Understanding: What is one risk associated with injecting drugs?

October 13, 2025 •

3 min read

According to the CDC, injection drug use is a major driver of bloodborne infections, including HIV and hepatitis. A primary and severe answer to what is one risk associated with injecting drugs is the transmission of deadly viruses through shared or unsterile equipment.

Quick Summary

Injecting drugs poses numerous health dangers, with a heightened risk of bloodborne infections like HIV and Hepatitis C due to shared needles or unsterile practices. Other serious complications include skin infections, vein damage, and a significantly increased risk of overdose.

Key Points

Bloodborne Infections: Sharing needles and equipment can transmit viruses like HIV and hepatitis C, leading to chronic illness.
Overdose Risk: Injecting directly into the bloodstream increases the intensity and speed of effects, causing a higher risk of fatal overdose.
Local Infections: Unsterile injection practices can cause abscesses, cellulitis, and other skin infections at the injection site.
Systemic Infections: Bacteria from injections can enter the bloodstream and cause serious infections like endocarditis (heart) and osteomyelitis (bone).
Vascular Damage: Repeated injections damage and collapse veins over time, impairing circulation and causing long-term complications.
Harm Reduction: Harm reduction programs provide sterile equipment and education to mitigate health risks for people who inject drugs.

The Primary Risk: Bloodborne Pathogen Transmission

One of the most severe risks of injecting drugs is the transmission of bloodborne pathogens. Sharing needles, syringes, or other injection equipment can spread viruses and bacteria from one person to another, contributing to the spread of serious infectious diseases.

HIV and Viral Hepatitis

HIV and viral hepatitis are among the most serious bloodborne infections linked to injecting drug use. HIV weakens the immune system, increasing vulnerability to infections. Hepatitis C (HCV) is particularly common among people who inject drugs and can lead to severe liver damage. The risk of transmission is high when sharing equipment, as viruses can survive in used syringes.

Overdose: A High and Immediate Danger

Injecting drugs significantly increases the risk of a fatal overdose. The drug enters the bloodstream rapidly, leading to intense effects and making accurate dosing difficult, especially with street drugs of unknown potency. This can result in respiratory depression and death, particularly with opioids. Combining drugs further elevates this risk.

Local and Systemic Infections

Poor hygiene and unsterile practices can cause various infections:

Abscesses and Cellulitis: Skin and soft tissue infections like abscesses (pus collections) and cellulitis (bacterial skin infection) are common at injection sites. These can spread and become life-threatening without treatment.
Endocarditis: Injecting drugs is a major risk factor for this serious infection of the heart lining or valves. Bacteria can travel to the heart and cause severe damage and blood clots.
Septic Arthritis and Osteomyelitis: Infections can reach joints and bones, causing painful septic arthritis and osteomyelitis, which can lead to long-term disability.

Long-Term Vascular Damage

Repeated injections can cause lasting damage to veins:

Collapsed Veins: Trauma from injections can cause veins to scar and collapse, hindering blood flow. This may lead to injecting into more dangerous areas.
Venous Thrombosis: Damage can lead to blood clots, like deep vein thrombosis (DVT). A DVT can be life-threatening if it causes a pulmonary embolism.

Comparison of Major Injection Risks


Risk Category	Primary Cause	Potential Consequences	Immediacy of Risk
Bloodborne Infections	Sharing contaminated needles, syringes, or equipment.	HIV, Hepatitis C, Hepatitis B; chronic illness, organ damage.	Medium to Long-Term
Overdose	High dose, unknown potency, fast delivery to brain.	Respiratory depression, cardiac arrest, death.	Immediate
Local Infections	Unsterile technique, dirty needles, adulterants.	Abscesses, cellulitis; spread of infection.	Short-Term
Systemic Infections	Bacteria/fungi from injection site entering bloodstream.	Endocarditis, septic arthritis, sepsis; organ damage, death.	Short to Long-Term
Vascular Damage	Repeated injections, scarring, poor technique.	Collapsed veins, DVT; impaired blood flow.	Long-Term

Addressing the Risks: Harm Reduction

Harm reduction strategies aim to reduce the negative health consequences of injecting drugs. These include:

Syringe Services Programs (SSPs): Providing sterile equipment and safe disposal to prevent HIV and hepatitis transmission.
Addiction Treatment Referral: Connecting individuals to treatment and recovery services.
Overdose Prevention: Distributing naloxone and providing training to reverse opioid overdoses.
Vaccinations: Offering hepatitis A and B vaccinations.
Wound Care: Providing services to treat skin infections early.

More information is available from the National Harm Reduction Coalition's resources.

Conclusion: The Urgency of Awareness and Intervention

The risks of injecting drugs are numerous and severe, including bloodborne infections, fatal overdose, systemic infections, and long-term vascular damage. Raising awareness and increasing access to harm reduction services and medical care are crucial steps to minimize these devastating consequences and support recovery.

Frequently Asked Questions

Missing a vein, or a 'missed shot,' can cause pain, swelling, and lead to skin and soft tissue infections, including painful abscesses.

Yes, sharing needles and other drug injection equipment with someone who has HIV is a major risk factor for transmitting the virus.

A track mark is a line of tiny, dark dots or scars caused by repeated needle punctures at the same injection site.

Endocarditis is an infection of the heart's inner lining. It can occur when bacteria from unsterile injection practices enter the bloodstream and travel to the heart.

Regardless of the specific drug, injecting is a high-risk method of use due to the potential for infection, overdose, and vascular and tissue damage. Some street drugs may also be contaminated with dangerous additives.

While using sterile needles is crucial and reduces risk, it does not eliminate all dangers. Contaminants in the drug itself, bacteria on the skin, and fillers in crushed pills can still cause infections.

Harm reduction programs provide sterile equipment, safe disposal services, education, and referrals to treatment. Their goal is to reduce the spread of diseases like HIV and hepatitis and mitigate other health risks.

Repeated injections can cause veins to scar and collapse, permanently damaging the circulatory system in that area and forcing the user to find more dangerous, deeper veins to inject into.