IN THIS ARTICLE:
Injecting drugs directly into the bloodstream, often referred to as “shooting up” drugs, is a common route that many people use to get high. Even though this route of drug use comes with many unique and severe risks, some people still choose to use drugs this way. We look at several of the signs and indicators for how to tell if someone is shooting up drugs.
Some of the more noticeable behavioral signs that someone is shooting up drugs include frequent and extended trips to the bathroom. This is so that someone may shoot up and get high again; a process which can take a few minutes at least. Shooting up not only exhibits behavioral effects but there are also physical signs that someone has been shooting up. Injection sites, also known as track marks, are most often seen on the arms on the inside of the elbows, although they may appear elsewhere as well.
How To Tell if Someone is Shooting Up
Shooting up drugs is a very intense route of using drugs, and the process itself can become somewhat addictive and ritualistic. Someone may take frequent and prolonged breaks away from others so that they can shoot up, and it is not uncommon for someone to return from these breaks in a profoundly different state than when they left in the first place, It depends on what kind of drug they are shooting up, but someone may return in a hyperactive, talkative, and ecstatic state if they were shooting up a stimulant, or they may return almost comatose and shuffling if they are shooting up depressants.
Another effect of shooting up drugs is the rapid escalation in someone’s tolerance to a drug. This can result in them spending all of their money on a drug at first, and once their money is gone, asking to borrow money frequently. Someone may ask to borrow small amounts of money very regularly, and once they received the money they will often have to hurry off on some unexpected emergency. Finally, once their tolerance has increased so much, they may begin stealing from strangers, friends, and even family.
Physical Signs of Injecting Drugs
While the inside of the elbow may be the easiest spot to shoot up and it is often the area that someone starts shooting up in, after a while veins and arteries may become damaged, or “blown”, and they will have to find other spots.
Some common spots that someone may choose to shoot up drugs can include:
- Inner Forearm
- Outer Forearm (just below the elbow)
- Inner Bicep
- Top of the Feet
- Back of the Hand
- Neck (rare, but it does happen)
What Do Track Marks Look Like?
Track marks will look like little puncture wounds, but if someone shoots up enough, these may be close enough together and numerous enough to appear like a long cut or scratch. Another sign that someone may be shooting up is wearing clothing that is far too warm for the weather or setting, such as hoodies or sweaters. This is most often done in an attempt to cover up track marks and hide the obvious physical signs of shooting up from people who may be concerned.
Some other things to look for that may indicate someone is shooting up drugs can include:
- Bite Marks on the Belt
- Tourniquets or Ligatures in their Car or Home
- Spoons or Small Metal Caps with Scorch Marks
- Tiny Pieces of Cotton Lying Around (possibly dark with drug residue)
Paleness, frequent illness, skin infections, and a variety of other illnesses are also quite common signs that someone is shooting up drugs. Abscesses and swollen injection sites are quite common among people who inject drugs, and these may happen frequently. The lack of proper hygiene and failure to disinfect the area before shooting up makes it very easy to get infected.
What Drugs Do People Shoot Up?
There are many different drugs that people can shoot up, although there are some that are more commonly injected than others. Some of these drugs include:
- Crystal Meth
- Opioid Painkillers such as morphine, oxycodone (Roxicodone), hydromorphone (Dilaudid), and oxymorphone (Opana)
The reasons for injecting these drugs are very similar, as injecting allows a smaller amount of a drug to produce stronger effects. The effects and dangers of these drugs can vary greatly, as some of them produce powerful depression, while others are extremely powerful stimulants. Regardless of the particular drug someone is shooting up, when someone does a drug by injection, their tolerance will increase rapidly.
Why Do People Shoot Up Drugs?
When someone eats or snorts a drug, it must first pass through the digestive system and liver before it is fully in the body and bloodstream. On its way through these routes, the drug is diluted, some of it is metabolized, and the amount that enters the blood is much less than the amount that was ingested. By skipping this phase, known as “first-pass” metabolism, the drug can almost immediately enter the blood and nearly 100% of the drug that is injected will make it to the brain, producing a much stronger and more sudden effect.
Progression of Drug Use
Shooting up drugs straight into the blood may seem like an extreme method of using drugs, and it is. Why, then, would someone choose to do this? By injecting drugs straight into the blood, the effects of the drugs are almost instant and very intense. This is often why people begin using drugs this way; the potent euphoria it produces. After a time, tolerance will build rapidly due to injecting drugs, and it will become more and more difficult for someone to get high any other way.
After continued drug injection, the amount of drug needed to get high by eating, snorting, or smoking would be immense. While shooting up may be a novel way to get very high at first, it rapidly becomes the only way someone can get high. It is also much more efficient from the standpoint of money, as much less of a drug can produce a much stronger effect. That being said, when injecting a drug, it is metabolized much more quickly than if it were taken by any other route, so someone will need to do more much sooner to stay high. This can rapidly escalate someone’s drug use habits, oftentimes to the point where they must shoot up several times per day to prevent withdrawal symptoms from emerging.
Dangers Of Shooting Up
Shooting up drugs poses some unique risks compared to other routes of drug use. There is, of course, an increased risk of overdose, since it is possible to inject a fatal dose of a drug in less than 1 second. For drugs other than opioids, once a fatal dose of a drug has entered the blood, if medical professionals are not present already, there is little hope for survival. Opioids do have a reversal medication in the form of naloxone, but this does not guarantee survival in case of an overdose, it just increases the odds.
Aside from overdoses, there are many other dangers that accompany this form of drug use. Just a few of the most serious dangers that arise from shooting up drugs include:
- Cardiac Arrest
- Ischemic Stroke (brain damage or death)
- Myocarditis or Endocarditis (inflammation of the heart muscles, commonly due to infection)
- Embolism (artery blockage due to injecting foreign matter or air bubbles)
- Septicemia (body-wide inflammation due to an infection in the blood)
- Diseases such as HIV/AIDS and Hepatitis C
- Necrotizing Fasciitis (a flesh-eating bacterial infection that is fatal in roughly 50% of untreated cases)
These dangers should not be underestimated, and they can cause severe complications and death, sometimes immediately and sometimes slowly. Sharing needles is quite common among people who shoot up drugs, and this can lead to spreading diseases. Some diseases, such as HIV/AIDS and Hepatitis C can be spread to others through sex, and someone may not even be aware that they have acquired these diseases from shooting up.
If someone has been shooting up drugs, it is common for withdrawal symptoms to be quite severe when they do eventually quit using their drug of choice. If someone wants to successfully and safely stop using drugs, it is highly recommended to enter a medical drug detox center. These facilities can provide medications, medical monitoring, and clinical services to reduce the risks and the discomfort of drug withdrawal and detox. After detox has been completed, these centers may also be able to refer someone to further treatment and care at a drug rehab program, providing the tools and support for someone to continue their recovery and find a life free from drug use.
Further reading about the different signs of drug abuse: