Abscesses – A Major Update

Identification, Treatment and Prevention

Abscesses are something most of us have encountered before and they can be everything from hardly noticeable, to extremely painful. Medical care can be hard to come by for many of us around the world who inject drugs and so some people resort to treating themselves, for reasons of cost, access, stigma or fear. This can lead to some serious complications as the toxicity of an abscess can vary considerably. Here are a few things to remember when it comes to getting to grips with an abscess -and whether you can really treat it yourself.  Yes, you may think you know what to do if you have an abscess, but there is new guidance in terms of treating them these days, to ‘pack or not to pack’ , antibiotics everytime or just some of the time? Yes, this is a big article and has had a major update, and we will edit it down in the coming weeks, but for now here is all the information we have collected to help you make the most important decision -when to get help. Yes, it is worth reading the whole thing if you are concerned about abscesses, or at least read the summary!

A fairly typical large abscess on a heroin user who seemed to have skin popped heroin.

A fairly typical large sized infected abscess on a heroin user who is said to have skin popped heroin recently.

 

here is one where it was recommended to just cut and drain, and not necessarily dispense antibiotics

This is a pic of an infected abscess, but one where it was only recommended to just cut and drain, and not necessarily dispense antibiotics.

A Sterile Abscess is caused by injecting either an irritating or insoluble substance into a vein – and if some of the cut in your drugs are insoluble, a sterile abscess is sometimes formed. It is basically a milder form of the same process of an infected abscess, caused not by germs this time but by nonliving irritants such as drugs. If an injected drug is not absorbed, it stays where it was injected and may cause enough irritation to generate a sterile abscess—sterile because there is no infection involved. Sterile abscesses are quite likely to turn into hard, solid lumps as they scar, rather than remaining pockets of pus. It will not usually show signs of heat although there may be a touch of redness and it can feel like a solid nodule under the skin and isn’t likely to be sore. Soreness will depend on the volume of substance under the skin. Don’t try to squeeze or poke it as it will usually go away in its own time and squeezing it could induce an infection.

A Septic or  an Infected Abscess can occur anywhere in the body. In the injecting community in which we are referring to here, these can be caused by either using non-sterile injecting equipment or by bacteria from your skin entering under the skin via the injecting process. An infected abscess will soon come up as a swollen lump on or near the injection site. Appearing inflamed and red, it feels hot to the touch and soon becomes very painful. The abscess may come to a ‘head’ or ‘point’ and be filled with pus. Sometimes a deep abscess will eat a small channel (sinus) to the surface and begin leaking pus. It can be tempting to squeeze or burst it now – but DON’T! This will only spread the infection, driving it deeper and wider, and it could head for the bloodstream making you very ill by giving you blood poisoning which can be fatal!

For a much more in depth look, click here for the rest of the article which covers topics such as Antibiotics -Yes or No?, Prevention, Treatment, Home Treatment, click here.

For information concerning users of steroids and performance enhancing drugs, and abscess, click here.

Endocarditis

Heart diagram with labels in English. Blue com...

Image via Wikipedia

BP takes a long hard look at INFECTIVE ENDOCARDITIS, a potentially life-threatening infection of the heart valve. Mainly caused by bacteria entering the skin through injecting, IE can be extremely unpleasant and has a nasty habit of ironing you out completely if left untreated. Know the signs & symptoms.

Although relatively uncommon in comparison to most health problems intravenous drug users encounter, it is extremely important for us to be aware of infective endocarditis (IE) for several reasons:

First of all, Infective Endocarditis has a high mortality rate, and almost always kills the patient if left untreated;

Secondly, it is often preventable. Knowledge of the symptoms of IE, early diagnosis and correct manage­ment are what makes all the difference to your recovery.

And thirdly, a hygienic injecting regime is crucial when avoiding the types of bacteria that cause endocarditis.

In most cases, these organisms are streptococci (“strep”), staphylococci (“staph”) or members of other species of bacteria that normally live on body surfaces, entering the bloodstream through a break in the skin, as happens through injecting,

What is it?

Explaining what endocarditis is requires a little translation of the name; endo- means inside, -card- refers to the heart (like ‘cardiac’) and the -itis bit signifies a process of inflammation. Combining all three gives you an inflammation of the inside of the heart, usually caused by an infection, but occasionally by a fungus.

To read the rest of the article (which appeared in Black Poppy Issue 8) click here

Clostridium

Remember the news that seems to pop up each year concerning contaminated heroin? Dozens of injecting drug users have died over the years from contaminated heroin containing the bactrium Clostridium. And while it is still reasonably rare – it DOES HAPPEN with reasonable regularity and we see no reason why such a bacteria would stop any time soon. There are things you can do to keep aware of it though. Be sure to check out info on Anthrax as well (being another emerging poison affecting injecting drug users – and it seems heroin smokers as well.)

If you are an intravenous or intramuscular injector – this concerns you.

The bacteria (Clostridium) has been present in a few batches of contaminated heroin over the last few years, which appeared to particularly affect people who either injected into the muscle, skin-popped, or who missed a vein when injecting. Tragically, around 35 drug users have died as a result so far.

Over the last 10 years, various outbreaks have occurred affecting drug users in Dublin, Glasgow and London as they began turning up in surgeries and hospitals, exhibiting very similar symptoms to each other. It was initially thought that the same batch of heroin had been ‘retrieved’, mixed with different gear to disguise the ‘look’ and put back out on the street for re-sale.

This was a Black Poppy leaflet, to read the rest, click here.

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