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Intravenous (IV) drug users have an increased risk of developing abscesses and other types of skin infections and inflammation. Bacterial infections are among the most common health risks associated with any kind of drug use that involves an injected route of administration (e.g., intravenous, intramuscular, and subcutaneous needle injections).

A skin abscess is a walled-off collection of pus within and underneath the skin. It can feel warm and painful to the touch and appear as a red, raised bump on the skin.Abscesses can develop when viruses, bacteria, parasites, or other foreign substances are introduced and entrapped underneath the skin.

As the skin gets infected, the body’s immune system tries to fight the infection by sending white blood cells to the infection site, causing inflammation. Pus forms from the resulting mixture of germs, dead tissue, and white blood cells, both dead and living.

Abscesses must be treated, either at home or at a medical center. Applying warm compresses and keeping it free from contamination are important steps to take. A doctor may prescribe an antibiotic to treat an abscess that is large or has become infected. 


Why IV Drug Users are Susceptible to Bacterial Infection

Bacterial infections are commonly caused by the user’s own communal bacteria. In other words, the bacteria naturally living on a healthy person’s skin, such as various species of staph and strep bacteria, can cause a painful and sometimes life-threatening infection. When a needle comes in contact with dirt and bacteria as it pierces the skin, it transfers them through the epidermis, sometimes causing a sub-dermal infection and abscess to develop.


How to Recognize an Abscess

Abscesses are usually fairly easy to recognize. Abscesses are typically:

    • Round or oval-shaped with dark, pus-filled masses at the center.
    • Anywhere on the body, but more commonly located at or around the injection site.
    • Painful, swollen, and tender to the touch.

If allowed to grow unchecked, the abscess may spread into the bloodstream or into deeper tissues, where the septic contents can create further health complications.


Complications of an Untreated Abscess

Though skin abscesses can resolve on their own, they can lead to the following complications if left untreated:

  • Swollen lymph nodes.
  • Sepsis, or the spreading of the infection throughout the body.
    • Skin tissue death (gangrene and possible limb amputation).
    • Endocarditis (inflammation of the heart lining).
    • Infection of the bone (osteomyelitis).
  • Recurrent skin infection.
  • Death.

Treating an Abscess

If an intravenous drug user is unable or unwilling to visit a physician for treatment, smaller, more superficial abscesses can be treated at home. Larger abscesses, or abscesses with surrounding red streaks, will be need to be treated professionally.

Self-treatment

If the abscess is less than one centimeter or one half inch across, it may be possible to treat it at home:2

  1. DO use a warm compress. The heat may help the infection by promoting drainage. Applying the warm compress on the affected area for 30 minutes four times per day may help the abscess heal on its own.
  2. DO protect against contamination. Take care to wash your hands, towels, and clothing after touching the infected region.
  3. DO NOT cut or squeeze the abscess yourself.

Epsom Salt Baths

Soaking in an Epsom salt bath is another method to promote healing.3 Epsom salt naturally draws toxins from the body and are easy to use. Do not use an Epsom salt if any of the following conditions are present:4

  • Diabetes.
  • Pregnancy.
  • Allergy to sulfur.
  • There are red streaks around the abscess. Red streaks could be a sign that the infection has spread. Consult a physician immediately.

Get Medical Help

If the abscess is larger than 2 centimeters in diameter, or if the abscess has red streaks, won’t heal, or recurs, professional treatment is needed. A doctor will likely numb and drain the area of infection so the wound can heal. He or she will take bacterial cultures from the wound and prescribe a round of antibiotics that broadly covers skin bacteria. Antibiotics may be adjusted when the specifically involved bacteria is identified.

Man being bandaged

Antibiotics commonly used to treat abscesses include:5,6

  1. Intravenous administration of vancomycin.
  2. Oral administration of antibiotics that fight MRSA (methicillin-resistant Staphylococcus aureus), including:
  • Vancomycin.
  • Dalbavancin.
  • Telavancin.
  • Clindamycin.
  • Trimethoprim-sulfamethoxazole.
  • Doxycycline.
  • Minocycline.
  • Linezolid.
  • Tedizolid.

Fear of being judged for taking drugs may prevent some IV drug users from seeing a doctor when health problems develop. However, they should consider the possible consequences of not seeking medical attention. Abscesses are in many ways like any other bacterial infection. As they grow, they become increasingly difficult to effectively treat and, when left untreated, may spread and cause a range of complications, including death.


How to Avoid Developing an Abscess

Consistent use of clean needles and rubbing alcohol before injection can reduce the risk of developing a skin abscess from IV drug use but will not eliminate it entirely. Any time the skin is pierced with a foreign object, the risk of infection will remain. The best way to avoid the development of skin abscesses is to eliminate the underlying and more dangerous problem, which is the intravenous drug use.


Is it Time to Seek Help for an IV Drug Problem?

Man afraid at doctors'Intravenous drug users risk losing friends, relationships, employment, and financial security—even life itself. Drug abuse may lead to a serious illness that could end in premature death.

Recovery from IV drug addiction is possible. It will not only improve the odds of living a longer life, but it will also improve the quality of life.

Drug Rehab Treatment Facility Types

If you’re ready to end your addiction and start looking into treatment, you will want to familiarize yourself with a few of the different rehab facility types available to you:

  1. Luxury rehab facilities offer 24/7 residential addiction treatment with a wide range of plush, resort-like amenities.
  2. Executive rehab facilities provide residential addiction treatment to busy professionals while offering the resources and program structure they need to stay involved at the workplace during recovery.
  3. Standard rehab facilities offer both residential (“inpatient”) and non-residential (“outpatient”) addiction treatment. They are a more affordable option for those with more limited budgets.

Sources

  1. Summanen, P.H., Talan, D. A., Strong, C., McTeague, M., Bennion, R., Thompson, J.E. Jr., Väisänen, M.L., Moran, G., et al. (1995). Bacteriology of skin and soft-tissue infections: comparison of infections in intravenous drug users and individuals with no history of intravenous drug useClin Infect Dis, 20(2), S279-282.
  2. May Clinic. (2019). Boils and Carbuncles
  3. Watson, L. (n.d.). Epsom Salts: Baths, and Beyond…
  4. Bobrow, B.J., Pollack, C.V. Jr., Gamble, S., Seligson, R.A. (1997). Incision and drainage of cutaneous abscesses is not associated with bacteremia in afebrile adults.Ann Emerg Med, 29(3), 404-408.
  5. Wilson, W., Taubert, K. A., Gewitz, M., Lockhart, P. B., Baddour, L. M., Levison, M.,…Durack, D.T., (2007). Prevention of infective endocarditis: guidelines from the American Heart Association. Circulation, 116(15), 1736-1754.

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