Since the 1990s, it has been demonstrated that vascular complications including deep vein thrombosis (DVT) have high morbidity among intravenous drug users (IVDU). Injection drug use and particularly sharing needle practices are known risk factors for skin and soft tissue infections, infective endocarditis (IE), and also blood-borne infections, which are a topic of concern having played an important role in the further spread of HIV and hepatitis B and C. There are approximately 15.6 million people who inject drugs (PWID) worldwide and this may be an underestimate of the real problem as the use of injection drugs is an illegal and stigmatized practice, making data collection challenging. Intravenous drug use has become a major public health problem, the prevalence of which has increased significantly in the last decade. Intravenous drug abusers having DVT are affected by multiple complications and poorer outcomes such as slower recovery, recurrent venous thromboembolism (VTE), and a longer hospital stay, which put them at higher risk of morbidity, mortality, reduced productivity, and economic burden. Extended anticoagulant therapy with low-molecular-weight heparin combined with warfarin is the recommended treatment. Venous ultrasound is the method of choice for diagnosing DVT. There are over 50 conditions that present with swollen and painful limbs comparable to DVT in IVDU, making precise diagnosis critical for timely treatment. There appeared to be a delay in reporting symptoms, which was most likely due to the social stigma attached to IVDU. Prevalent clinical presentations include local pain, swelling, and redness with typical systemic symptoms including fever, cough, dyspnea, and chest pain on top of addiction features. The right-sided femoral vein is the most common vein affected. The pathogenesis of DVT development in IVDU is mainly attributed to the interplay of trauma to the vessel by repeated injection and the injected drug itself. Deep vein thrombosis typically manifests itself eight years after the initial intravenous drug administration, rendering it a silent killer.Īiming to review and summarize existing articles in this context, we performed an exhaustive literature search online on PubMed and Google Scholar indexes using the keywords “Deep Venous Thrombosis (DVT)” and “Intravenous Drug Users (IVDU).” English articles that addressed epidemiology, pathogenesis, clinical manifestations, diagnosis, differential diagnosis, management, and outcomes of DVT, including those in IVDU, were selected and analyzed. Peer pressure and poverty in high-risk groups such as sex workers, females, and young adults raise the risk of intravenous drug use, which expresses itself in the form of venous thromboembolism eventually. Intravenous drug use is a global problem, with the main culprit being heroin. The prevalence of intravenous drug use has increased in the past decade and it represents an important risk factor for deep vein thrombosis.
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