Destroyed veins from IV Cocaine

[hoogabooga]

Hello Dr.   A recovering addict that I know has some vein issues. In '04 he started using hydrocodone and oxycodone for back pain, rarely abusing it until last year. That is when the hydromorphone and syringe use started. 8-16mg injections with a 30gauge, 5-6 times a day was the norm. About 3 months ago, he went "cold turkey" and the veins in his hands healed nicely.  About 3 weeks ago, he lost his wife, his house and his job.. At the time, Cocaine and a syringe seemed to be the answer. IV Cocaine is much different than IV opioids with the constant re-dosing while on a "fiend" . Two and a half ounces of very high quality product was used in 2 weeks, all with a 30 gauge in the arms and hands. There were several  "misses" but amazingly, no abscesses developed. The Cephalic vein on one arm and the Forearm Basilic  on the other, were ruptured by injecting too quickly. The opposite two are collapsed from overuse. It got so bad that if the injection was on RH side, the  L arm and hand went numb from leaking veins. The L arm hurts near the axillary-Basilic junction when it is lowered below heart level.
After 6  days of no use, flow has not returned the Cephalic, Basilic  nor to any of the smaller veins. If flow does return, approx. how long will it take? How long to make new veins? Is there anything that can be done, heat/ice, or supplements that can be taken to help?
FYI...
Users normal BP/HR has always been low   80/60  50bpm
User is tall and skinny 6'0 160lbs
A .22 micron wheel filter was used
User flushed the last 3-4 grams

Thank You!

[hoogabooga]

There is circulation in the extremities and good color in the hands and nails. The vein from bicep along pinky side of arms have both come back up and are carrying blood. The Cephalic is not carrying blood.  Hopefully there are no clots anywhere. Heating pads have been used on both forearms for long periods each day since the act of stupidity finished. At least a new needle was used each time instead of ripping tissue with dull spikes.

I think he will stay away from everything, especially IV Coke, from now on. I think he cares about the future more than he thought.

Thank you for answering

[Julia M Aharonov, DO]

Wow, I do hope your friend never does that again. He could have really done much more damage, but how do you know that he did not thrombose major vessels in his arms? Does he have pulses in both extremities? If he has pain in his L arm when he lowers it he may have a thrombus or lack of circulation. He needs warm compresses and a vascular surgeon in this does not resolve. Oh, my!