Hirra Azmat
Srinagar: Who knew the short-lived drug-induced pleasure and happiness would cost him his arm one day? Asif, (name changed), a 25-year-old salesman at a shop was introduced to heroin by his friend three years ago. Of late, he decided to seek treatment for the de-addiction. However, he couldn’t get back on track and relapsed.
Last week, he rushed to the addiction treatment facility at SKIMS, Bemina with searing pain and a swollen arm. Asif had inadvertently injected a crushed tablet into his arm, given to him by the drug de-addiction center to help him get off intravenous drug abuse. It is to be taken orally as recommended.
Since the medicine is not for IV use, it can cause tissue injury in the limb and lead to muscle necrosis. Necrosis is the death of body tissue. It occurs when too little blood flows to the tissue.
“This is what happened in his case. As a result, his limb became swollen. Since such patients usually don’t have someone around to care, they present at the hospital late. He didn’t reach in time either,” the doctor treating him said.
The doctor said they had to perform an immediate surgical procedure to relieve the swelling and pressure in the concerned area. “Unfortunately most of his muscles were damaged by then. He’s still admitted and being monitored. We fear he might end up with an amputation eventually.”
Drug abuse in Kashmir has increased in alarming proportions. The latest study conducted by the Department of Psychiatry at Government Medical College, Srinagar has revealed that around 33 thousand syringes are used to inject heroin by drug abusers in Kashmir daily. Heroin is among the most common drugs used by these abusers and 90 percent of drug abusers are using heroin.
While the damage incurred by substance abuse is manifold, it leads to many health complications in the abusers which are less talked about. They include compartment syndrome and necrotizing fasciitis.
Orthopaedic Surgeon at SKIMS Bemina, Dr. Jibran Bashir told The Kashmir Monitor that drug overdose can occasionally lead to compartment syndrome (CS).
“In this type of syndrome, the pressure within the muscles builds to dangerous levels. This pressure can decrease blood flow, which prevents nourishment and oxygen from reaching nerve and muscle cells. Also, injecting a substance into the muscles or tissues rather than the veins may lead to increased intra-compartment pressures due to tissue injury,” Bashir said.
He said, similarly necrotizing fasciitis is another complication of chronic IV drug abuse. “Necrotising fasciitis is a rare but life-threatening complication of intravenous drug use. In drug users, it most frequently affects an injection site on the arm. It presents as an area of cellulitis ie red, swollen, tender skin with a fever. The patient can get extremely sick and may collapse in shock,” he said.
On average, the treatment facility sees at least two patients with post-injection complications in a month.
“Amputation is rare but patients who present late and are neglected may end up with severe limb infection and may need an amputation. Needle sharing may also lead to local and systemic infection by other bacteria. And since these patients are mostly immunocompromised, it may lead to sepsis and even death,” he said.
The doctor added, most of these patients are in the age group of 18- 26. They mostly present with signs and symptoms like redness, uncontrollable increased pain, swelling at the site and limb, numbness, and color changes.
“Prevention is seeking medical help at de-addiction centers. Also, it’s high time that we have multiple conversations about drug abuse and raise awareness of it.
He noted that more importantly, mental illness and substance abuse often go hand in hand. If you are dealing with a mental illness such as anxiety, depression, or post-traumatic stress disorder you should seek professional help from a licensed therapist or counselor.
“A professional will provide you with healthy coping skills to alleviate your symptoms without turning to drugs and alcohol,” Bashir said.
