From the Guidelines
This situation is extremely serious and requires immediate medical attention, as injecting substances like Suboxone and methamphetamine directly into veins can cause severe vascular damage, including blockages in major arteries, which can lead to heart attack, stroke, or death if not treated properly. The procedure mentioned is likely an angioplasty or stent placement to clear these blockages, and according to the 2014 AHA/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes 1, it is reasonable to use coronary angiography to detect severe CAD. The procedure itself typically takes 1-2 hours, but recovery requires hospital monitoring for 24-48 hours, followed by several weeks of recovery at home. Long-term, the patient will need lifelong medication (like blood thinners) and regular medical follow-ups.
- Key considerations for treatment include:
- Complete cessation of injection drug use is absolutely necessary for any treatment to be effective long-term
- Substance use disorder treatment should be pursued immediately alongside medical treatment for the arterial blockages
- The patient may require treatment for vasospastic angina, which can be managed with calcium channel blockers alone or in combination with nitrates, as recommended by the 2014 AHA/ACC guideline 1
- The patient may also require treatment for endothelial dysfunction, which can be assessed with invasive physiological testing, such as coronary flow reserve measurement 1 The damage from intravenous drug use is cumulative and can cause permanent vascular scarring, reduced blood flow, and increased risk of future blockages. It is essential to address the underlying substance use disorder to prevent further vascular damage and reduce the risk of morbidity and mortality. As stated in the guideline, it is reasonable to administer catecholamines for symptomatic hypotension in the absence of LV outflow tract obstruction, and to use IABP for refractory shock 1.
From the Research
Procedure Details
- The procedure for addressing blockages in the main artery is typically an angioplasty or atherosclerosis treatment, which can last anywhere from 30 minutes to several hours, depending on the complexity of the case.
- The seriousness of the procedure depends on various factors, including the location and severity of the blockages, as well as the overall health of the patient.
Risks and Complications
- Injecting Suboxone and Meth into the oxygen vein can lead to serious health complications, including cardiac arrhythmias, long QT syndrome, and increased risk of mortality 2.
- Methamphetamine use has been linked to cardiovascular disease, including vasoconstriction, pulmonary hypertension, atherosclerotic plaque formation, cardiac arrhythmias, and cardiomyopathy 3.
Treatment and Management
- Anticoagulation therapy may be recommended to prevent further complications, such as stroke or pulmonary embolism 4, 5.
- The choice of anticoagulant medication will depend on various factors, including the patient's medical history, kidney function, and other health conditions.
Long-term Outcomes
- Patients who have used methadone, buprenorphine, or naltrexone for opioid use disorder may have different cardiac and mortality outcomes, with methadone associated with a higher risk of cardiac arrhythmias, long QT syndrome, and death 2.
- The long-term effects of injecting Suboxone and Meth into the oxygen vein can be severe and potentially life-threatening, highlighting the need for prompt medical attention and treatment.