)rug abuse iI a global social and health problem. It seems that all
:ountries arc affected including conservative and stable countries
ike Saudi Arabia. In 1994, 579 new cases of drug :llld alcohol
,dwclion were reported in Saudi Arabia, which represelllcd I. I'"
,f all the new psychiatric cascS. There was a 30% increase in the
,lUmber. of drug ulera compared with the 1993 statistics.'
Cenainly, the magnitude of the problem haa already been noticed
in other countries.1-4 In the United States, the state of Michigan
1I0ne, for example, had an estimated 50000 imravcnous heroin
lIsen in 1988.'
Modern addicts arc quite sophisticated with regard to intravenous
access aites. However, tltis is not the case in developing
countriea where they prepare and inject these substances in a printitive
way. In Saudi Arabia, heroin addicts dissolve approximately 1g
of heroin in 100 mL tap water, boil the ntixture, filter it, then inject
themselves in any accessible vessel. Some heroin addicts require
more than 10 g/day. This repeated septic vascular access results in
serious life and limb-threatening complications. The adverse socioeconomic
consequences of this self-abuse arc not only reflected on
the addicts themselves, but also extend to involve each member of
their families, particularly when the addict loses one of their limbs.
In this article, the firSt series of patients with vascular complications
of drug abuse in Saudi Arabia is reponed. The best surgical
approaches will be discussed
The Journal of the Royal College of Surgeons of Edinburgh