Fire in the vein: Heroin acidity and its proximal effect on users' health

被引:50
作者
Ciccarone, Daniel [1 ]
Harris, Magdalena [2 ]
机构
[1] Univ Calif San Francisco, Dept Family & Community Med, San Francisco, CA 94143 USA
[2] London Sch Hyg & Trop Med, Ctr Res Drugs & Hlth Behav, London, England
关键词
Heroin; Injection drug use; Risk environment; Skin and soft tissue infection; Venous sclerosis; Vein care; Vein damage; Vein loss; INJECTION-DRUG USERS; SOFT-TISSUE INFECTIONS; DEAD-SPACE SYRINGES; BLACK-TAR HEROIN; STAPHYLOCOCCUS-AUREUS; BACTERIAL-INFECTIONS; HIGH PREVALENCE; SAN-FRANCISCO; HIV; RISK;
D O I
10.1016/j.drugpo.2015.04.009
中图分类号
R194 [卫生标准、卫生检查、医药管理];
学科分类号
摘要
The loss of functioning veins (venous sclerosis) is a root cause of suffering for long-term heroin injectors. In addition to perpetual frustration and loss of pleasure/esteem, venous sclerosis leads to myriad medical consequences including skin infections, for example, abscess, and possibly elevated HIV/HCV risks due to injection into larger jugular and femoral veins. The etiology of venous sclerosis is unknown and users' perceptions of cause/meaning unexplored. This commentary stems from our hypothesis that venous sclerosis is causally related to heroin acidity, which varies by heroin source-form and preparation. We report pilot study data on first ever in vivo measurements of heroin pH and as well as qualitative data on users' concerns and perceptions regarding the caustic nature of heroin and its effects. Heroin pH testing in natural settings is feasible and a useful tool for further research. Our preliminary findings, for example, that different heroin source-forms and preparations have a two log difference in acidity, have potentially broad, vital and readily implementable harm reduction implications. (C) 2015 Published by Elsevier B.V.
引用
收藏
页码:1103 / 1110
页数:8
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