Prevalence and factors associated with chronic venous insufficiency, leg ulceration and deep-vein thrombosis among people who inject drugs in London, UK

Jason Doran*, Vivian Hope, Talen Wright, Jenny Scott, Daniel Ciccarone, Magdalena Harris

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Introduction: People who inject drugs (PWID) are vulnerable to a range of harms, including vascular conditions such as chronic venous insufficiency (CVI), leg ulcers and deep vein thrombosis (DVT). The extent of vascular conditions has rarely been studied, despite contributing to considerable illness and disability among PWID. We assess the prevalence and associations of vascular conditions in PWID in London, UK. Methods: Survey data from the community-recruited Care and Prevent Study of PWID in London were analysed. Participants were asked about CVI and leg ulcers using pictorial questions, and if they had ever been diagnosed with DVT. Associations between vascular conditions and demographic/drug-use information were explored using univariate and multivariable logistic regression. Results: Among participants (n = 455), the prevalence of CVI, leg ulcers and DVT was 13% (n = 57), 10% (n = 46) and 23% (n = 105), respectively. CVI and DVT were positively associated with injecting into the groin, while injecting into the leg was positively associated with leg ulcers and DVT. CVI was also associated with not cleaning injection sites and diagnosed hepatitis C virus, and DVT with hepatitis C virus. Discussion and Conclusion: The prevalence of vascular problems among PWID in London is very high in comparison to the general population. These conditions are primarily associated with injection into the femoral vein. Use of these injection sites indicates peripheral venous access problems. There is a need to reinvigorate safe injection information provision in harm reduction services, with attention to reducing risk practices associated with venous damage and transitions to femoral injection.

Original languageEnglish
JournalDrug and Alcohol Review
Publication statusAccepted/In press - 2021

Bibliographical note

Funding Information:
The authors would like to thank Care and Prevent study collaborators, study sites and participants for their excellent contribution to this study. MH was funded by a National Institute for Health Research Career Development Fellowship (CDF‐2016‐09‐014) for the Care and Prevent Study. The views expressed are those of the authors and not necessarily those of the National Health Service, the National Institute for Health Research or the Department of Health and Social Care.

Publisher Copyright:
© 2021 Australasian Professional Society on Alcohol and other Drugs.


  • chronic venous insufficiency
  • deep vein thrombosis
  • harm reduction
  • leg ulcer
  • people who inject drug


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