Athena Vale
Heroin is a highly addictive opioid drug that can be injected, snorted, or smoked. Injecting heroin directly into a muscle is known as muscling or muscle popping. This method of administration is less common than intravenous injection (known as mainlining) or subcutaneous injection (skin popping), as intramuscular injection produces a slower onset of effects and does not induce the intense rush that users seek. However, intramuscular injection can still lead to serious health risks, including muscle fibrosis, focal myopathy, and an increased risk of contracting blood-borne diseases such as HIV if needles are shared.
| Characteristics | Values |
|---|---|
| How it's administered | Intramuscular injection, intravenous injection, sniffing, snorting, smoking |
| Peak effects | Intramuscular injection: 5-8 minutes; Intravenous injection: a few seconds |
| Additives | May be cut with stronger drugs, harmful toxins or chemicals |
| Health risks | Abscesses, skin infections, blood vessel collapse, heart lining and valve infections, muscle atrophy, focal upper limb muscle weakness, rhabdomyolysis, hypoxia, coma, permanent brain damage, death |
| Overdose treatment | Medicine called naloxone, available as a nasal spray or injectable |
| Safe injection advice | Avoid injecting into muscle or tissue outside a vein; only inject particle-free solutions; use a sterile needle and syringe |
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What You'll Learn
Intramuscular injection is slower than intravenous injection
Intramuscular injection is a technique used to deliver a substance or medication deep into the muscles. It is often abbreviated as IM. It is one of the most common medical procedures performed annually. It is also a common way of administering heroin.
When administering an intramuscular injection, the injection site must be cleaned before injecting the medication. The person receiving the injection should get into a position that is comfortable, provides easy access to the location, and keeps the muscles relaxed. The injection is then administered in a fast, darting motion to decrease the discomfort to the individual. The needle should be long enough to reach the muscle without penetrating the nerves and blood vessels underneath. Generally, needles should be 1 inch to 1.5 inches for an adult and will be smaller for a child. They will be 22-gauge to 25-gauge thick. The needle size and injection site will depend on several factors, including the age and size of the person, and the volume and type of medication.
Intramuscular injections commonly result in pain, redness, and swelling or inflammation around the injection site. These side effects are generally mild and last no more than a few days. However, nerves or blood vessels around the injection site can be damaged, resulting in severe pain or paralysis. If proper technique is not followed, localized infections such as abscesses and gangrene can occur.
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Muscle-popping carries a high risk of abscess formation
Injecting heroin into the muscle is one of the most common ways to use the drug, as it results in a powerful high that occurs very quickly. However, this method of heroin use carries a range of serious health risks, including the high risk of abscess formation.
An abscess is a mass beneath the skin that is filled with pus, bacteria, and debris. A heroin abscess refers to a collection of fluid or pus that has built up in the tissue of the person. It is a common issue for injection drug users, and heroin injection, in particular, can put someone at a higher risk of having an abscess even over the use of other drugs intravenously. This is because the needle puncture introduces bacteria into the skin and surrounding tissue, causing an infection within the layers of the skin or just underneath.
The bacteria from a heroin abscess can spread throughout the body, causing infections in the blood, heart, and other vital organs. If left untreated, the infection can lead to tissue death, or gangrene, which may result in the need for amputation or even death. In addition, the infection can cause further damage to the skin and make the infection spread faster. Pus may also leak out, creating an open wound that is even more vulnerable to infection.
Harm reduction strategies, such as using clean injection equipment, can help prevent abscesses. However, if an abscess does develop, it is important to seek medical treatment, especially if symptoms worsen.
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Heroin may cause fibrotic myopathy
Injecting heroin directly into the muscles is a common method of administration. However, this practice can lead to severe health complications, including fibrotic myopathy.
Heroin myopathy (HM) is a condition where chronic heroin injection causes muscle fibrosis and weakness, particularly in the upper limbs. This condition can lead to painless stiffness in the elbow joints and weakness in the shoulder and upper limb muscles. In some cases, this can result in atrophy and further complications.
Human and animal studies have shown that heroin injection may cause fibrotic myopathy, especially in muscles that have been repeatedly injected over time. The pathogenic mechanism by which heroin induces these myotoxic effects is still not fully understood. However, in experimental animals, the presence of eosinophils and a homogeneous mass of hypercontracted myofibrils in degenerated fibres were notable features.
Additionally, intramuscular heroin injection can lead to peak effects within five to eight minutes, providing a powerful and quick high. This rapid effect may contribute to its popularity among users despite the associated health risks.
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Muscle weakness and atrophy can occur
Injecting heroin into the muscles, or "muscling", is one of the ways heroin is administered. Other common ways include injecting heroin into a vein (mainlining or intravenous use) and under the skin (skin-popping). Heroin can also be snorted, smoked, or sniffed.
Muscling heroin is slower-acting than mainlining, with peak effects occurring within five to eight minutes after taking the drug, compared to a few seconds for intravenous use. The "rush" or high that is often sought by users is also not experienced with intramuscular injections.
Despite the slower effects and less intense experience, muscling heroin is still dangerous and can lead to muscle weakness and atrophy. A 24-year-old female with a 5-year history of heroin abuse experienced painless stiffness of elbow joints and weakness of shoulder and upper limb muscles. Electromyography (EMG) and magnetic resonance imaging (MRI) revealed abnormalities and muscle fibrosis in both injected and non-injected muscles. This suggests that heroin has long-distance effects on the body, causing focal myopathy and muscle weakness.
In addition to muscle weakness and atrophy, muscling heroin can also lead to abscess formation, especially if the injected solution has any particles in it. The risk of transmitting viruses and other blood-borne bacteria through needle-sharing is also as serious as with intravenous injection.
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Heroin overdose can be treated with naloxone
Injecting heroin directly into a vein is often called mainlining or intravenous use, and under the skin, it is called skin-popping. Injecting heroin is dangerous and can lead to abscesses, skin infections, and even cause blood vessels to collapse. It can also lead to infections of the heart lining and valves. Regular injection can weaken the body's functionality and muscle strength, and holes can appear in the skin.
Heroin is a powerful opioid that can cause euphoria, and one of the main reasons it is taken for non-medical reasons. It is a central nervous system depressant that is often used to relieve pain. However, opioids can cause difficulties with breathing, and an overdose can lead to death.
In the event of a heroin overdose, the medication naloxone can be used to prevent death if administered in time. Naloxone should be made available to people likely to witness an opioid overdose, such as health-care workers and emergency services personnel. Training on using naloxone and resuscitation techniques for opioid overdose is also crucial. After successful resuscitation with naloxone, the person's level of consciousness and breathing should be closely monitored until full recovery.
Naloxone is an opioid antagonist that can reverse the effects of an opioid overdose. It is available over the counter and through prescription, and it is also offered by SAMHSA's National Helpline, a free and confidential treatment referral service.
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Frequently asked questions
Muscle popping is a term used to describe the act of injecting heroin into a muscle instead of a vein.
Injecting heroin into a muscle can lead to abscess formation, especially if the injected substance has any particles in it. There is also a high risk of transmitting viruses and other blood-borne bacteria as a result of needle sharing.
The effects of muscle-popping heroin come on much more slowly than intravenous injection (within 5-8 minutes as opposed to a few seconds), but the overall intensity of the experience is similar. The "rush" that is produced when drugs like heroin are administered intravenously is not experienced by individuals who inject intramuscularly.
