It's already been said - it's art if you say so.
This image for me though is quite literally surgical. As it stands, for me it sits between two extremes in my mind. It's way too clean for normal gear - the needle isn't bent, the spoon isn't rusty for example. But then, is it just the Trainspotting crowd who do coke and heroin? Nope. What about exploring the contrast between the shiny world of the high-flier and the grubby secret habit? That's what springs to mind for me here.
I know an IT contractor who worked briefly in New York. Day One was at the plush offices, view over the Park, mega-expensive and classy everything. Then he went to the loo and found the place looked like the inside of a flour factory - there were dregs of white stuff lying everywhere, like it was nothing. He found the contrast quite a shock.
Something to play with?