People who inject illicit drugs have a risk for getting wound botulism (“BOT-choo-liz-um”), a serious illness that can be life-threatening. Your risk of getting wound botulism increases if you inject illicit drugs, especially black tar heroin, under your skin (“skin popping”) or into your muscle (“muscle popping” or “muscling”).

Wound botulism is a rare but serious illness that happens when a germ called Clostridium botulinum gets into a wound and makes a toxin. This toxin attacks your body’s nerves, which can make it hard to breathe and can cause muscle weakness and even death. If you get wound botulism, you will need medicine called antitoxin. The antitoxin can stop the toxin from causing more harm, but it can’t undo the damage already done. Even after receiving antitoxin, you might need to stay in the hospital for several weeks or even months before you recover enough to go home.

If you get wound botulism and don’t get medical treatment, you might die. If you have symptoms of wound botulism, see a doctor or go to an emergency room immediately.

What to Watch For

Symptoms of wound botulism usually appear several days after injecting contaminated drugs rather than immediately. That’s because it takes several days, or even a couple of weeks, for the germs to multiply in the body and produce the toxin.

Some of the symptoms you might have are:

  • Double vision
  • Blurred vision
  • Drooping eyelids
  • Slurred speech
  • Difficulty swallowing
  • A thick-feeling tongue
  • Dry mouth
  • Muscle weakness

As the disease gets worse, you may develop more symptoms, such as:

  • Difficulty breathing
  • Paralysis

You can get wound botulism even if the injection site doesn’t look infected.

If you or someone you know has symptoms of botulism, see a doctor or go to the emergency room immediately. If you do not, your symptoms may continue to get worse and can even be life-threatening. It is important to get medical care as quickly as possible, because the antitoxin and other treatments work better the earlier they are given.

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