People who inject heroin may develop abscesses, a type of skin and soft tissue infection. A heroin abscess may happen the first time a person abuses the drug or to people who have used heroin for many years.

Research has found that up to one-third of people who inject drugs currently have or recently had a skin abscess or infection. Heroin is the most frequently injected drug, and because of this, people who inject heroin could have a significant risk of developing an abscess.

Without treatment, serious medical complications from heroin abscesses can occur, including amputations, sepsis, and death.

Heroin addiction treatment can have a key role in reducing the risk of abscesses and other infections caused by heroin abuse. A comprehensive drug rehab program could also help a person find sobriety and improved physical and mental health.

What Is A Heroin Abscess?

A heroin abscess is an infection of the skin and soft tissue. An abscess causes pus to collect in or under the skin.

When the infection is in a person’s skin it’s called a cutaneous abscess. An infection that exists below the surface of the skin is referred to as a subcutaneous abscess.

Abscesses most commonly occur where the heroin is injected, however, an abscess may develop anywhere. Heroin abscesses on the arms and legs are common, as these are frequent injection sites for the drug.

While some abscesses develop almost immediately, they typically take two to five days to develop, according to the United Nations Office on Drugs and Crime (UNODC).

The UNODC explains that an abscess can take two forms:

  • exploding abscess: The infection breaks through the skin and is visible on the skin’s outer surface.
  • impounding abscess: The pus forms beneath the skin. The infection spreads underneath the skin and does not break the skin’s surface.

Heroin Abscess Signs And Symptoms

Knowing the signs and symptoms of a heroin abscess could help a person or their loved to receive prompt medical care.

When a person has an abscess they may have chills, fever, or swollen lymph nodes. The site of the abscess may be:

  • painful
  • red
  • shiny
  • swollen
  • tender
  • warm

An abscess may have a foul smell. It may also ooze pus when pressure is applied to the infected site or when the wound is bumped. Pus is a thick, cloudy liquid that may be greenish, yellowish-white, or yellowish-brown in color.

Heroin Needle Injection And Abscesses

Injecting heroin can introduce harmful, abscess-causing bacteria into a person’s body. Heroin may be injected into the vein, or intravenously (IV); into the muscle, or intramuscularly (IM); or just beneath the skin, or subcutaneously (SC).

An abscess can develop from any of these ways, however, injection drug users face a five times greater risk of getting an abscess if they inject subcutaneously, which is also referred to as skin popping. An individual may skin pop heroin on purpose, however, skin popping frequently occurs when a person attempts to IV inject heroin and misses their vein.

Unsanitary injection practices, such as using dirty, old, used, or shared needles can increase the risk of bacteria passing into a person’s body. In turn, people who engage in these practices may have a higher likelihood of getting an abscess.

Risk factors for heroin injection abscesses include:

  • Unclean or dirty heroin needles can carry higher numbers of the bacteria that cause abscesses. Failing to clean or sanitize a heroin syringe may also result in more bacteria being present.
  • Using spit or saliva to clean a needle does not sanitize it. Doing so could expose a person to oral bacteria that cause abscesses as well.
  • Sharing a heroin needle or syringe could transmit bacteria from one person to the next.
  • Using a heroin needle over and over can cause it to become dull. A dull needle can create more damage at the injection site. This could make the skin and soft tissues more prone to infection.

Heroin Abscesses: The Causes

In addition to being on the heroin syringe, abscess-causing bacteria may also be on a person’s skin. Staphylococcus aureus, a bacteria that commonly occurs on the skin, is frequently responsible for cutaneous abscesses or skin abscesses from heroin.

Failure to clean the injection site, licking the skin to clean it, or not washing hands before injecting could increase the chance that abscess-causing bacteria enter a person’s body through injection. Injecting the drug frequently or injecting into an already damaged site may also raise this risk.

Chronic heroin abuse can also weaken a person’s immune system and make it harder for their body to fight off infection.

Heroin is frequently cut with other drugs or chemical adulterants. Injecting impure or laced heroin could lead to an abscess. When an adulterant passes into a person’s vein or body it could act as an irritant or block the vein, circumstances that may lead to an abscess.

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Research also suggests that injecting black tar heroin may increase the risk of abscesses. This form of heroin may be more difficult to inject, a characteristic that could lead to a person skin popping the drug.

Abscesses from black tar heroin may also result from higher numbers of bacteria that occur from crude processing methods or dirt that’s cut into the drug.

Heroin may be mixed with cocaine and injected, a combination referred to as a speedball. While the dangers of speedballing are many, mixing heroin and cocaine in this way could lead to an abscess.

Cocaine is not readily absorbed by skin popping or intramuscular injections. Due to this and the vasoconstrictive properties of cocaine, a person may get an abscess from speedballing.

Heroin Abscess Dangers And Complications

Abscesses are one of the top two reasons why people who inject drugs visit the emergency room or are admitted to the hospital, according to research.

An untreated heroin abscess may lead to other infections or medical problems, some of which may be life-threatening.

The complications and dangers of heroin abscesses include:

  • chronic abscesses: Chronic, recurrent abscesses from heroin may occur in people who have been injecting drugs for ten years or more, according to the World Health Organization. This may be due to colonies of bacteria that cause abscesses.
  • ulcers: If an abscess is ignored it could break through the skin and becomes a heroin ulcer.
  • gangrene: Without treatment, gangrene, or tissue death, may develop. Gangrene from an infection can spread quickly. Gangrene from heroin injection could lead to scarring, reconstructive surgery, or even death. Maggots may also infest the ulcer and dying tissue.
  • osteomyelitis: The infection from an untreated abscess or ulcer may move into the bone.
  • amputation: If gangrene is severe, or if a person develops osteomyelitis, their limb or other infected body part may need to be amputated.
  • sepsis or septic shock: If the bacterial infection from an abscess or gangrene moves throughout the body, a person may develop sepsis. If sepsis isn’t treated, it can progress to septic shock. While both states can be fatal, the risk of death is higher with septic shock. Septic shock can also cause organ failure.
  • endocarditis: An untreated abscess may result in the infection moving to other areas of the body, such as the heart. Endocarditis is an infection of the heart’s lining and valves that may be deadly without medical treatment.
  • tetanus of the wound: The bacteria Clostridium tetani may release toxins that cause tetanus of the wound.

If a heroin abscess is suspected, seeking professional help could reduce the risk of these and other dangerous complications.

Heroin Abscess Treatment

While some skin and soft tissue infections may heal on their own, an untreated abscess could lead to serious health problems. Treating an abscess at home could result in adequate care and complications. Because of this, professional medical treatment may be advised.

In certain cases, a doctor may perform an incision and drain the pus from the abscess. Analgesia or hospital treatment may be necessary in certain circumstances. Antibiotics may also be administered to treat the infection.

If an abscess has caused any other complications or medical conditions, further medical treatment may be necessary. Some, like septic shock or endocarditis, could require intensive treatment and a hospital stay.

Becoming sober can help a person avoid future abscesses and other dangers of heroin abuse.

Getting Treatment For Heroin Abuse And Addiction

While the best drug rehab programs for heroin addiction help a person’s body heal, people with serious heroin-related medical problems may need specialized medical care or hospital-based services prior to rehab.

Once a person is stabilized, they can move to detox and rehab. Heroin can cause severe physical dependence, and because of this, a medical detox program for heroin is often recommended.

A medically supervised detox program offers 24-hour oversight while a person’s body begins to flush the drug from its system. Medications, such as Suboxone, are commonly used to reduce withdrawal symptoms and cravings.

When a person has successfully detoxed, they can transition to rehab. An inpatient drug rehab program for heroin provides the highest level of care. Residential addiction treatment offers a sober community where a person can heal body, mind, and spirit from addiction.

Contact Vertava Health today for more resources on the dangers of heroin abuse and ways to get treatment.