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Just be truthful. While the details about chemical addiction may fly over a 6 year old's head, the general idea is really not that hard to understand. Tell them that drugs are chemicals that can make people feel really good, but that are very unhealthy. Fundamentally, it's like candy and sweets, but far more dangerous (the consequences are more than obesity and tooth decay). This is something a child can easily relate to without making it appear alluring (who would want poisoned candy, anyway?).

My general approach is that it's not a good idea to hide the world from your children. Of course I wouldn't go into the gruesome details of drug addiction, but my view is that when I explain this to my kids, then it is me who is in control of the narrative.

In these cases I try to not "explain" the matter to my children, but to engage them in a conversation. In this case it could go something like this (but the replies of the children might be different and it's important to adjust your conversation to truly involve them). You will be amazed how much they can understand if you explain it the right way:

Parent: You know that there are some things that you need to do to be able to live, like eating.

Child: Or like breathing.

P: Yes, exactly. And when you don't breathe or eat, how does it make you feel?

C: It makes me feel bad because I get hungry. Or I can't breathe.

P: Yes, and there are drugs you can take that, once you have taken them, it makes you feel bad when you don't take them anymore. You don't need them to live, but your body thinks it does. So people who take drugs find it difficult to stop taking them.

C: But why do people take drugs when they make you feel bad?

P: Because it makes them feel good the first time they take them but then very soon it stops feeling good and they just take them to not feel bad. So drugs make people ill and we call this illness "drug addiction". That's why you should never take drugs, because they make you ill.

C: But why do people use syringes?

P: Because for some drugs you need a syringe to take them. And when they use a syringe it gets into contact with other diseases this person might have. And when you get stung by such a needle you can also get very sick. So don't touch them and when you are with a grown up, tell them and ask them for help.

Of course you try to answer any other question your child has to the best of your ability.

I'm going to basically repeat an answer that I gave in response to this unrelated question: Answer your child's questions accurately and truthfully, using language they can understand. Most of all, let your child guide the conversation.

Child: I thought those were used by doctors.

You: They are. But sometimes people who aren't doctors give themselves shots.

...and shut up. Wait for the next question. It might come immediately, it might come sometime later, or it might never come. But when it does, just answer the question in a matter-of-fact manner, using language that they understand, but without giving your child information overload. When I think about this, I think of a friend of mine who, at age 4, asked his father where babies came from and got the full lecture, with accompanying pictures out of a textbook. This was probably too much.

When he or she does ask that next question, it will probably be something like:

Child: But why do they give themselves shots?

You: Some people are sick and have to give themselves shots, but sometimes people give themselves shots just because they think the shots make them feel good.

At some point, this may lead to a full-fledged discussion on drug abuse. Or not. Let your child's questions guide you.

This is how we answered almost all of our boys' questions, from the ever-feared, "Where do babies come from?" to handling a similar situation when our younger son found and picked up a used hypodermic syringe in the park.

Overview

I lean towards a modified idea of what Gregory posted in a now deleted answer combined with the current top rated answer by forest. Kudos to you both for having good answers.

Developmental State

There are things you can discuss and things which are better not discussed because a child is not developmentally ready for this information. I say this because 6 years are still learning and acting out much simpler things like; learn and practice basic social skills like sharing and negotiating, learning to win and lose at games, group objects based on shape and size, begin seeing right and wrong and compare abilities of different children like in drawing.

However, while a 6 year old is exploring simple thing like the above, they are also developing critical thinking skills and moral reasoning. However, while kids are developing these skills it is important to understand where they are. For instance, according to Piaget, a child at the age of 6 would be developing a strong sense of absolute morality but have no understanding of relative morality. An example from the source text reads:

A child who can decentre to take other people’s intentions and
circumstances into account can move to making the more independent
moral judgements of the second stage

To me this means a 6 year old is not capable of processing information from the perspective of another person fully, so certain explanations you give him regarding the reason for drug addiction and self harm will not be useful.

Application to a 6 year old

Some details of, and even the wording of 'intravenous drug abuse' is too much for a 6 year old. I think you should be honest and also vague, generalize the issue.

Addictionisreal.org has some advice that starts with this overview:

This is a good time to introduce more detail into your conversations
about drugs, especially what they are and the consequences of using
them. Explain the concept of addiction – that some people may not
understand how harmful drugs are or that some people try drugs and
then have a hard time quitting. Introduce them to the idea that drug
use can lead to abuse, which can lead to addiction.

So in conclusion I would keep the response somewhat vague while addressing the reality of what your son sees.

• What are drugs

• What can drugs do to your mind and body

• Why do some people choose to do this to themselves

• How should a 6 year old respond to this

What I would say, Final Answer

Drugs are strong and can be a medicine to help you, but they can also hurt you. Drugs should be only be used when a doctor has told you to, we can trust doctors. Some people use drugs on their own because they think they are smarter than doctors or for other selfish reasons. Some drugs change your brain and your body, and they make you crave them like you're starving. Once this happens you can't make good decisions anymore and the drug is in charge of you. Your only hope is to have someone help you. It is a very sad place to be and I hope you never end up with drugs in control of your life. Because you are young you have not seen people on drugs or using drugs. As you get older you will see people who do drugs, and you may even have friends who choose to do them because they think they are smarter than doctors or just don't believe what I'm telling you today. I'm your father and I will always tell you the truth and protect you. When you do see drugs I trust you will not let them control you, and you never use them without a doctor telling you it is okay.

If you have a faith this would be a good time to say a prayer or whatever your thing is. A prayer for protection from drugs, wisdom in resisting drugs and using doctor prescribed drugs, and redemption for those who are using drugs in your community to have someone come into their life and help them break their addiction.

Most kids have been to the doctor for shots by the time they can hold a conversation. Most kids know that when they're sick they get medicine, and sometimes this medicine makes you feel better when you feel bad.

Unfortunately, some people are using this particular medicine without getting the help of a doctor first. They don't always get it from a pharmacy like we get our medicine, and they aren't always clean about how they go about it. And most importantly, they aren't thinking about any downsides to taking this medicine. It's a lot more complicated than this, and you'll learn more about it as you get older. For now, if you do see one of those needles, DO NOT try to pick it up. I know you're trying to help, but you're much better off getting an adult to clean it up.

Relating it back to medicine and doctors draws upon something they know to expand their knowledge without getting into exactly how illicit dark drug use (especially the kind that leaves needles in public) can be.

People use drugs when they feel sad, like something is missing from their life. They try to fill it with drugs. It's illegal to but these people are a little bit lost, they haven't had very good upbringings so they struggle to make good decisions. There are chemicals inside the drugs that can make people feel good, but it actually ends up harming their bodies. It can harm their brains so people don't think properly either. That's why you can't touch them because it could hurt you very much.
These people aren't bad, they just haven't had anyone teach them the difference between bad and good.

That's why we can't judge them. We haven't lived the life they've lived or seen the things they've seen. All we can do is hope that in time they'll get better.

A six-year-old will be aware of such activities as smoking and alcohol consumption, and will have seen some drunk people. Therefore you can just tell the child that intravenous drug abuse is pretty much more of the same.

Your direct question was how to explain that junkies use the same equipment medics do. Through their own experience with healthcare, the child will likely feel (not sure if it’s actually accurate though, but the association will probably be there) that it’s the strongest substances for the most dire cases that tend to be administered by injection, so it’s only natural that people who have fallen beyond smoking and drinking are resorting to injection.

Other commenters have also addressed important points such as teaching your child not to conceal incidents from you, not to instill too much fear of legitimate medical procedures etc.

I'd stress the carelessness of people not cleaning up their mess. That's something kids can understand. You can remind kids that people like diabetics have a legitimate need to use syringes outside of a doctor's office. You don't know what the people were injecting, people's medical conditions are private, etc. You can feign ignorance about what and why people are are injecting themselves with.

A partial dialog, where one unsympathetic question leads to another:

Child: Why are these dirty needles left lying around?

Parent: The same reasons dirty liquor bottles and cigarette butts are left lying around. The people who enjoy these products hate always being judged harshly, and are sometimes afraid of being arrested, so they're in a big hurry to hide or get rid of the evidence. Some of them litter because messy things don't bother them right after they've had drugs, (but they may feel sorry about the mess later). But some of them litter as a petty revenge on the cleaner people who blame them for being messy.

C: Why can't they just do all that at home?

P: Not all of them even have a home. And some who have homes are yelled at or punished if they bring the products home.

C: Why can't they go to a hospital?

P: Because doctors are afraid of losing their jobs if they gave them as much drugs as they'd ask for. Also, not everybody can afford to pay the hospital's prices.

C: [Now thinking of an easy solution] Why can't they all go to jail until they promise to never use drugs or litter again?

P: Well there are too many people who use drugs, and not enough jail cells, and jails can be very expensive; so that the city might not be able to afford a Zoo or a playground because it spent all its tax money on jails. Also often people in jail promise not to do things, but then leave and go off and do the same things anyway.

C: [Growing more vexed]: Why can't we just take away all the bad drugs? So nobody can use them.

P: It's been tried, and police work very hard at it, but it's more difficult than it sounds. It's so easy to underestimate the determination, cleverness, and forcefulness of people that enjoy and supply illegal drugs. They work hard too, and some of them become very rich, richer than police, and pay jealous and unhappy policemen to help them. Also most of the drugs have good uses as well, and many people would suffer and die without them...

Note: The dialog could be made more sympathetic, (i.e. why folks use and why some oppose that), but it would be longer, so this answer takes the easier road of posing conundrums in hopes of slowing down the rate of such questions so the parent is not exhausted.