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In recreational drug use, drug injection is a method of introducing a drug into the body with a hollow needle and a syringe which is pierced through the skin into the body (usually intravenous, but also intramuscular or subcutaneous). This act is often colloquially referred to as shooting or banging .
Although there are various methods of taking drugs, injection is favoured by some users as the full effects of the drug are experienced very quickly, typically in five to ten seconds. It also bypasses first-pass metabolism in the liver, resulting in a higher bioavailability for many drugs than oral ingestion would (so users get a stronger effect from the same amount of the drug). This shorter, more intense high can lead to a dependency, both physical and psychological, developing more quickly than with other methods of taking drugs.
Specifics and Slang Terms
The Agents
In some cases, ampoules or phials with sterile solution are available to users, or the user may have another form, intended for injection (dry ampoules, multi-purpose and hypodermic tablets) or not which is dissolved, usually in water, and then injected. In descending order, the most popular injected drugs in unsupervised use are opioids, anabolic steroids, stimulants, depressants, dissociative hallucinogens, other hallucinogens, and anticholinergics. Some groups also administer local anaesthetics for their intended use. Cannabis, inhalants, volatile solvents, and several categories of depressants are not injected either in clinical or unsupervised use. Specialised methods are used for extracting drugs, especially opioids, from extended-release tablets and suppositories as well as other non-injectables such as paregoric, laudanum, and topical preparations.
Drugs which must be injected to have the usually sought effect include ketamine, fentanil (fentanyl)-class opioids, and many other are much weaker and/or very different by mouth than by injection (or other rapid methods like smoking or insufflation, which are often intermediate betwixt injection and other methods rather than being just like injection), e.g. some groups of opioids, cocaine, &c. In many cases with opioids and some depressants, IV administration is the only route that causes the "rush" or "bang" 100 per cent of the time mutatis mutandis.
All of these drugs need to be dissolved in a vehicle, usually either water or 9‰ (0.9 per cent) saline. The hierarchy of water to use according to the Heroin Helper and other sites is
1. Sterile water or saline for preparing injections
2. Distilled water
3. Mineral water (without gas!)
4. Tap water
5. River or rain water
6. Toilet water (main tank preferred)
...an item 1½ may be added—the sterile 9‰ (0.9 per cent) saline used for wound irrigation. Swimming pool water is low on the list, and ocean water, usually about 35‰ (3.5 per cent) salinity, should not be used for a number of reasons.
Mixing drugs in the syringe is observed in some cases. The "speedball" was invented c.a. 1906 by Harry K. Thaw and popularised in different locations at different times during the 20th Century. Commonly, the speedball includes an opioid like heroin, morphine, methadone, hydromorphone, oxymorphone, nicomorphine, ketobemidone, pentazocine &c. plus a stimulant, usually cocaine but often methamphetamine,. other amphetamines, methylphenidate, and the like. The addition of caffeine as a third ingredient is not unheard of. Some morphine and other opioid users will mix scopolamine, orphenadrine, or other anticholinergics in with the opioid to enhance the rush and/or buzz/body load. Morphine or hydromorphone plus scopolamine is a medical drug or procedure known as "twilight sleep" Pentazocine is often mixed with the antihistamine tripelennamine in a mixture known as Ts and Blues; with or without the antihistamine a lot of pentazocine users seem to like mixing methylphenidate with the pentazocine for injection or insufflation (called kibbles and bits)
Antihistamines, anticholinergics, vitamins, anti-asthmatic agents, centrally-acting skeletal muscle relaxants, catabolic steroids like methylprednisolone and other medicinal drugs may also be injected for their intended clinical reasons (like countering or pre-empting the histamine-caused and mediated side effects of injected morphine), for side effects like drowsiness, vasodialation, euphoria...
Needle Fixation
...and/or because the user likes giving injections to themself, even possibly having a needle fixation . Those with this fixation have been known to inject vehicle (e.g. distilled water, saline solution, or the like) or other inert liquids simply for the act of injecting, which can very well produce a transient psycho-somatic rush. Kurt Cobain, James Fogle, and William S. Burroughs amongst others have commented on this issue.
The Equipment
The two most common implements used for injection are the eye or medicine dropper fitted with a hypodermic needle, often fit to the dropper with a "collar" made from paper or other material, and the hypodermic syringe ("hypo"). These implements are called "artillery", "rigs" and other terms, and the entire set of tools including syringes, droppers, needles, tourniquets, candles and/or lighters or matches, cotton or other filters, spoons or other implements for cooking the drugs (like bottle caps, bottoms cut off of soda cans), and other things is called the "outfit", "works" and similar terms. Hypodermic syringes can be modified by attaching a bulb from a dropper, a pacifier or the like to make it possible to operate with one hand. An outfit can be anything from a single hypodermic syringe to elaborate collections of tools of the trade including all of the above including multiple syringes and/or droppers plus small bottles to carry prepared solution, powder, pills &c. as well as alcohol swabs and other necessary items.
The Routes
Intravenous injection is known as shooting, banging, mainlining (when large veins are used, especially those of the arm), shooting up, jacking up, whacking up, IV, &c. Users determine whether they are in a blood vessel by looking for a "register"; often this is by pulling back on the plunger although the pressure of blood can cause it to shoot up into the barrel of the syringe and those made of clear materials are often called "self-registering."'
Intramuscular injection is called muscling, popping, poking, IM and other terms. Anabolic steroids, when used outside of medical supervision. are often injected into the muscle being worked on. IM injection typically allows a drug to last longer than the IV route, although the "rush" may not be present or as intense; amongst opioids and some other categories or subgroups like non-cocaine stimulants only a very few drugs can subjectively be distinguished from one another by a user after the rush is over or never happened; for example,. an IM, SQ, oral, sublingual/buccal, rectal, or intranasal dose of morphine and heroin cannot be distinguished by most users according to studies; a smoked or nebullised dose may be like the IV in this regard or intermediate betwixt IV and IM subjectively.
Subcutaneous injection is known as skin popping or SQ. It can be shallow or deep, just as it is in clinical settings.
Intra-arterial injection is very rarely intended and not the subject of well known slang terms; spinal, intra-cardiac, intra-osseous, intra-peritoneal, intra-cerebral , and intra-articular injection are usually virtually impossible by one person and not generally known to be done by recreational users to one another. Users injecting into the leg and arm in particular can in some cases hit a vein or artery; some opioid users in particular who IM into the upper legs will likely hit certain veins not visible on the surface and may in fact aim for them on subsequent attempts. A handful of psychoactive drugs (plus some others like vaccines) work via the intra-dermal route, i.e. into the dermis or epidermis, most often the ultra-potent opioids of the fentanyl and Bentley Compound subgroups. Injecting into a mucous membrane usually results in the drug being delivered to an area with a high concentration of blood vessels.
Urban legends abound about people using their testicles, penis, clitoris, or eyeballs for injecting heroin, morphine, cocaine, amphetamines, barbiturates, or other opioids like dextromoramide. oxymorphone, hydromorphone or others. Another urban legend concerns people using corn oil or the like to dissolve non-water-soluble drugs like carisoprodol, meprobamate or others and injecting that solution, or in some cases using alcohol. The intravenous injection of Everclear or reagent-grade ethanol has been reported in rare cases, as have unexpected agents being intravenously injected such as LSD and mescaline. Shooting opioids or other drugs betwixt the toes is theoretically possible but not ideal.
Cases are known of administration of LSD, sufentanil and other ultra-potent CNS agents via needle scratch, shallow intradermal injection of a small volume of liquid with a 30 gauge or finer needle to the deeper layers of the epidermis, or via the various vaccination and skin-testing implements (viz. tuberculin tine test apparatus, rotary lancet, lancet, or bifurcated needle)
Origin of the Hypodermic Needle and Early Use
The hypodermic needle & syringe in its cur
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