Drawing blood from IV drug users

[Mr. Self Destruct]

I have been working in a county jail for a few months now. I work the night shift in the infirmary and it is usually my responsibility to draw any labs the doctor orders. Since I started working here, I don't think I have once been able to successfully draw blood from an IV drug user. We use butterfly needles, and occasionally I'll get a flash, but the blood comes out like it's molasses and I can never get more than a few ccs. At night it's just me and one other nurse, and I need a doctors order to try their foot. Whenever I ask them what vein works best, I'll usually get a chuckle followed by "none of them anymore" or "in the hospital they have to use my neck." Any tips here? I feel like there has to be a secret to this.

[Esme12, ASN, BSN, RN]

I usually ask them for the best vein and let them apply the tourniquet in some cases. In the ED we just do radial or brachial arterial sticks with the butterfly.

Get the order or look into a standing order for ankle feet sticks.