ABSTRACT
When considering the use of licit or illicit drugs it is important to recognise that an essential part of the treatment of substance misuse is the principle of harm reduction. Injectors may be very adept at gaining vascular access for the administration of drugs, and any clinician should be aware of the wide variety of sites that may be used for injection. Infectious systemic complications occur less often, such as transmission of human immunodeficiency virus and hepatitis, but in some areas of the world essentially all injection drug users are infected with the hepatitis C virus. Botulism and tetanus as a result of wound infections due to Clostridium botulinum and Clostridium tetani among users of injected drugs occurred in the UK during 2003 and 2004. The legal status of drugs varies widely around the world and different jurisdictions have different ways of classifying drugs in relation to their perceived harm to society.
