I was only one of two that gave you an 8. I did not like the subject at all, and the image truly repulsed me, but I have a problem with needles anyway. I thought it definitely depicted the challenge really well. Your detail was exceptional. Of course, I think most people voted low because of the subject, not because it was badly done photographically. My problem too. I get a lot of low scores probably because my subject is not west coast enough. I live in merry New England, and I think my highest scores come from Europeans and Canadians.
The additional blurring around the center seems to be more of a distraction to me than a way to hightlight the main subject. The lighting is a little brash.Good subject ...a real Dead End.
Good challenge entry with impact... Can't help thinking though that It may have looked a little more intense in black and white. Color dosn't help the image I feel... :)
The fuzzy vignetting is something typically reserved for pictures of weddings and puppies and smiling babies; using it here just seems bizarre. The busy pattern on the fabric behind the arm is distracting; a solid color located further behind the arm would have helped to direct attention to the intended subject.
The subject itself is somewhat ambiguous. Is this person taking some necessary drug (e.g. insulin), some illicit substance, or is this an intended suicide? Although such ambiguity could create dramatic tension and make the image more interesting, I don't think it works in your favor here.