Bilateral thrombosis is estimated to occur 6.8% to 37% of the time; however, thrombosis in the opposite leg might be asymptomatic. The most commonly occurring local symptoms were groin pain, swelling, erythema, elevated local temperature, and/or cyanosis or skin necrosis of the affected limb 15. It is projected that the urban population will increase by approximately 23% during this decade, distorting the relationship between urbanization and drug use 27. Access to prevention services is essential for all persons who inject drugs, who are at greater risk for Viral Hepatitis, HIV, and other infections. Because sharing needles is a common cause of HIV infection and hepatitis, a harm-reduction movement was started. Thus, users are provided clean needles and syringes so they do not reuse others’ needles.
- Plus, AAC treatment centers are in-network with a number of insurance providers, which typically cover part or all treatment costs.
- Cellulitis, an acute infection of the dermis and subcutaneous tissues, is a clinical diagnosis when uncomplicated and is treated with antibiotics and supportive measures 8.
- A D-dimer test (SimpliRED) performed on a patient’s finger-prick blood sample is also adequate to rule out DVT.
- Frontal and lateral radiographs of the chest demonstrate a thin linear radiodensity in the right midlung.
ExcludeTraining GuideGetting Off Right: A Safety Manual for Injection Drug Users
Sharing needles can transfer infected blood from one person to another, facilitating the rapid spread of these viruses. If an individual has been using IV drugs for years, he or she may seek higher doses due to an increased tolerance of the drug. We’ve got some tips for people who use drugs to access healthcare and advocate for yourself with healthcare providers – check out Quality Healthcare Is Your Right resource. General symptoms of hepatitis include fatigue, loss of appetite, nausea, mild fever, and muscle aches, and if you smoke cigarettes, you may notice that they taste unpleasant. More severe symptoms of hepatitis include dark (tea-colored) urine, light-colored stools, and jaundice (a yellowing of the skin and the whites of the eyes). SSTIs are commonly due to Staphylococcus and Streptococcus species, although anaerobic and polymicrobial infection has also been reported in PWID (34).
Persons Who Inject Drugs (PWID)
The increasing prevalence of injection drug use has contributed to a higher incidence of DVT in young patients and its association is undeniable 11. However, this association may be overlooked by physicians, and intravenous drug use is not even included in the Wells criteria, the most commonly used tool to screen patients for DVT. Although research is challenging, more studies are needed to gain a better understanding of the problem. Broader knowledge will lead to the development of more appropriate preventive measures, diagnostic approaches, and treatment protocols 9,15.
- Two emerging illicit drugs should be considered when evaluating a PWUD with skin or soft-tissue symptoms.
- Filler agents can also damage the endothelium of heart valves, thus increasing the risk ofendocarditis.
- Bacterial infections from IV drug use may occur when the germs on the skin are pushed into the body when a needle is used.
- While necrotizing fasciitis is rare, it is a serious and life-threatening complication from intravenous drug use.
- The kind of therapy given to our IVDU group at follow-up visits was similarly inconsistent.
- Intravenous drug users with skin infections often have at least one abscess in the past six months, with 11% of them divulging at least one abscess in the past six months.
Bone and joint complications
Radiographic findings in acute osteomyelitis include periosteal reaction (Fig. 9), regional osteopenia, Halfway house cortical erosion, endosteal scalloping and overlying soft tissue swelling or deformity 17, 18. Plain radiographs are, however, relatively insensitive in early bone and joint infections as bone destruction of up to 30% may be needed for radiographic identification and visible erosions in osteomyelitis can take up to 3 weeks to develop 17, 18. CT findings are similar to those on plain radiographs and include soft tissue swelling, regional osteopenia and cortical erosions. While CT provides greater sensitivity than plain radiographs and is the imaging modality of choice for assessment of osseous erosions, it cannot reliably identify bone oedema early in the disease process 17, 18. The magnetic resonance imaging (MRI) sequences employed in suspected soft tissue infection will typically include T2, a fluid-sensitive sequence such as short-tau inversion recovery (STIR) and unenhanced and post-contrast T1. Diffusion-weighted imaging (DWI) may be added in certain cases, such as to assess for abscess formation.
The immune system causes swelling to develop, and pus is created from the combination of white blood cells, germs and damaged tissues. Symptoms of necrotizing fasciitis include increasing redness and swelling and extreme pain at the wound or injection site accompanied by a fever. This may look a few different ways, the flesh around the site of infection will be very red, swollen, with severe pain, and possible fever. Over the course of days the skin can turn from red-purple to blue-gray and the skin could break down within 3-5 days. Since this infection is fatal, early treatment with antibiotics is crucial to survival, although even appropriate therapy does not prevent death in all cases. 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).
Hepatitis C, HIV, and Injection Substance Use
Several things can arise due to repeated substance abuse, such as heart problems, respiratory issues, liver and kidney problems, seizures, collapsed veins, insomnia, fatigue and a compromised immune system, among others. A 28-year-old man with a history of IVDU presented to our emergency department with pleuritic chest pain, dyspnea, and malaise. He was afebrile, with elevated ESR (48mm/hr), elevated c-reactive protein (140 mg/L), elevated D-dimer (3.05 mcg/mL), and borderline leukocytosis (10,260/uL, 67% neutrophils, no bands).
Getting the Treatment You Need for Your Addiction
The risk of systemic infections is particularly high when people lack access to proper medical care or neglect to address abscesses promptly. The repeated use of shared or unclean needles and the introduction of substances directly into the bloodstream create an environment that can cause bacterial infections. Intravenous (IV) drug use involves injecting substances directly into the bloodstream using a needle and syringe. When drugs are injected in the venous system, those germs can travel to the heart almost immediately, and they can stick to the heart valves, causing inflammation, infection, and build-up. If left to heal, a collapsed vein may show improvement after the inflammation has gone down. A healed collapsed vein can function normally, with blood flowing through the vein once again.
The same healthcare needs of the general population apply but services should be flexible to adapt to specific need. Unfortunately, a common criticism iv drug users complications from intravenous drug users is that the standard of health care received can be affected prejudicially by their drug use. Because of venous access difficulties and unreliability of attendance for monitoring, the newer oral anticoagulant drugs such as rivaroxaban and dabigatran may be the most suitable agents. Guidance about length of treatment in the general population is not based on evidence from this particular group.