There are many health problems — from overdose to infections — associated with shooting drugs.

The best way to avoid overdose is to try not to use alone. If you pass out, it’s good to have someone around to help you.

Fighting infections stresses out your immune system, especially if you have HIV, so it’s best to avoid them. Below is a list of some of the health problems you might face. See a doctor or nurse at a needle exchange or community health clinic if you think something might be wrong:

• abscess (skin infection) — A skin sore caused by dirt or germs on the skin, dirty water, reusing needles, missing a vein or using the same injection site before it heals. It starts with redness and swelling near the injection site and becomes a hot, hard, painful, pus-filled sore. Without treatment, it can turn into a dangerous blood infection.
• blood clots and embolisms —A blood clot is a thickened piece of blood that can get stuck in a vein and block blood flow. An embolism is a free-floating blood clot moving through the veins and arteries. These can be caused by dirt or germs getting into your veins. Your veins become red, swollen and tender, and are hard and warm to the touch. A clot in your arms and legs can cause pain and swelling. In your lungs, it can cause chest pain or shortness of breath. In your brain, it can cause numbness or weakness in any part of your body, fainting, blurred vision or speech problems. A clot in your lungs or brain can make you pass out, cause a stroke or even kill you. If you’re injecting pills, crush them up as finely as you can and filter them well to reduce the chance of clotting. Better yet, avoid injecting pills.
• cotton fever or “the bends” (septicemia) — A potentially deadly blood infection caused by dirt and germs in a hit. This could be from dirty fibres in the filter, a piece of the cotton breaking off, dirt or germs on your skin or in the water, or the cut in the drugs. Shortly after shooting, you get a high fever, chills, sweats, the shakes, nausea, vomiting, diarrhea, weakness, tiredness, twitching or confusion. Always use a new filter (ask for them at your needle exchange) to stop larger bits of the drug from getting into the syringe. Wash your hands before you ball the cotton. Touch the filter as little as you can; the more you touch it, the more germs get on it. Do not share filters.
• heart infection (endocarditis) — A potentially deadly infection of your heart tissue, caused when dirt or germs in your veins travel to your heart valves. Signs are high fever, chest pain, shortness of breath, heart palpitations, pain in muscles or joints, swollen feet, fainting and bruising under your fingernails. See a doctor if you have any of these symptoms.
• bacterial pneumonia — An infection of your lung tissue. Signs are sudden fever and a wet cough with mucus in the chest. Cut down on smoking, eat well and rest (your risk of pneumonia increases if your immune system is weak or if you smoke). A vaccine (Pneumovax), available in most provinces, can prevent many kinds of pneumonia.
• cellulitis and phlebitis — Cellulitis is a swelling of the skin. Phlebitis is a swelling of a vein under the skin. They are caused by missing the vein, digging around with a needle, or dirt and germs in a hit. Signs are swelling, bumps, redness, pain or heat at the injection site. Flag to make sure you’ve hit a vein. Pull the needle out if the injection site starts to hurt or swell and try again in a different place. Avoid digging for veins.
• chalk lung — If you’re injecting ground-up or crushed pills, small bits of the chalk can get into your blood and end up plugging your lungs or eyes. Signs are blurry vision and shortness of breath. Filter well if you’re injecting pills. Better yet, try to avoid injecting pills.

If you think you’re problem is very serious, go to emergency. It is never too late to get treated, but the earlier you go for help, the easier it is to take care of a problem. Remember: You have a right to good health care whether or not you use drugs.