Chronic Ulcers Caused by Injection of Substances

Obesity, insulin-dependent diabetes mellitus, a sedentary lifestyle, and chronic ulceration can all be complicated by refractory substance abuse. A case is presented featuring significant improvement of these parameters and others, including successful resolution of the refractory ulceration after control with naltrexone hydrochloride implants. The case is important both as a novel form of treatment for ulcer healing in drug-dependent persons, and for potential pathophysiological insights to wound healing that might be suggested by the likely mechanisms of action of naltrexone.