title: Intentional Intra-arterial Injection of Heroin: A Case Report.
abstract: Intravenous injection of drugs is associated with a host of medical complications, notably soft-tissue infections. On the contrary, intra-arterial injections of drugs have also been reported, largely restricted to inadvertent injections. Here we describe a patient who engaged in repeated intra-arterial injections of heroin when she exhausted most of her venous access, and presented acutely with a radial artery occlusion requiring thrombolytic therapy. Clinicians should have a high index of suspicion for intra-arterial injection in injection drug users who present with limb pain, ischemia, and motor/sensory deficits. Given the reluctance patients may have in discussing their injection practices, clinicians should proactively discuss and counsel patients about safe injection practices and the dangers of intra-arterial injections.
authors.affiliation: Brigham and Women's Hospital (JS); Harvard Medical School (JS, ESV); and Harvard Longwood Psychiatry Residency Training Program (ESV), Boston, MA.
authors.forename: Joji
authors.initials: J
authors.lastname: Suzuki
authors.forename: Erin S
authors.initials: ES
authors.lastname: Valenti
mesh_terms: D000328:Adult; D001157:Arterial Occlusive Diseases / Q000188:drug therapy / Q000209:etiology*; D005260:Female; D006556:Heroin Dependence / Q000150:complications*; D006801:Humans; D007269:Injections, Intra-Arterial / Q000009:adverse effects*; D017534:Radial Artery / Q000473:pathology*; D015912:Thrombolytic Therapy