Purpose:This presentation will examine themes in six research studies (1995-2003) about persons who have a history of injection drug use and chronic venous insufficiency (CVI). Conceptual Framework: The studies were based on physiologic changes to the legs from destruction of the venous system from injection drug use. Subjects: The number of participants in the studies ranged from 32 to 204. The majority were African-American men and women with mean ages in the 40s. Method: This descriptive review examined demographic characteristics of participants, pain, severity of CVI, and ankle joint mobility. Four studies were done in an outpatient wound clinic; one, in methadone treatment clinics; and one, in a combination of the two. Results: The drug of choice was injected heroin (mean years injecting=17). Chronic leg pain was the most common clinical problem. In prospective studies, worse pain was related to larger wound area. Pain was a reason given by patients for missing clinic appointments. Increased severity of CVI was significantly associated with increased pain. Path analysis showed that leg pain is a mediator of the relationship between CVI and behavioral functioning controlling for the effects of other chronic diseases. CVI was evident in 87.7% of persons in methadone treatment. There was a linear functional relationship between years of injection drug use and CVI clinical classification, but only when the injections were in the veins of the groin, legs, and feet. Parameters of ankle mobility (flexion-extension, inversion-eversion) important for the calf-muscle pump were significantly related to CVI disease severity. Conclusions: Persons who have used injected drugs, especially in the groin, legs and feet, are at high risk for CVI. CVI severity increased leg pain which negatively impacted ability to function and motion of the ankle joint.
Session #1219 - Poster Session I
The 29th Annual MNRS Research Conference (April 1-4, 2005)