The skin ulcers may be the result of injecting accidents (meant to inject into a vein and missed) or intentional.
Factors contributing to the ulcerations:
(1) direct effect of the drug of abuse
(2) effect of drug vehicle
(3) secondary infection
(4) comorbid conditions like diabetes, HIV infection, etc.
(5) autoimmune disease secondary to comorbid conditions
(6) malnutrition
Control of the ulcerations requires:
(1) stopping the injection drug use
(2) addressing comorbid conditions contribute to the ulceration
(3) improving nutritional status
Reece used naltrexone hydrochloride implants to help control the opiate abuse. The naltrexone may contribute to skin ulcer healing since it stimulates cell growth.
