The Needle and the (Infectious) Damage Done

People have been injecting drugs for a long time now. And when people shoot up, often in unsanitary settings, with shared needles, infections are bound to follow. We can’t help recalling the grisly amputation sequence in Requiem for a Dream, when Jared Leto loses an arm to a needle-related infection. Things don’t have to reach extremes like that to be a problem, however. Researchers at the University of Texas, in collaboration with Indian researchers in Mumbai, concluded in the Journal of Medical Microbiology that injecting drug users are susceptible to “pulmonary, endovascular, skin and soft tissue, bone and joint, and sexually transmitted infections caused by a wide range of bacterial, viral, fungal and protozoal pathogens.” Yuck. In addition, “injection drug users are at increased risk for infections such as human immunodeficiency virus, hepatitis B virus, hepatitis C virus, tetanus, and malaria.” And we’re not done yet: “Illicit drugs also affect several components of the complex immune system and thus modulate host immunity.” Finally, there are the ancillary factors: “Lifestyle practices such as multiple sexual partners, overcrowded housing arrangements and malnutrition serve as co-factors in increasing the risk of infection.” But if you want to get really technical, we need to pay particular attention to “unconventional routes of transmission (malaria transmitted via injection equipment), re-emergence of old diseases (tetanus), unfamiliar pathogens (Paenibacillus larvae), specific drug-infection associations (black tar heroin and wound botulism), atypical sites of infection (cutaneous diphtheria), outbreaks of rare infections (anthrax)….” Okay, enough.