex-addict buddy of mine) and the above cited Lanegan wouldn’t bother snorting heroin for the same reason.

12

Back when I was a young lad a common practice was skin popping for that slower, longer lasting effect.

13

Moderately risky. But the external jugular vein is less risky than the internal jugular. The former is conveniently located just under the skin, but being in the neck, it’s surrounded by lots of other complex anatomy.

The association of the jugular veins with death is is that a predator biting one in the neck can sever said veins and the bleeding can be difficult to control. So avoid jaguars, wolves, etc and also don’t poke holes in your own neck if you want to live longer.

14

IV use gives the user the strongest, most quick, most euphoric effects. ‘Skin popping’ or shooting into a muscle or fatty tissue doesn’t give nearly as strong or rapid effects.

15

What’s the mechanism there? Necrosis? Sepsis? Does the heroin clog capillaries?

16

My brother was an intravenous user for many years. He has track scars from his elbows to his wrists, the back of his hands, behind his knees, on his ankles, the tops of his feet and on the sides of his neck. He finally quit when he ran out of places to shoot up.

17

Well, something in his shot sure did.

18

Ouch! Just another of the long list of things you don’t know, until you find out too late. I’d have never thought that happens. Hey, I used to think you’d shoot “H” in the arteries. What did I know? Everything I know about heroin I learned from Starsky and Hutch.

19

I kinda think that’s about all the info most people ought to have. Including me. Knowing more is the often the sign of a hard life badly lived. Not always, but often.