Research Round Up 2: Femoral Injection

Research Round Up 2: Femoral Injection

Reviews of medical research relating to and/or informed by harm reduction

When I was getting my bachelor’s degree I was surprised with how much of academic research is focused on stating things in dry, scientific, objective, language about things that seem like common knowledge. A recent article out of England, published in the journal Drug and Alcohol Dependence, attempts to figure out why people inject in to their femoral vein. The authors of the article are concerned about people injecting into their femoral veins, as the risks associated with femoral vein injection are much higher than with injecting into peripheral veins on the arms.

The authors did a pretty big survey of injection drug users and their two big results might seem pretty obvious: one, older users inject in their femoral vein because they have run out of other useful veins in which to inject, and two, younger users inject there because it is a discreet site which won’t leave noticeable track marks on them.

There were some long-term users in Pittsburgh who always got long needles because they’d been going in their femoral site for years, but that was in Pittsburgh where the heroin is a little kinder on one’s veins. Anyway, the article noted that the femoral vein is a pretty stable, it’s a big vein and once one figures out how to find it it’s a pretty reliable place in which to inject. The problem with the femoral vein (like with injecting into muscles) is that if things go wrong, it tends to take awhile to present itself and usually by that point it’s pretty bad.

So what are the risks of using the femoral vein as an injection site? In their study there’s a much greater risk for developing sepsis- so as opposed to injecting some nasty shit into your arm and having your body wall it off and try to contain it (which is a way to describe the forming of an abscess), the infection hits a big vein which rapidly goes straight to your heart and from there back out to everywhere else. They also noted a much higher incidence of deep vein thrombosis (DVT), that is a large traveling clot that can lead to respiratory failure. So those are the big risks. Other potential serious problems to look out for are abscess formation, circulation problems (like if your leg suddenly swells), and the potential to hit the femoral artery as well as nerve bundles (as they are right next door to the vein!). Because this area is on a mainline to one’s heart, because it moves large volumes of blood, because it services your whole leg, and because the consequence are so serious- if you are injecting into your groin and have any problems- first stop injecting into that area, and second seek medical help at a clinic or a hospital right away. I couldn’t find a link to this one, but an abstract is here.

Going into the groin: Injection into the femoral vein among people who inject drugs in three urban areas of England. V. D. Hope, J. Scott, K. J. Cullen, J. V. Parry, F. Ncube, M. Hickman. Drug Alcohol Depend. 2015 Jul 1; 152: 239–245. Published online 2015 Apr 9. doi: 10.1016/j.drugalcdep.2015.03.029