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Wound care and IV therapy for a person who uses drugs treat infections and skin injuries that can become medically dangerous without hospital-level attention. These include injection-related wounds, abscesses, and infections that have spread into the bloodstream or bone. If your loved one has a wound that isn't healing, or an infection tied to substance use, treating the wound and treating the substance use disorder at the same time gives the best chance at a full recovery.
This guide is written for you, the family member or caregiver watching someone you love struggle with a wound, an infection, or both. It explains what these conditions are, why they sometimes require inpatient hospital care rather than a walk-in clinic, and what you can do to help without overstepping. Valley Forge Medical Center (VFMC), a hospital-based treatment center in Norristown, Pennsylvania, describes itself as the leading provider of addiction wound care in the state, so this is a topic its clinical staff sees every day.
What kinds of wounds and infections are we talking about?
The most common wounds tied to substance use are injection-related, meaning they develop at or near a site where someone has injected a drug. Increasingly, these wounds are linked to xylazine, an animal sedative that has been showing up mixed into the fentanyl supply and is known to cause deep, slow-healing skin wounds even at sites far from the injection point, according to the DEA and CDC.
Other conditions VFMC treats include venous stasis wounds (skin breakdown caused by poor blood return in the legs), stage II and some stage III pressure ulcers (skin damage from prolonged pressure, often from being immobile for long periods), and abscesses (pockets of infection under the skin). IV therapy, meaning medication delivered directly into a vein, is often used for endocarditis (infection of the heart valves), osteomyelitis (infection in the bone), cellulitis (infection of the skin and tissue beneath it), and septicemia (infection that has spread into the bloodstream). Complications from hepatitis C or uncontrolled diabetes can also slow healing and make infections harder to fight.
Why does this need a hospital instead of an outpatient clinic?
Some wounds and infections are simply too unstable for outpatient treatment, especially when they're paired with withdrawal risk or another medical condition. A wound that's spreading, an infection that has reached the bloodstream, or a person who also needs medical detox all require close monitoring that an outpatient wound clinic isn't set up to provide.
This is where the term ASAM Level 4 comes in. The American Society of Addiction Medicine (ASAM) sets national standards for matching patients to the right intensity of care, and Level 4, called medically managed intensive inpatient services, is the highest level in that system. It means 24-hour nursing care and daily physician oversight inside a licensed hospital, which is exactly the setting needed when a wound infection and a substance use disorder are both active at once. VFMC's acute inpatient care is built for this combination, and its wound care program works alongside medical detox so both conditions are addressed together rather than one at a time.
Once your loved one is medically stable, the wound may still need dressing changes, IV antibiotics, or follow-up while the underlying substance use disorder is treated at a somewhat lower intensity, such as residential treatment. VFMC's case management team helps arrange that step down, which is one reason it's worth asking early about the full continuum of care rather than assuming hospital admission is the only option or the only step.
What should you watch for in your loved one's wound or symptoms?
Watch for redness that's spreading, increasing pain, warmth around the wound, or drainage that smells bad or looks different than before. These can be signs that a localized infection is getting worse or moving into deeper tissue.
Also pay attention to fever, chills, confusion, a fast heartbeat, or your loved one seeming unusually drowsy or hard to wake. These broader symptoms can point to an infection that has entered the bloodstream, which is a medical emergency and not something to wait out at home. If you see these signs, the right move is to get your loved one evaluated at an emergency department or call for medical help right away rather than trying to manage it yourself.
What questions should you ask the treatment team?
Start by asking what level of care your loved one has been placed in and why, and what the plan is if their condition changes. Ask specifically how the wound care plan and the substance use treatment plan connect, since treating one without the other tends not to hold.
Other useful questions include how long IV therapy is expected to last, what signs would mean a step up or step down in care, and who on the team is coordinating between the medical side and the addiction treatment side. VFMC's case management staff can usually answer questions about discharge planning, insurance coordination, and what comes after this stay, including aftercare and alumni support.
What should you avoid saying or doing?
Avoid framing the wound or infection as a consequence your loved one "brought on themselves." Shame doesn't speed up healing, and it often makes people less likely to tell staff about new symptoms or ask for help, which can delay treatment of something serious.
Try not to press for details about how the wound happened or push for promises about future substance use while your loved one is still medically unstable. Those conversations, if they happen at all, go better later, once the immediate medical situation is under control and there's room for a calmer discussion.
How does insurance or payment work for this kind of care?
Coverage depends on your loved one's specific plan, and in Pennsylvania that may include Medical Assistance behavioral health managed care or private insurance, each with its own rules about authorization and length of stay. VFMC's admissions team can review coverage details and walk you through what's typically involved before treatment starts.
Because costs vary by individual circumstances, VFMC does not quote prices in a blog post like this one. You can review general cost information on the price transparency page, and the admissions team can answer specific questions once they know more about your loved one's situation and coverage.
What happens after the wound heals?
Once a wound is stable and any bloodstream or bone infection has been treated, the focus usually shifts toward the substance use disorder that's connected to it. For many patients, that means moving from hospital-level care into residential treatment, a structured, live-in program that's less medically intensive but still provides daily support.
Wounds related to injection drug use can recur if the underlying substance use continues, which is part of why VFMC treats the two together rather than sending someone home with antibiotics and no addiction treatment plan. Case managers typically help line up follow-up wound care, outpatient appointments, and aftercare before discharge, so your loved one isn't leaving with loose ends. You can see how VFMC structures this whole process, from intake through discharge, on the what to expect page.
How do you get your loved one evaluated?
The fastest path is to call VFMC's admissions team directly, describe the wound or symptoms, and let them tell you whether hospital-level evaluation is appropriate. Admissions staff are used to fielding these calls from worried family members, not just patients themselves.
You can also review the full services overview to understand what's available beyond wound care, including detox and residential programs, before you call. Having a general sense of the options makes the first conversation with admissions faster and less overwhelming.
Frequently asked questions
Can a wound from drug use get better on its own without treatment?
Some minor skin irritation may improve on its own, but wounds tied to injection drug use, especially those linked to xylazine, often worsen without medical care and can lead to serious infection. If a wound is growing, draining, or not improving after a few days, it needs to be evaluated by a medical professional rather than watched at home.
Is IV therapy only used for severe infections?
IV therapy is generally reserved for infections that are too serious or too deep for oral antibiotics to reach effectively, such as endocarditis, osteomyelitis, or septicemia. A physician determines whether IV treatment is necessary based on how far the infection has spread and how the patient is responding.
Does VFMC treat the wound and the substance use disorder at the same time?
Yes. VFMC treats wound care, IV therapy, and substance use treatment together rather than sending patients elsewhere for one and back for the other, which is part of what makes its hospital-based model different from a standalone wound clinic.
What if my loved one refuses to go to the hospital?
You can't force most adults into treatment, but you can share what you've observed calmly and offer to help them call admissions or a medical provider when they're ready to talk. If there are signs of a medical emergency, such as confusion, fever, or a rapidly spreading infection, call for emergency medical help regardless of hesitation.
Will my loved one stay in the hospital the whole time?
Not necessarily. Many patients start in medically managed inpatient care while the wound or infection is unstable, then move to residential treatment once they're medically stable, with case management coordinating that transition.
Does VFMC only treat patients from Pennsylvania?
No. While VFMC is located in Norristown, Pennsylvania and serves patients throughout the state, it also treats patients traveling from New Jersey, Delaware, and New York.
This content is for educational purposes only and is not a substitute for professional medical advice. If you or someone you know is in crisis, call 988 or your local emergency number.
To talk with our admissions team, start the admissions process here or call (610) 539-8500. If you or someone you know is in crisis, call or text 988 anytime.
