Substance guides
IV drug use infections: Risks, prevention, and when to go to the ER
Published March 15, 2025 · 8 min read · Updated April 2026
Reviewed for accuracy by licensed clinical professionals.
Abscesses and cellulitis are the most common complication. Bacteria from skin, drugs, or equipment enter through injection.
Endocarditis
Bacteria infecting heart valves requires weeks of IV antibiotics, possibly surgery. Life-threatening.
Blood-borne viruses
Hepatitis C: 80% of new cases injection-related, now curable. HIV: sharing equipment transmits it. PrEP available for prevention.
When to go to ER
Persistent fever, red streaking from injection site, chest pain, confusion, or signs of sepsis. These progress rapidly.
Frequently asked questions
What infections from IV drug use?
Abscesses, cellulitis, endocarditis, hepatitis B/C, HIV, sepsis, and bone infections.
How to prevent infections?
Never share needles or equipment, use sterile supplies, clean injection sites, rotate sites, and seek treatment for any infection signs.
When to go to ER?
Fever, red streaking, inability to use the limb, or feeling systemically ill. IV drug infections can progress to sepsis rapidly.
Disclaimer: Informational only. Not medical advice. SAMHSA: 1-800-662-4357.