Department of Anesthesiology, University of Minnesota, Minneapolis, MN, USA
*Corresponding author: Ratan K Banik, Department of Anesthesiology, University of Minnesota, Twin Cities Campus, B515 Mayo Memorial Building, 420 Delaware Street SE, MMC 294, Minneapolis, MN 55455, USA. Fax: 612 626-2363; E-mail: rkbanik@umn.edu
Received: February 10, 2024; Accepted: April 05, 2024; Published: April 11, 2024
Chronic pain is common among patients with illegal drug use. In a recent study, 87% of percent of patients who were screened positive for illegal drug use suffered from chronic pain [1]. It is therefore important for pain physicians to recognize cutaneous signs of drug abuse. Injections with some illicit drugs can result in skin scarring, dark pigmentation in the puncture site, which are called track marks [2]. Figure 1 shows a picture of the arm of a 33-year-old male, who has a history of heroin abuse and was noted to have the characteristic linear hyperpigmented track marks on his non-dominant forearm. Heroin is well known for creating these track marks [3]. Heroin is sold in the US drug market as white powder (snorted) or black tar heroin (intravenous or intramuscular) [4]. Black tar heroin is usually mixed with quinine, mannitol, dextrose, lactose, and/or baking soda, which can cause sclerosis in the veins [5]. The most common site for track marks is the forearm of the non-dominant hand. Interestingly, intravenous use of cocaine usually does not induce track marks. It is important to note that the lack of track marks does not preclude IV drug use.
This work was supported by the Department of Anesthesiology, University of Minnesota.
not applicable.
The case was presented to the American Society of Anesthesiologist Annual meeting in 2019.
Authors declare no conflicts of interest within the 36 months of submission.
Citation: Banik RK, Zaro A, Goelkel-Garcia L (2024) Teaching Image: Cutaneous Signs of Illicit Drug Abuse. J Anes Rese 2: 003.
Copyright: © 2024 Banik RK, et al., This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
