Demographic Description of the Presentation and Treatment of Lower Extremity Skin and Soft Tissue Infections Secondary to Skin Popping in Intravenous Drug Abusers

Drug use generations and patterns of injection drug use: Birth cohort differences among people who inject drugs in Los Angeles and San Francisco, California

“…This can occur with injection of opiate prescription medications (an increasingly difficult task with the advent of abuse deterrent formulations of these drugs) or through switching to heroin, which is cheaper and has increasingly become available throughout the US (Carlson et al, 2016; Cicero and Ellis, 2015; Jones, 2013). National and local studies have now confirmed that the vast majority of young heroin users began opioid use with prescription drugs (Cicero and Kuehn, 2014; DeBeck et al, 2016b; Novak et al, 2016; Peavy et al, 2012; Pollini et al, 2011) and that heroin use is strongly associated with injection routes of administration (Novak and Kral, 2011; Pirozzi et al, 2014). As a consequence, we would expect the current trend of increased drug injection among younger cohorts in the US to continue (Chatterjee et al, 2011; Klevens et al, 2015).…”

Not in the vein: ‘missed hits’, subcutaneous and intramuscular injections and associated harms among people who inject psychoactive drugs in Bristol, United Kingdom

“…This difficulty with vascular access can result in accidental subcutaneous and intramuscular injections -'missed hits' (Hankins , Palmer, & Singh, 2000;Rhodes, Briggs, Kimber, Jones, & Holloway, 2007). In addition, for some people who inject psychoactive drugs (and also for those people who inject image and performance enhancing drugs, such as anabolic steroids and melanotan) their usual injection practice will be subcutaneous ('Skin Popping') or intramuscular ('Muscle Popping') (Binswanger, Kral, Bluthenthal, & Rybold, 2000;Pirozzi, Van, Pontious, & Meyr, 2014;.…”

“…Intentional or accidental subcutaneous and intramuscular injections among people who inject psychoactive drugs are known to be a risk factor for injection related bacterial infections (Binswanger, Kral, Bluthenthal, & Rybold, 2000;Pirozzi, Van, Pontious, & Meyr, 2014), particularly those caused by anaerobic organisms, such as, wound botulism and tetanus (CDC, 1995;Brett, Hood, Brazier, Duerden, & Hahne, 2005;Palmateer, et al, 2013).…”

Lower extremity manifestations of “skin-popping” an illicit drug use technique: A report of two cases

“…The patient's lack of motivation to heal the "shooter's patch" is the most challenging barrier, as it is the primary means to the abuser's offending habit. An example seen in a study by Pirozzi, et al where 73.47% of their skin popping subjects did not return for scheduled outpatient visits [10]. The patient requires physical and medical attention, but also full emotional, social, and even spiritual support.…”