Heroin users say they experience a rush of excitement. A sense of happiness and warmth fills their bodies. Little do they know that, along with euphoria, a dangerous mold or fungus may also infect their brains.
A local neurologist is now warning that a very real, but little known, consequence of heroin use is a devastating fungal infection that may invade the user’s brain.
“These are young lives that are taken away very quickly and unexpectedly,” said Dr. Simona Ferioli, a neurologist with the neurocritical care team at the University of Cincinnati Neuroscience Institute.
Ferioli says the source of this brain infection is a mold that contaminates the heroin, the needles used to inject the heroin or the tools used to inhale it.
“Once it reaches the blood stream, either through dirty needles or sometimes through snorting of drugs, it can have very lethal consequences,” said Ferioli. “It invades the brain [and] creates a severe inflammation that ultimately leads to increased intracranial pressure that leads to death.”
The infection is called cerebral mucormycosis, a life-threatening fungal infection of the central nervous system most commonly found in intravenous drug users or in people with diabetes, cancer and weakened immune systems.
“Our communities need to be aware of this insidious type of brain infection as another deadly consequence associated with heroin abuse in otherwise young, healthy individuals,” said Ferioli. Ferioli and her colleagues, Drs. Joao Mc-O’Neil Plancher and Christopher Kiefer, documented the case of a young patient at the annual meeting of the American Academy of Neurology earlier this year.
Their patient, in his 20s, arrived in the emergency department with sleepiness, high fever and confusion. When a brain scan revealed an abscess — a pocket of infection — doctors treated him with heavy antibiotics, but the patient died in a few days. An autopsy confirmed that a yeast infection, mucormycosis, had invaded the blood vessel walls.
According to the Centers for Disease Control and Prevention, the infection is caused by fungi that are typically found in the soil, in decaying leaves, compost piles or rotten wood.
“Unfortunately this type of infection revealed to be a very aggressive mold that we commonly find in our soil or even in our household,” said Ferioli. “We don’t know for sure how this mold ended up reaching this young person’s blood stream, but either dirty needles … or by snorting substances that have been contaminated.”
As it turns out, this patient had a history of abusing heroin by inhalation, but even people trying heroin for the first time are at risk.
“Usually we think about heroin causing death because of overdose or in longtime users. This type of infection can occur anytime, however, even in first-time users,” said Ferioli.
She says she’s seen at least three similar cases in the same age group over the last three years.
Infections in Heroin Users
Ferioli said other types of infections in heroin users are fairly common. In IV drug users, the most common infections are from bacteria that enter the blood stream and damage the heart valves or travel to the brain and cause abscesses or infected arterial aneurysms that can rupture and result in massive strokes.
Fungal infections are less common in drug users. They can be less obvious to diagnose, but they can be rapidly fatal. For this reason, Ferioli urges doctors to be aware of the potential signs — fever, confusion, sleepiness, altered mental state and a possible history of drug abuse.
Ferioli warned that there is no safe method by which to use heroin or any other drug. “Not everybody knows that, among all the complications, lethal brain infection can really be associated with any drug abuse.”
According to the National Institute on Drug Abuse, other immediate effects of heroin use are:
- A pleasureable sensation, warm flushing of skin, dry mouth and heavy feeling in extremities.
- Nausea, vomiting and itching.
- Drowsiness and clouded mental function.
- Slower heart function.
- Slower breathing, which can be life-threatening.
- Irreversible coma and permanent brain damage.
To find a local treatment program for yourself or someone you know, type your ZIP code into the treatment locator sponsored by the Substance Abuse and Mental Health Services Administration.
Learn more
- Read more about the U.S. heroin epidemic from the U.S. Centers for Disease Control.
- Learn about heroin abuse from the National Institute on Drug Abuse and about drugs and children from the Partnership for Drug-Free Kids.
- Read what it feels like to use heroin.
- Find local treatment programs through the Substance Abuse and Mental Health Services Administration.
- Read about cerebral mucormycosis from the CDC and National Institues of Health.
- The National Institute on Drug Abuse offers information on the short-term effects of heroin use and on medical complications from long-term use.
- Read an article in the medical journal Neuology on a patient who died of a fungal brain infection after inhaling heroin. It was written by Cincinnati Drs. Ferioli, Kiefer and Mc-O’Neil Plancher.
