Infectious Complications of Injection Drug Use

This addiction typically involves the injection of drugs directly into the bloodstream using needles and syringes, which allows for rapid drug delivery and intense effects. IV addiction can encompass a variety of substances, including but not limited to opioids, stimulants, sedatives, and other drugs. To account for this, we manually reviewed patient medical records with a mention of IVDU or synonyms in any report to confirm that patients in fact presented with an upper extremity infection, and to determine the presence or absence of IV drug use. Second, this study represents the population at one academic medical center in the Northeast United States, and some results may not be generalizable to other geographic regions and metropolitan areas. Fourth, due to the retrospective nature of this study, we cannot comment on patients who sought care at another institution after receiving initial treatment at our facility. Fifth, the reasons for more IVDU infections are not explored in this study.

Public Health Problems Related to IV Drug Use

Our team takes a compassionate approach to treatments and is there to help patients along their sobriety journeys. Those with HIV may not develop symptoms immediately or assume they may just have a cold or flu. As HIV progresses, it may cause irritated, flakey skin, shingles, oral thrush and significant weight loss. Latency in HIV can last as long as 10 to 15 years, preventing people from receiving a proper medical diagnosis if they are asymptomatic. A potential overdose needs to be addressed and treated immediately by a medical professional.

• IV drug use involves introducing a drug directly into the bloodstream through a needle.
• According to CDC data from 2014, 27 million people aged 12 or older tried drugs in the last 30 days, about 1 in 10 Americans (3).
• This study was approved by our institutional review board and granted a waiver of informed consent for this retrospective chart review.
• Osteomyelitis as a result of local soft tissue infection may involve any bone, commonly affecting bones close to injection sites such as the extremities and pelvis in PWID.

Clinical Procedures for Safer Patient Care

In adults, haematogenous osteomyelitis typically involves the spine and is rare at other sites 17. Osteomyelitis as a result of local soft tissue infection may involve any bone, commonly affecting bones close to injection sites such as the extremities and pelvis in PWID. MRI is, therefore, the imaging modality of choice for the acute diagnosis, similar to osteomyelitis elsewhere in the body. MRI protocols typically include sagittal T1, T2, STIR and contrast-enhanced imaging of the affected segment of the spine in addition to axial T2 and contrast-enhanced imaging at levels noted to be abnormal on initial sagittal sequences 20. MRI demonstrates high signal intensity in the intervertebral disc space on T2 images with corresponding low signal on T1 (Fig. 13).

Table 7.11 Areas for Improvement to Prevent IV Medication Errors

Continual injections at the same site can cause scarring, bruising and even vein collapse. With continual intravenous injections through the same vein, the vein’s internal lining may become inflamed and collapse. A collapsed vein can no longer function properly, and blood does not travel through this vein anymore. Although infections in IDUs can be challenging to manage, they can be satisfying to look after with the right approach. Skin and soft-tissue infections and complications of bacteraemia remain common, but outbreaks of rare infections do occur, so it is essential to remain alert for severe or unusual presentations. Scar tissue can develop in the limbs, and the risk for skin abscesses and infection are high.

• CT is also important in the evaluation of sites such as the sacroiliac or sternoclavicular joints where plain film assessment is limited 24.
• Contiguous spread from SSTIs, direct inoculation, and hematogenous spread may result in septic arthritis or osteomyelitis in PWID (37).
• Protocols and force functioning need to be developed to minimize potential errors and to identify potential gaps in the system process.
• Important alternative causes of bone and joint infections to consider at the outset include recent trauma, recent surgery or joint instrumentation, or previous intervention involving insertion of fixation hardware or prostheses.
• Along with skin infections, IV drug use can also lead to blood infections.

Proper circulation is necessary to the body’s ability to heal a wound, such as an injection wound. Without adequate blood flow, the injury is unable to heal properly and can turn into an ulcer. Additional complications may include nerve or tissue damage, medication being absorbed too fast or too slow, wrong location for the medication (i.e., heparin given IM instead of SC), pain, bleeding, or a sterile abscess (Perry et al., 20148. Sharing needles or cookers puts IV drug users at risk for contracting HIV, the virus which causes AIDS.

IV drug use often causes more intense highs, making it difficult for someone to gauge how much of a drug they have taken. Research has shown the number of Americans who reported using heroin in the last year has been increasing each year since 2007. In addition to heroin, other common IV drugs include Talwin, fentanyl, buprenorphine and hydrocodone. 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. Track marks are the scars that appear along the veins of someone who injects alcoholism symptoms frequently and repeatedly uses the same  injection sites.

• Arterial pseudoaneurysms have a characteristic appearance on ultrasound which demonstrates an anechoic collection adjacent to the artery containing turbulent flow which appears as the “yin-yang sign” (Fig. 17) on Doppler ultrasound 28.
• 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.
• The immune system causes swelling to develop, and pus is created from the combination of white blood cells, germs and damaged tissues.
• Administration of drugs by injection poses multiple additional health risks when compared to other methods of consumption.
• In the IVDU cohort, 87 subjects were male (59%) and 130 (92%) were white.

IVDU patients trended toward more complex procedures such as amputation and flap coverage of open wounds, which may be a significant finding in a larger cohort. Finally, IVDU patients had overall longer hospital admissions and were more likely to require discharge to a rehabilitation facility. The incidence of IVDU cases presenting to the emergency department of a single urban center with an upper extremity infection in 2005, 2010, and 2015. The number of IVDU cases presenting to the emergency department of a single urban center with an upper extremity infection in 2005, 2010, and 2015.

Assistance for persons who use drugs

Vascular complications may manifest as injury to the vessel wall, interruption of blood flow in the lumen with resultant ischaemia or haematogenous spread of a pathogen from the injection site. Osteomyelitis is defined as bone inflammation caused by an infectious process and may be acute or chronic 17. It is often difficult to diagnose in the acute setting and can rapidly progress to a destructive process leading to significant long-term disability and pain.