Should IV Illicit Drug Users Be Offered PICC Lines Or Venous Access Devices


We were recently asked about this during a debate and we thought we’d share this with you as a blog post so that you can have your say too! If you’ve never heard of PICC (peripherally inserted central catheter) lines or VAD’s (venous access devices) then you’re not alone.

They’re most commonly used by those who need longer term IV treatment for things such as antibiotics, chemotherapy, and even to take regular blood samples without needing to hunt for a new vein each time a test is due. This also allows patients to spend less time in hospital when their treatment can be done from home. However this then poses the risk that addicts who administer their substances via IV will be tempted to use these devices to quickly get their hit each time they want to use.

But should patients who have known IV addictions be offered a PICC line or similar in order to reduce their risks of infections, blood clots, scarring, circulatory damage and impairment, injecting into arteries or damaging nerves in the surrounding structures, or should these types of device be avoided in order to reduce the temptation the other associated risks of having a VAD in place for any length of time? This is the topic of todays blog post!…

Remember you can join in and continue this conversation, along with others as well as see our other blog posts on our social media pages. Links can be found by clicking here!…

What Are PICC Lines & VAD’s?

A PICC line is a narrow tube that is put into a vein in the arm, usually in the elbow area. It’s similar to a cannula you may have had inserted if you’ve ever been in hospital and had blood or medication administered intravenously. PICCs allow medicines and antibiotics to be given directly into the venous bloodstream. The tip will lie in a big vein, just near the opening of your heart. The PICC can stay in place for weeks to months, depending on your treatment requirements and can be removed and a new PICC line inserted into a different vein once the current one has been in place for its designated amount of time.


Possible Benefits

  1. Reduction in damage to vein walls, nerves and other surrounding structures.
  2. Elimination of risk of “hit” misses and blown veins, especially with chronic users who have bad/damaged veins already.
  3. No longer needing to use needle exchange programs as syringes and dressings are given by the PICC provider. Also reduces the cost of incinerating and disposing of used injecting equipment.
  4. Reduces the risk of sharing injecting equipment.
  5. Provides quick, easy access.
  6. Reduces time and money spent in hospitals, or with doctors and nurses in GP practices to treat injecting site infections and chronic wound ulcers.
  7. Quick and easy to install by trained, experienced healthcare professionals.
  8. Can be used to inject medications in an emergency such as an overdose where naloxone may be required, as well as quick and easy blood taking for tests/monitoring for drug tests, medical tests and health condition diagnosis.
  9. Costs approximately £233.09 ($286.00) per PICC line which could last up to 6 months, compared to an annual cost per patient who use a needle exchange program of between £570.00-£1,630.00 ($700-$2000) depending on their usage, equipment used and the supplementary costs associated with running the program.

Possible Risks/Downsides

  1. Same risks of blood clots and infections as conventional injecting practices.
  2. May need expensive equipment to find and verify correct placement.
  3. Can slip out naturally, get caught on clothing, or be pulled out accidentally.
  4. May enhance the risk of the person’s substance use increasing because it’s so quick and easy to use in order to take their substance(s).
  5. Requires trained, expensive healthcare professionals to install, maintain and remove them.
  6. May increase the risk of overdose or increasing amount/dosage toleration.
  7. The person may have an allergic reaction to the sticky dressings or materials the PICC line is made from.
  8. Increased risk of blood-borne infections due to having the PICC line in place 24/7.
  9. Risk of blockages or clot formation in the PICC line.

What The Research Says

Research in this area, like many others in addiction studies is severely lacking to say the least! However we found 3 research articles that may be relevant to this discussion.

Research 1 – Oxford Academic
Research 2 – Science Direct
Research 3 – Harm Reduction Journal
Other External Debate/Case Study

Questions We Need To Ask Ourselves

We need to be honest with ourselves, addicts will use, even with the criminal sanctions that most governments around the world currently impose on addicts, and also still knowing the negative consequences that active substance use has on their physical/mental health and their world around them. The fact that addiction, overdose and death rates are continuing to grow yearly is evidence that most (though not all!) of what we currently do, just isn’t working. We all need to think creatively about how we manage addiction and the routes we have to access recovery.


We Want To Know What You Think!

Could this be another possible tool in our recovery toolbox by reducing the risk of infections, ulcers and unnecessary stays in hospitals? Or are the risks just too great by promoting further substance use? Comment below this blog post or join us on social media to share your views and see what others think too!…


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    Should patients who have known IV addictions be offered a PICC line or similar in order to reduce their risks of infections, blood clots, scarring, circulatory damage/ impairment, injecting into arteries or damaging nerves in the surrounding structures, or should these types of device be avoided in order to reduce the temptation the other associated risks of having a VAD in place for any length of time? This is the topic of todays blog post and we want to know what you think!
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Published by Drink ’n’ Drugs

Providing useful, relevant, up to date information and support for those suffering from active addiction or those who are in recovery.

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