A Musculoskeletal Syndrome in Intravenous Heroin Users

Abstract

During a recent 5-mo. period, 16 i.v. heroin users were hospitalized with a previously unrecognized complication of drug abuse. The characteristic symptoms were similar in all patients and included fever, paraspinal myalgias and periarthritis. There was no evidence of bacterial infection, hepatitis or drug abstinence as the cause of these musculoskeletal symptoms. Continued heroin use was associated with progressive musculoskeletal symptoms, while discontinuation of heroin use resulted in complete recovery. Antibiotics did not affect the outcome, and the syndrome was self-limited in all hospitalized patients. The pathogenesis of this syndrome is unknown but may be related to the brown heroin.