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===Risks===
Risks from drug injection are caused by a variety of factors, including unclean or unsafe injection practices such as [[Flashblood|blood flashing]]<ref name="flashbloodnyt">{{cite news |last1=McNeil Jr. |first1=Donald G. |title=Desperate Heroin Addicts Inject Blood of Other Users |url=https://link.gale.com/apps/doc/A231383957/HWRC?u=rock21695&sid=bookmark-HWRC&xid=bb4ea1e9 |access-date=11 May 2022 |work=New York Times |agency=Gale Health and Wellness
Additional risks from unsafe injection practices result primarily from sharing materials (needles, cookers, syringes) used in injection.<ref name=":0" /> [[Blood-borne disease|Blood-borne pathogens]], such as [[HIV]], [[Hepatitis B]], and [[Hepatitis C]] are of particular concern among injection drug users who share supplies, and increase the likelihood of infection.<ref name=":0" /> An added challenge, is that not only infected individuals know their positive status and continue to share supplies, placing other users at risk for infection as well.<ref name=":0" /> 30-50% of adults will not experience acute [[Hepatitis B]] symptoms, and those that do experience [[lethargy]], nausea, upper abdominal pain, muscle aches, or a darkening of urine will need to connect these symptoms to a possible infection to seek care and limit spreading of the virus.<ref name=":0" />
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[[Harm reduction]] is a public health approach that serves as an alternative to abstinence-only guidance. While it does not condone the use of illicit or illegal drugs, it does seek to reduce the harms, risks and dangers associated with illicit drug use, both for the person using illicit drugs and the wider community. Injection drug users that re-use drug delivery components put themselves and others at risk for diseases such as HIV, hepatitis B, and hepatitis C, as well as increase their chances of getting a serious infection.<ref>{{Cite web|url=https://www.cdc.gov/nchhstp/dear_colleague/2016/dcl-112916-hiv-and-injection-drug-use.html|title=HIV and Injection Drug Use: Syringe Services Programs for HIV Prevention {{!}} 2016 {{!}} Dear Colleague Letters {{!}} NCHHSTP {{!}} CDC|website=www.cdc.gov|language=en-us|access-date=2017-10-31}}</ref><ref name=":1">{{Cite web|url=https://www.cdc.gov/hiv/risk/ssps.html|title=Syringe Services Programs {{!}} Injection Drug Use {{!}} HIV Risk and Prevention {{!}} HIV/AIDS {{!}} CDC|date=2017-09-28|website=www.cdc.gov|language=en-us|access-date=2017-10-31}}</ref> In 2015, the CDC performed an HIV Surveillance Report and attributed 2,392 (6%) of new HIV diagnoses to IV drug use in the US.<ref>{{Cite web|url=https://www.cdc.gov/hiv/risk/idu.html|title=Injection Drug Use {{!}} HIV Risk and Prevention {{!}} HIV/AIDS {{!}} CDC|website=www.cdc.gov|language=en-us|access-date=2017-10-31}}</ref>
A prominent method for addressing the issue of disease transmission among intravenous drug users are [[needle exchange program]]s (also known as syringe exchange programs, syringe service programs or needle-syringe programs), where people who inject drugs (PWID) can access sterile needles, syringes, and other paraphernalia.<ref name=":1" /><ref>{{Cite journal|last1=Mackesy-Amiti|first1=Mary E.|last2=Boodram|first2=Basmattee|last3=Spiller|first3=Michael W.|last4=Paz-Bailey|first4=Gabriela|last5=Prachand|first5=Nikhil|last6=Broz|first6=Dita|last7=NHBS Study Group|date=2017-07-01|title=Injection-Related Risk Behavior and Engagement in Outreach, Intervention and Prevention Services Across 20 US Cities|journal=Journal of Acquired Immune Deficiency Syndromes|volume=75 Suppl 3|issue=3 |pages=S316–S324|doi=10.1097/QAI.0000000000001406|issn=1944-7884|pmid=28604433|s2cid=3505532}}</ref> In addition to providing sterile devices used in drug injection, these programs often offer access to infectious disease testing, referrals for substance use or mental health treatment programs, and more.<ref name=":1" /> The idea behind harm reduction approaches is to slow disease transmission, such as HIV/AIDS and hepatitis B and C, and promote public health by reducing the practice of sharing used needles.
In countries where harm reduction programs are limited or non-existent, it is quite common for an IV users to use a single needle repeatedly or share with other users. It is also quite uncommon for a sterilizing agent to be used on needles and syringes. This creates a high risk population for the spread of bloodborne pathogens.
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