The Health Dangers of IV Drug Use

Of those with septic arthritis, common pathogens include Staphylococcus species (including MRSA), Streptococcus, Pseudomonas, and Serratia species (37). As previously mentioned, vertebral osteomyelitis and discitis are common in PWID and can be complicated by epidural abscess, so practitioners should have a high-index of suspicion for PWID with back pain. CDC’s infectious disease programs work to implement evidence-based prevention programs in school and community settings, and to stop the spread of infectious diseases like hepatitis C, hepatitis B, and HIV among people who inject drugs.

These items may have blood in them, which makes them very risky to share among users. If the blood is infected with HIV, the infection can be spread to other people. Failing to clean the skin before injecting drugs or using dirty needles can lead to numerous skin infections. The most common one is cellulitis, an infection of the skin and tissues underneath. On top of the fact that drug abuse can damage several aspects of a person’s life, the route of administration can lead to added health problems for the user. While many people may be willing to brush off these warnings, IV drug use complications are no joke.

We can offer psycho-educational group sessions, individual therapy, group therapy, recreational activities, alcohol and drug educational groups, and more. Each element in the program is included to help the client reach his or her recovery goals. To learn more about our residential drug and alcohol treatment program, contact us today. Needle tracks is a term used to describe visible marks from repeated injections in the same place. Even years after completing drug detox and treatment, these marks may still be visible.

Septic Thrombophlebitis

While there are many bacteria and even fungi that can cause cellulitis, most cases result from group A Streptococcal bacteria. Cellulitis is one of the most common infections that affect people who use IV drugs. It’s a form of staph infection that can enter the body through vulnerable areas, such as an injection site.

• Radiographic findings in acute osteomyelitis include periosteal reaction (Fig. 9), regional osteopenia, cortical erosion, endosteal scalloping and overlying soft tissue swelling or deformity 17, 18.
• Soft tissue abscess may develop locally at site of injection or extend to deeper locations due to direct of haematogenous spread.
• Symptoms of wound botulism include droopy eyelids, blurred or double vision, and a dry, sore throat which may progress into difficulty speaking and swallowing, a weakness of the neck, arms, and legs, and difficulty breathing.
• Intravenous drug administration is a rapid and precise means of delivering medications, as it allows for immediate absorption into the circulatory system, ensuring that the drug’s effects are felt quickly and in a controlled manner.
• In chronic infections, destruction of the joint surfaces and peri-articular structures occurs with resultant deformity and reactive sclerosis (Fig. 16).
• If you have an open wound from an IV injection or IV drug use, bacteria may enter and cause tetanus to develop.
• Without adequate blood flow, the injury is unable to heal properly and can turn into an ulcer.

Persons Who Inject Drugs (PWID)

Based on the clinical features and exam, also consider CT with contrast to investigate suspected NSTIs (44), or contrast CT or ultrasound for suspected pseudoaneurysm (6). Ultimate management should not be delayed, but consider CT Angiography and early vascular surgery consultation in those with suspected limb ischemia (45). SSTIs are commonly due to Staphylococcus and Streptococcus species, although anaerobic and polymicrobial infection has also been reported in PWID (34). While AMS can often be explained by acute intoxication or withdrawal, this should be a diagnosis of exclusion. Be wary of PWID who do not appear to metabolize and recover their mentation as expected and in those with signs of trauma and/or focal neurological deficits. Injection drug use is via the hypodermic needle, which was invented in the mid-1800’s and available for purchase in the U.S. by the late 1800’s/early 1900’s (1).

The severity of a drug overdose will depend on the type and quantity of the drug taken. An overdose can cause serious medical complications and can result in permanent damage or even death in the most severe cases. In the past hepatitis C treatment was largely ineffective and had serious side effects. Since 2013, there have been highly effective, all-oral, cures for hepatitis C. However, it may be difficult to access treatment based on where you live, your medical coverage, and your liver damage.

Endocarditis (inflammation within the heart)

Our recommendations are limited to our experience at the IDEA SSP and our unique academic medical center environment. Echocardiography is one of the critical steps in diagnosing and identifying complications of infective endocarditis and is one of the major modified Duke criteria (43). Besides aiding in diagnosis of endocarditis, it is helpful in assessing valvular function and ventricular function.

Intravenous (IV) drug administration presents a unique and complex set of challenges in the context of substance abuse and addiction, often resulting in various complications. While intravenous drug use carries inherent risks, individuals who misuse drug addiction substances face an increased likelihood of experiencing complications that can be both acute and chronic. Understanding the common IV drug use within the context of addiction is crucial for healthcare providers, policymakers, and researchers striving to address the multifaceted nature of this public health concern. Some long-term intravenous drug users will get a swollen hand after shooting up. It is usually the result of a skin infection and can range in severity.

Clinical Procedures for Safer Patient Care

However, imaging should be considered in all patients with a confirmed history or considerable clinical suspicion of injected drug use due to their higher risk of complications. Soft tissue abscess may develop locally at site of injection or extend to deeper locations due to direct of haematogenous spread. A psoas abscess is a recognised complication of injection into the ipsilateral groin, for example. Infectious complications are the most common reason for inpatient admission in PWID 7. Soft tissue infection due to intravenous injection with contaminated needles or subcutaneous/intramuscular injection may manifest as a range of disorders of varying severity which include cellulitis, abscess, myositis and necrotising fasciitis. These infections are often polymicrobial and Staphylococcus aureus and Streptococcus pyogenes are among the most common organisms 7.

• MRI may be performed where there is diagnostic uncertainty or for the evaluation of surrounding soft tissues and bones.
• Patients with an IVDU-related infection were identified by manually reviewing the medical record and matched with patients with non-IVDU–related infection on demographics.
• On top of the fact that drug abuse can damage several aspects of a person’s life, the route of administration can lead to added health problems for the user.
• With repeated injections, a person may experience collapsed veins or blood clots like septic thrombophlebitis, which can be life-threatening.4 Without treatment, these veins can be permanently damaged.
• This method of drug delivery involves using a sterile needle and a syringe or an IV catheter to introduce the medication into a vein, typically in the arm, hand, or another suitable access point.
• Even years after completing drug detox and treatment, these marks may still be visible.
• Consulting with your primary care physician or a mental health professional is a good place to start when you decide to get help.

Access to comprehensive prevention services is essential for all persons who inject drugs. IV drug use involves introducing a drug directly into the bloodstream through a needle. IV drugs are often injected into the veins (intravascular), under the skin (subcutaneous) or the muscle (intramuscular). Apart from marijuana, most drugs can be injected, resulting in stronger and more dangerous effects on the body.

Multimodal imaging plays a key role in facilitating prompt diagnosis and treatment, and early imaging should be performed in PWID presenting with signs or symptoms suspicious for osteomyelitis 17, 18. Osteomyelitis due to haematogenous spread tends to result in a slow, insidious progression of symptoms whereas osteomyelitis from direct local extension presents with more pronounced and aggressive local manifestations. Given its insidious onset, primary or metastatic malignancy is an important differential for haematogenous osteomyelitis, particularly Ewing’s sarcoma in young adults 17, 19.

Talc is a bulking agent that can be injected with IV drugs and can lead to pulmonary talcosis, in which talc particles travel to the pulmonary vasculature and interstitium and cause a granulomatous reaction (27). It can lead to acute respiratory failure, and as the disease progresses can lead to the conglomeration of micronodules into masses, emphysema, chronic respiratory failure, pulmonary hypertension, and right heart failure (27). It can present as diffuse infiltrates or ground-glass opacities on imaging (25). Complications from septic emboli due to infective endocarditis to other organ systems are mentioned throughout this article in their respective sections.