Injection-Related Venous Disease and Walking Mobility

Abstract

Injection users are at risk for vascular injuries resulting in chronic venous disease (CVD). We examined walking mobility in relation to CVD for 713 persons in methadone treatment. We used a cross-sectional, comparative design, stratified on age, sex, ethnicity, and drug use. CVD was present in 92.3% of participants. The structural equation model supported the causal link between leg injection and CVD (.40, P<.001). The worse the mobility, the greater was the CVD classification (-.21, P<.001). CVD had an indirect effect on mobility through pain. CVD and pain need to be considered when assessing mobility in illicit drug users.

High rates of midazolam injection and associated harms in Bangkok, Thailand

“…Various injection‐related complications that have been observed among injecting drug users in other settings were also documented from our sample, and appeared to have been exacerbated by midazolam use. Reported complications included soft‐tissue infections (e.g.…”

Wounds and Skin and Soft Tissue Infections in People Who Inject Drugs and the Utility of Syringe Service Programs in Their Management

“…Injecting into the lower extremities may additionally cause nerve and muscle damage, with resultant impaired calf muscle and ankle joint function; compromised walking mobility has been found to have a direct relationship with severity of CVD in this population [25].…”

“…IDU also has deleterious effects on the veins of the lower extremities and damage inflicted progresses even after active IDU has ceased [23]. As a result, PWID have been found to have an increased risk of chronic venous disease (CVD) [24,25]. CVD is associated with progressively debilitating sequelae such as lower extremity edema, varicose veins, skin changes, refractory ulcers, and chronic pain [26].…”

“…Mobility deficits, such as difficulty walking, climbing stairs, and working, are thus a largely underrecognized consequence of IDU [26]. A study among 713 participants with a history of IDU found 25% of their population had abnormal Tinetti balance and gait scores, with 20% of the participants being at risk for falls, and 7.7% at high risk for falls [25].…”

“…23 As a result, PWID have been found to have an increased risk of chronic venous disease (CVD). 24 , 25 CVD is associated with progressively debilitating sequelae such as lower extremity edema, varicose veins, skin changes, refractory ulcers, and chronic pain. 26 IDU has been reported to augment the typical risk factors associated with CVD, such as deep venous thrombosis (DVT).…”