Flesh Eating Bacteria Caused by Intravenous Drug Use


Flesh Eating Bacteria and IV Drug UseThe association between deadly flesh eating bacteria and intravenous drug use is one that warrants significant attention from the drug abuse prevention and treatment communities. While rare, this horrific disease can strike an IV drug user from as little as one single injection, and the treatment is nearly as traumatizing as the disease itself. With mortality rates of late cases hovering near 50%, educating drug users about this serious threat isn’t a method of drug use prevention – it’s a critical method of harm reduction and life preservation.

What is Flesh Eating Bacteria?

Flesh eating bacteria refers to a wide variety of bacteria that aggressively infects and destroys skin, muscle, tissue and organs. While flesh-eating bacteria generally refers to a specific type of bacteria, the term necrotizing fasciitis more accurately describes the overall condition, which can be caused by many types of common bacteria. (1)

Bacteria that cause necrotizing fasciitis enter the skin through trauma varying in severity from a minor cut to a large surgical incision. Once the bacteria enters the body its biological processes cause tissue death and a cycle of infection and re-infection as the blood system circulates more and more of the bacteria throughout the body. This is why a case of necrotizing fasciitis that begins in the thigh can often result in complications and infection in the abdomen, hands and even the face.

In many cases treatment includes extensive surgical debridement, potent antibiotics, exploratory surgery and multiple amputations.

Why are IV Drug Users so Susceptible to Flesh Eating Bacteria?

14 years ago health officials in California reported a case of 3 linked intravenous drug users who contracted flesh eating bacteria. One died, one was left in critical condition and one fared somewhat better. (2) The case prompted shock and a significant amount of media coverage, but the fact of the matter is that IV drug users have long been associated with outbreaks of necrotizing fasciitis, including cases studied by the University of California Davis Medical Center starting as early as 1984. (3)

In most cases the types of bacteria that cause necrotizing fasciitis are not life threatening, but when they are able to infect underneath the skin, the same bacteria can quickly become deadly. IV drug users invite this hazard by repeatedly breaking the skin during injections. Often needles used are not sterile, are re-used or are shared among other drug users. This unsanitary practice is a breeding ground for bacteria to grow and aggressively proliferate once introduced under the skin.

These risks are compounded by the fact that many drug users become injured as a result of their intravenous drug use. Skin infections, cellulitis, low grade fevers, collapsed veins and heavy scarring are just a few of the problems IV drug users bring upon themselves. All of these conditions invite infection and compromise the immune system so that when bacteria is introduced the susceptibility to flesh-eating disease increases substantially. And considering that multiple studies have found samples of heroin and drug injection materials where up to 89% were infected with pathogens (4), the correlation between IV drug use and flesh eating bacteria cannot be ignored.

Prevention Measures

The obvious prevention method is abstinence from intravenous drug use, but for people already addicted to drugs this is easier said than done. Therefore, prevention for IV drug users will require the strict use of clean needles for every injection, sterile equipment and cleaning materials as well as a sterile environment in which to perform the injection. Preferably injections should only be carried out by professionals, as injuries caused by amateurs are common and encourage infection. Some or a combination of these prevention measures should be carried out, although this may be difficult for many drug users.

It is precisely for this reason that we need safe injection sites for intravenous drug users as part of a comprehensive community harm reduction plan. You can help right now by sharing this article and spreading the word.



(1) Necrotizing Soft Tissue Infection National Center for Biotechnology Information, U.S. National Library of Medicine November 22, 2011 Accessed 01/15/2013 http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002415/

(2) Flesh-Eating Bacteria Kills Drug User in S.F. San Francisco Gate 06/17/1999 Accessed 01/15/2013 http://www.sfgate.com/health/article/Flesh-Eating-Bacteria-Kills-Drug-User-in-S-F-2924754.php

(3) James L. Chen, Kathleen E. Fullerton, and Neil M. Flynn Necrotizing Fasciitis Associated with Injection Drug Use University of California Davis Medical Center, Division of Infectious Diseases, Sacramento Accessed 01/15/2013 http://cid.oxfordjournals.org/content/33/1/6.full.pdf

(4) P. Del Giudice Cutaneous Complications of Intravenous Drug Abuse The British Journal of Dermatology. 2004;150 MedScape Today News Accessed 01/15/2013 http://www.medscape.com/viewarticle/468419_3

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