Surgical implications of rising heroin abuse

With heroin abuse on the rise in the United States, related surgical complications are also increasing, including severe infections and complications related to heroin injection. A firsthand perspective on how acute care surgeons can best help reduce heroin-related morbidity and mortality is presented in an article published in Surgical Infections.

In "The Heroin Epidemic in America: A Surgeon's Perspective," Gary Vercruysse, MD, University of Michigan (Ann Arbor) and coauthors from University of Nebraska (Omaha), University of Arizona (Tucson), and University of Maryland Medical Center (Baltimore) discuss the changing demographics of heroin abuse in the U.S., including growing numbers of women and white Americans. They focus on the main complications of heroin injection, including skin and soft tissue infections, septic thrombophlebitis, and mycotic pseudoaneurysms. Necrotizing soft tissue infection and other types of problems such as bacteremia can also occur. Rapid recognition and management of these complications may be life-saving.

"Infections following the self-administration of heroin and other injectable agents have increased in frequency and severity. These infections are being identified across all cultures and ethnic groups and can no longer be viewed as a problem of minorities and indigent patients," says Surgical Infections Editor-in-Chief Donald E. Fry, MD, Northwestern University Feinberg School of Medicine, and Executive Vice-President MPA Healthcare Solutions, Chicago, IL.