Table of Contents
Key Points
- Cotton fever is a medical condition that can happen when you misuse intravenous (IV) drugs that have cotton as a filter.
- The symptoms of cotton fever may include a high fever and a general feeling of illness, mimicking an infection.
- Cotton fever is typically a self-limiting condition that resolves without treatment.
Cotton fever is a medical condition that can happen if you misuse intravenous (IV) drugs that have been filtered through cotton. It usually presents as an infection with a fever and fast heart rate, but it’s not an actual infection.
Cotton fever often resolves without intervention and isn’t generally life-threatening, but complications can occur. Learn more about cotton fever causes, symptoms, and treatment.
What Is Cotton Fever?
As the name indicates, cotton fever is a medication condition that causes a high fever after using IV drugs with cotton as a filter. It only happens with non-medical IV drugs, such as illicit IV drugs.
Cotton fever can have uncomfortable symptoms, but it’s not usually dangerous. However, using IV drugs to the point of experiencing cotton fever can be an indication that your drug abuse has become a more serious problem.
Cotton Fever Causes
Cotton fever occurs when cotton from a cotton plant is used to filter heroin or other IV drugs. However, it can happen even if cotton filters aren’t involved. Medical researchers don’t fully understand the cause of cotton fever, but it may be the body’s immune response to cotton particles that remain in the drugs. When the cotton particles are injected into the body of intravenous drug users, the immune system may have a temporary response that causes a fever.[1]
If cotton particles end up in the bloodstream, chemical reactions may cause a fever and other symptoms, including general malaise or feeling unwell. Others believe that cotton fever may be caused by an endotoxin response from the Enterobacter agglomerans bacteria that live in cotton.[2] This mild toxin is in the cotton, which ends up in the drug and later the bloodstream, causing a reaction.
The medical community generally accepts the endotoxin response as the cause of cotton fever, but research has not fully demonstrated this.
Cotton Fever Symptoms
Cotton fever doesn’t have a lot of research or case studies, so there’s no list of symptoms like more common conditions. Several symptoms are often reported, however, including:[3]
- High fever
- Abdominal pain
- Chest pain
- Headache
- Chills
- Tachycardia (Fast heart rate)
The symptoms of cotton fever usually occur immediately after using an IV drug filtered with cotton. Doctors usually look for other possible causes before determining that the condition is cotton fever (diagnosis of exclusion).
How Is Cotton Fever Treated?
Without a definitive cause, the treatment for cotton fever seeks to treat the symptoms instead of trying to cure the condition. Supportive care may be provided, but cotton fever is often self-limiting, with symptoms that resolve after about 12 hours without any treatment.[4]
Other conditions can present, like cotton fever. Supportive care can help relieve the symptoms until they subside on their own. If they don’t go away, it could indicate that another condition is causing them.
Is Cotton Fever Life-Threatening?
Cotton fever can be unpleasant and uncomfortable but is not usually dangerous. The symptoms often subside on their own within a short period, but you may require supportive care to avoid any issues with dehydration or pain. Some people have mild to moderate cotton fever symptoms that can be managed at home with fluids and an anti-inflammatory medication like Tylenol (acetaminophen).
What Are IV Drugs?
Intravenous drugs, or IV drugs, are drugs that are injected into a vein. Heroin, cocaine, methamphetamine, prescription stimulants, and opioids are the most common IV drugs. Prescription drugs may be used intravenously in a medical setting by a doctor. However, they’re also misused by crushing tablets and dissolving them in water to inject the drug into a vein.
Injecting a drug into the vein leads to a faster onset of effects than other methods of use because it delivers the drug directly to the bloodstream. It often requires a lower dose than inhaling or ingesting the drug as well.
The drugs all enter the bloodstream at once, bringing an intense high that’s often short-lived. The rapid and intense effects can make it more appealing to binge the drug, leading to repeated use and rapid dependence.
Aside from cotton fever, recreational IV drugs have other dangers. Using an IV substance leaves you vulnerable to the adverse effects of the drug and associated complications like bloodborne infections, injection site reactions, and an increased risk of overdose.
When to Seek Medical Treatment
Cotton fever can happen after using IV drugs, especially if you use them often. While the condition is self-limiting, other complications can occur that have more serious risks – like addiction.
IV drug use is often associated with a severe form of addiction that increases the risks of overdose and health problems.[5] If you have been using IV drugs enough to experience cotton fever, it can indicate that your addiction has progressed.
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), addiction is a substance use disorder with the following criteria:[6]
- Taking larger amounts of a substance or taking it over longer periods than intended
- A persistent desire or unsuccessful effort to cut down or control substance use
- Spending a lot of time obtaining, using, or recovering from the substance
- Craving to use the substance
- Recurrent use of the substance failing to fulfill major role obligations at work, home, or school
- Continued use of the substance despite having persistent or recurrent social or interpersonal problems
- Giving up important social, occupational, or recreational activities to engage in substance use
- Recurrent substance use in situations in which it is physically hazardous
- Continuing substance use despite knowledge of having persistent or recurrent physical or psychological problems
Addiction Treatment
An addiction to any drug is difficult to recover from. Comprehensive addiction treatment programs can help you manage the physical withdrawal and discomfort, as well as the social and emotional aspects that contribute to addiction.
Depending on the drug involved, medical detox is often the first step to keep you safe and comfortable. Withdrawal can be unpleasant at best and dangerous at worst, but detox offers a medical team to manage your symptoms, administer medications as needed, and prevent complications.
Detox helps, but it’s not enough to overcome addiction on its own. Once detox is complete, you should undergo addiction treatment on an inpatient or outpatient basis. Treatment is always individualized but may include individual therapy, group counseling, peer support groups, family therapy, holistic therapies, or behavioral therapies.
Get Help for Addiction
Cotton fever is an unpleasant condition that occurs with IV drug use. While it’s not usually life-threatening, cotton fever can be uncomfortable and may indicate that your substance abuse is a problem and requires treatment.
Frequently Asked Questions
Below are some of the most frequently asked questions regarding cotton fever
OCEAN RECOVERY EDITORIAL GUIDELINES
The internet contains a vast amount of misinformation, but when it comes to your health only peer reviewed, research centered data matters. At Ocean Recovery, all content published throughout our website has been rigorously medically reviewed by a doctorate level clinician, and cross checked for medical accuracy. Our editorial process helps our readers trust that the information they are consuming is factual and based upon scientific data. Your health is our top priority, find out more about how we safeguard the integrity of information on our website. Read More About Our Process
