Health Matters Specific To Injecting Black Tar Heroin
Users who intravenously inject black tar heroin are at higher risk of venous sclerosis (a condition where the veins narrow and harden, making injection there nearly impossible) than users of powder heroin. Researchers at UC-San Francisco have found that the rapidity with which black tar heroin destroys veins (forcing users to inject subcutaneously), along with its gummier consistency (requiring that needles be thoroughly rinsed between use, in case new, sterilized ones are not available during usage), may put users at a lower risk of HIV infection.
At least one study has drawn attention to lower rates of HIV infection among injecting drug users in areas in which black tar heroin is the major form of street-available heroin, suggesting that this may be due to the need to heat black tar heroin to dissolve it (which also inactivates any HIV present in the solution).
However, users of black tar heroin can be at increased risk of life-threatening bacterial infections, in particular necrotizing soft tissue infection. The practice of "skin-popping" or subcutaneous injection predisposes to necrotizing fasciitis or necrotizing cellulitis from Clostridium perfringens, while deep intramuscular injection predisposes to necrotizing myositis. It can also be associated with Clostridium botulinum.
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