Leg ulcer studies of a wider population will tend to include from age 50 years of age or over [ 42 ], so 44 years was considered to be a safe margin. The sample included individuals with a current or previous history of injecting drug use, aged 16 to 44 years, who could understand and speak English. Participants were excluded if they did not meet the inclusion criteria or did not appear to be able to either understand what they are consenting to take part in or answer questions, including being visibly under the influence of drugs or alcohol.
Staff at the recruitment venues who were often familiar with individual participants also helped identify and exclude those who were not fit to consent at that time [ 48 ].
Posters and leaflets describing the study were displayed in each venue for at least 2 weeks prior to recruitment commencing. During recruitment, individuals were approached by the researcher as they entered each venue and asked if they would be interested in taking part in a research study and answering some questions about injecting and complications.
Informed consent was obtained and the interviews lasted an average of 20 min. A pilot study was undertaken earlier to test recruitment, data collections tools and analysis which informed the method. The study was conducted over a period of 3 months at the end of Interviews were conducted across the eight venues in the north, south, east and west of the city.
Participants provided initials and date of birth, together with the first few letters of their postcode—this allowed any duplicate interviews to be identified. A total of interviews were conducted. On three occasions, participants who the researcher thought had been interviewed before were adamant they had not previously been interviewed. The researcher felt obliged to conduct a second interview.
When initials and dates of birth were checked, the three interviewees were found to be duplicates. The data from these second three interviews were removed from the database.
A fourth interview was abandoned midway, and the incomplete data from the fourth interview were also removed and not included in the analysis. The analysis was conducted on the remaining interviews. All data were entered into SPSS version All identifiers were removed after checking.
Data were analysed using descriptive and inferential statistics. The data were reviewed for missing values and there were none. Percentages rounded up. This study is the first empirical work that accurately defines and matches described skin problems in injecting users to specified terms.
Drug users with skin problems are most likely to present to services such as needle exchanges and drug workers in the first instance, where staff have less expertise in the physical side of injecting complications, such as the identification of wound infection, and the management of acute and chronic wounds. It has therefore been difficult, until now, to empirically determine the nature and extent of skin problems because of the diverse presentation across the sector.
All skin problems within this study were self-reported by participants. Reassuringly, a closely relevant study by Morrison et al. Whilst the definitions were stringently applied to the data collection, some skin problems may have been forgotten, or exaggerated.
However, the evidence suggests that recall is fairly accurate, even in drug users [ 50 - 52 ]. There was an advantage in gathering data face to face in that the researcher was able to clarify and determine the precise condition reported by the participants by probing further and seeking clarification on position as well as appearance.
However, clinical examination was not undertaken; this may have been advantageous where there was a current skin problem but would not have assisted in identifying or clarifying past problems. However, the method had to be constructed to suit the population studied. The socio-demographic profile of Glaswegian drug injectors is known to be two-thirds male, typically unemployed and aged about 30 years, and mostly using heroin [ 53 - 55 ].
The sample in this study was similar in that the majority of participants were male with a comparable mean age. There were no participants under the age of 21 years, and no one was excluded on the basis that they were too young to participate.
This may indicate that injecting in this younger age group is low and so skin problems may be small or non-existent or that the services used for recruitment were not engaging with younger drug users and so this figure may not be indicative of skin problems in younger injectors.
Eight per cent complained of other skin problems over the duration of their injecting careers including bruising and varicose veins, phlebitis, cellulitis, haematoma, scarring and thin skin. These findings indicate that a large proportion has experienced abscesses and soft tissue infection.
This is unsurprising given that the injection process will not be a sterile procedure and the drugs injected are often cut and mixed with unsterile materials; nevertheless, the prevalence is extremely high. Any injecting injury is frequently referred to as an abscess by both service users and staff. Whilst there is no denying that infection is a common sequela to injecting illicit materials, this is a misrepresentation of the problem.
However, many papers commonly use the term abscess to describe any kind of red raised lump. This is confusing and possibly harmful. The injection may miss the vein, or puncture the vein, allowing fluid to escape into the tissues. They tend not to be pus filled, hot, or with spreading cellulitis; however, they may take some time to resolve but are not infected and do not require antibiotics [ 58 ]. The abscesses may require treatment with antibiotics, but overuse or inappropriate use of antibiotics can lead to resistance and other unwanted side effects [ 13 ].
However, appropriate assessment of skin problems and injecting injuries is important as misdiagnosis can have serious implications. Skin breakdown may be the first sign of problematic drug use. Beeching and Crowcroft [ 59 ], in their overview of tetanus in injecting drug users IDUs , warn clinicians of systemic effects of apparently trivial wound infections in IDUs when they present with collapse, sepsis or odd neurological symptoms which might otherwise be dismissed as direct results of drug intoxication.
Seemingly innocuous lesions can also indicate far more serious systemic disease e. It is normal for the body to respond with a temporary inflammatory response to injury, but what is more difficult is detecting the difference between normal inflammation and an inflammatory process which may indicate something more serious and systemic occurring.
Existing guidance errs very much on the side of caution, which, although correct, demonstrates the difficulty in differentiating between lesions, and partly why definition is so important [ 62 ]. Clearer guidance is needed for both health professionals and drug users on skin problems. The findings revealed a high prevalence of leg ulceration in the sample population of young injecting drug users.
Later studies have agreed with this figure [ 65 , 66 ], and therefore, the prevalence of leg ulceration within an injecting population is worryingly high.
This finding is of concern as once ulceration occurs, the long-term impact on health services may become onerous. Generally, this is a disease of old age and prevalence is known to increase with age [ 68 ]. Whilst considered a disease of the elderly population, it is not rare to develop ulceration before middle age. Work by Mackenzie et al. In mainstream studies of leg ulceration, it is possible that injecting drug use is not considered as a risk factor, especially if illicit use is hidden for example in femoral injectors [ 70 ].
However, if younger people are increasingly experiencing leg ulceration, then the impact on health services will be pronounced as recurrence occurs and as sufferers age. Leg ulceration is end-stage venous disease [ 34 ] and a chronic recurrent condition which is costly, not just in terms of treatment but long-term prevention of recurrence and also in terms of human suffering [ 71 ].
The ulcers can be painful, malodorous and debilitating, badly impacting on quality of life and costly to treat [ 72 - 74 ]. The impact on younger people may arguably be more severe, preventing normal activities and possibly even employment, and the ulceration may affect lives long after drug use has ceased [ 75 ]. Treatment for venous ulcers in a more elderly population consists of regular and frequent intervention, usually with specialised compression therapy requiring expert nursing staff and considerable time to achieve healing.
Generally, compression bandaging is followed with long-term compression hosiery. Frequent appointments for treatment and long-term follow-up can be challenging to achieve amongst a drug-using population with chaotic lives who often have unstable accommodation arrangements, and there are no specific guidelines to help practitioners manage this particular population.
Of course, the life expectancy of an injecting drug user may be reduced, and therefore, the figures for long-term injectors and older injectors in this study need to be interpreted with caution due to reduced life span and bias as a result of early death [ 76 ].
Within the general population, women tend to develop leg ulceration more commonly than men [ 77 , 75 ], and this increased prevalence is borne out within this study. It has been suggested, although not conclusively, that this is due to hormonal differences or longevity [ 78 ]. It may also be that women may tend to be more determined to hide the visual evidence of injecting and opt to inject in the groin which impacts on disease processes in the lower leg [ 6 ]. Femoral injecting may increase the risk of deep vein thrombosis due to repeated puncture, scarring and narrowing of the femoral vein [ 32 ], and one of the complications may be distal venous disease, including leg ulceration.
In Glasgow, femoral injecting is relatively common and the link between using this site and the high rate of leg ulceration is worth exploring in the future. This original paper reports on a unique empirical study to determine the prevalence of skin problems and leg ulceration in a sample of intravenous drug users. This is the first paper that the authors are aware of that sets out to carefully define skin lesions caused by injecting and quantify these within a sample.
This study demonstrates that skin problems are a significant, widespread issue for young injecting drug users. At Southern California Sunrise, we specialize in the treatment of meth addiction at our Mission Viejo inpatient facility. Learn more about how we can help you get your life and health back on track today. Opioids like heroin are made from morphine, a natural substance taken from the seeds of various opium poppy plants. Black tar heroin is a black. According to the National Center for Biotechnology Information, an estimated 9.
They also. Abuse of opioids has become a national health problem. Ketamine is an FDA-approved drug that is typically used for pain relief after surgery. Because ketamine is a potent dissociative anesthetic, it can be harmful. In the U. In addition to being highly addictive, opioids are commonly abused both with and. Relapse happens when an individual who has been clean from drugs or alcohol returns to these substances and begins to abuse them again. The active. If you or a loved need to safely detox from drugs or alcohol, contact Southern California Sunrise Recovery Center Today.
Call Blog Menu. Laguna Niguel. Mission Viejo. Orange County Rehab. Orange County Detox. What We Treat. Southern California Rehab. Alcohol Abuse. Drug Abuse. What is PTSD? What Exactly Is Meth? Meth face usually includes dental problems, skin issues, sores, false aging, and an overall deterioration of the face. The negative effects of meth on the face typically get worse with heavier and more frequent use. When meth use stops, many of these effects can be reversed, but these changes often take time, effort, and professional help.
What Are Meth Sores? Long-term use of meth causes sores on the face and body for many users. Meth sores may take the form of everything from small dots to large blisters or scabs that have become infected. On the face specifically, meth causes acne-like blemishes.
What Is Meth Mouth? Meth mouth is noticeable damage to the mouth and surrounding skin as well as the collection of dental problems from methamphetamine abuse. Dental problems from meth mouth can include yellow teeth, tooth decay, cavities, missing teeth, broken teeth, gum infections, and gum disease.
With time these problems get worse. Meth face is caused by a combination of mechanisms of how the body metabolizes methamphetamine as well as several behavioral factors as a result. Changes in appearance in different parts of the face will also be attributed to different causes.
It causes the body to work overtime because it increases heart rate and blood pressure. Depending on how cocaine is being ingested, other skin conditions may appear. Crack use often also causes skin burns from the hot pipe. Since crack use suppresses the immune system, it takes a lot longer for crack addicts to heal from these injuries. Skin problems for drug abusers and alcoholics can seem like commonplace, but even prescription medicines are known to also cause skin problems and damage, particularly stimulants.
There are many different types of prescription stimulants. Different prescription stimulants can cause different types of skin disorders. Not everyone will experience skin disorders from using these drugs. It all depends on your genetic makeup. Prescription stimulant use can cause rashes, hives and hypersensitivity.
Angioedema can also be a reaction to prescription stimulant use. This is a swelling of the epidermis, just below the skin. Serious conditions that have been linked to prescription drug use include Stevens Johnson Syndrome and toxic epidermal necrolysis. Stevens Johnson Syndrome is essentially a skin disease that appears if an individual is allergic to a prescription stimulant.
Not everyone will be allergic, so only a handful of users will ever experience this condition. Stevens Johnson Syndrome causes symptoms like:. The rashes can turn into blisters, and they will spread to other parts of the body. Blisters usually appear near the mouth, the nose, the eyes and the genitals.
After the blisters have formed, the skin in those areas will shed within a few days. If you are using prescription stimulants, and you experience this disorder, you should seek immediate medical attention before the condition gets worse. Toxic Epidermal Necrolysis , otherwise known as TENS, is also a skin disorder that can be caused by prescription stimulant use. This condition appears when an individual has a negative reaction to the stimulants.
The reason behind the negative reaction is unknown. As a result, this skin disorder only affects some patients and not others. The disorder involves shedding of the skin, hair and nails. Those affected often feel cold and are hypersensitive. An alcohol addiction can lead to major consequences for your physical health. Here are some common alcohol-related skin conditions:. Over time, dilation of the blood vessels. Also, this condition can cause blood vessels to become leaky, which leaves the skin with a puffy appearance.
Alcohol is a powerful diuretic — which means the stuff makes you urinate more frequently. This prevents your kidneys from effectively extracting water from the urine. When this happens, the skin becomes lackluster, dull, and lifeless. It also becomes itchy and scaly. Also, you should know that — like cocaine and crystal meth — alcohol speeds up the aging process.
Most people who have an addiction to alcohol look much older than they are. Needless to say, the aging process shows up on the face and it is irreversible. One of the most common complaints we hear from recovering people who come to us for alcohol addiction treatment is how alcohol has affected their face.
Alcoholics are also prone to developing skin conditions like urticarial reactions, pruritus, psoriasis, seborrheic dermatitis and cutaneous stigmata of cirrhosis. This is because alcohol substantially lowers immune function. Luckily, these skin conditions will usually heal themselves once an individual has quit drinking. Prolonged alcohol use can lead to jaundice, a serious liver disease.
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