Severe infections associated with opioid use often progress rapidly, especially when access to timely medical care is limited. This can cause devastating health effects, including life-altering amputations. Clinicians and local researchers have reported an increase in the number of amputations among opioid users, but national data describing long-term trends are limited.
The study, led by George Carandinos, MD, PhD, of Massachusetts General Brigham and Daniel Ciccarone, MD, MPH, of the University of California, San Francisco, looked at hospitalized patients in the United States from 2016 to 2022 to better understand how amputation rates have changed over time and across regions. Results are posted below Annals of Internal Medicine.
The study found that amputation rates increased for both opioid-related and non-opioid-related hospitalizations during this period, but the increase in opioid-related cases was particularly steep in the northeastern and western United States. Opioid-related amputations were also more likely to involve higher anatomical levels, such as above the knee or upper extremity, whereas non-opioid-related amputations were more likely to involve toes or parts of the foot.
The authors note that several factors may be contributing to this trend, including changes in the illicit drug supply. Although the increased presence of xylazine associated with severe tissue damage and difficult-to-treat wounds may play an important role, amputation rates also increased in areas where xylazine was not prevalent during the study period. At the same time, broader structural factors may also contribute, such as delays in treatment, limited access to wound care, and housing instability.
Overall, the findings highlight the increasing burden of serious but preventable harm among people using opioids and emphasize the need for early intervention.
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Reference magazines:
Karandinos, G. others. (2026). Amputation rates in U.S. opioid-related hospitalizations from 2016 to 2022. Annual report of internal medicine. DOI: 10.7326/annals-25-05273. https://www.acpjournals.org/doi/10.7326/ANNALS-25-05273
