Mexican black tar heroin is the most commonly sold form of the drug in the Western United States and also one of the most impure.
The infections, so far, have appeared only in people who inject black tar heroin under their skin or into their muscles.
California cases occurred in chronic drug abusers who turn to injecting black tar heroin
, a dark, gummy, cheaper form of the narcotic, into their skin when their veins have given out.
At Buckley Center, a sobering and treatment facility in Eugene, Director Bob Richards said black tar heroin
is no less prevalent now than it was five years ago.
Unusual infections have been linked to subcutaneous or intramuscular drug use, including tetanus and wound botulism among heroin and black tar heroin
users, respectively, in California [9,10], and group A streptococcal infections among cocaine users in Switzerland .
Most of the heroin supplied to the Southwest is available in the resinous form called "black tar" (27,28 ); the use of black tar heroin
may be increasing in this region (29).
In California, subcutaneous injection of Mexican black tar heroin
has been associated with a recent increase of wound botulism caused by infection with C.
All cases except one since 1991 have occurred in injecting-drug users, and many involved subcutaneous injection or "skin popping" of black tar heroin.
On September 23, a 44-year-old male user of black tar heroin developed an abscess on his right arm, which was treated unsuccessfully with cephelexin and ciprofloxacin; on September 29, the abscess was incised and drained.
On September 25, a 30-year-old pregnant woman who reported last skin popping black tar heroin on September 24 sought care at an ED in Ventura County because of a sore throat and the sensation of "heavy eyelids.