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What Is Cotton Fever?

Learn about cotton fever, a set of flu-like symptoms that can occur after injecting drugs. Find out how to prevent and treat it.

What Is Cotton Fever?

Cotton fever is a mysterious and potentially dangerous condition that primarily affects individuals who inject drugs. To fully comprehend the risks associated with cotton fever, it is important to understand what it is and how it occurs.\

Understanding Cotton Fever

Cotton fever, also known as "the shakes," is a term used to describe a set of flu-like symptoms that occur shortly after injecting drugs, particularly those prepared using cotton filters. It is not an actual fever caused by a viral or bacterial infection, but rather a reaction to the introduction of foreign substances into the body.

How Does Cotton Fever Occur?

Cotton fever is believed to occur due to the presence of bacteria or endotoxins on the cotton filter used to prepare drugs for injection. When the drugs are dissolved in water and filtered through the cotton, these contaminants can be introduced into the bloodstream. The body's immune system recognizes these foreign substances as threats and triggers an inflammatory response, leading to the symptoms associated with cotton fever.

The exact mechanisms behind the development of cotton fever are not fully understood, and research on the topic is limited. However, it is widely speculated that the bacteria or endotoxins present in the cotton filter are responsible for initiating the immune response.

Cotton fever is not exclusive to any particular type of drug. It can occur after injecting a variety of substances, including heroin, methamphetamine, and prescription opioids.

By understanding what cotton fever is and how it occurs, individuals can better recognize the symptoms and seek appropriate care. Educating oneself about the risks associated with drug use and the prevention of cotton fever is crucial for promoting overall health and safety.

Causes and Symptoms

Understanding the causes and symptoms of cotton fever is essential to recognize and address this concerning condition.

Contaminated Drug Use

Cotton fever is primarily associated with the use of illicit drugs, particularly those involving injection. It occurs when bacteria or endotoxins from contaminated cotton or drug paraphernalia enter the bloodstream. The most common source of contamination is the cotton filter used to prepare drugs for injection. However, it's important to note that cotton fever can also occur from other sources of bacterial contamination.

To prevent cotton fever, it is crucial to prioritize safe and hygienic drug use practices. Using sterile equipment, such as new needles and syringes, is essential. Additionally, avoiding the reuse of cotton filters and properly sterilizing drug preparation equipment can minimize the risk of contamination.

Onset and Duration of Symptoms

The symptoms of cotton fever typically develop within a few minutes to a few hours after exposure to contaminated substances. The onset is often sudden and may include:

  • High fever (above 101°F or 38.3°C)
  • Chills and shivering
  • Sweating
  • Muscle aches and pains
  • Headache
  • Fatigue
  • Nausea and vomiting

The duration of cotton fever symptoms can vary. In most cases, the symptoms subside within 12 to 24 hours without medical intervention. However, in some instances, the symptoms may persist for longer periods. Cotton fever is a self-limiting condition, meaning it resolves on its own without specific treatment.

If you or someone you know experiences symptoms of cotton fever, it is crucial to seek medical attention to rule out other potential causes and receive appropriate care.

By understanding the causes and recognizing the symptoms of cotton fever, individuals can take steps to minimize the risk of exposure and seek prompt medical attention if necessary. Spreading awareness about this condition and supporting individuals in recovery are vital in addressing the hidden danger of cotton fever.

Risks and Complications

When it comes to cotton fever, there are potential health risks and long-term effects that individuals should be aware of. Understanding these risks is crucial for taking appropriate measures to prevent and address this condition.

Potential Health Risks

Cotton fever is associated with the use of contaminated drugs, particularly those involving cotton filters. The introduction of bacteria or endotoxins into the bloodstream can lead to various health risks. Some of the potential complications include:

  • Fever: The hallmark symptom of cotton fever is a sudden onset of high fever, usually within 10 to 30 minutes after drug injection. The fever may reach temperatures as high as 104°F (40°C) and can persist for several hours.
  • Chills and Sweating: Along with the fever, individuals may experience intense chills and profuse sweating as the body tries to regulate its temperature.
  • Body Aches and Fatigue: Cotton fever can cause body aches, muscle pain, and general fatigue, making individuals feel weak and unwell.
  • Nausea and Vomiting: Some individuals may also experience nausea and vomiting as part of the symptoms associated with cotton fever.

It's important to note that cotton fever is a self-limiting condition, meaning it typically resolves on its own within 24 to 48 hours without the need for specific treatment. However, seeking medical help is recommended to manage symptoms and rule out any other potential complications.

Long-Term Effects of Cotton Fever

While cotton fever itself is usually short-lived, there can be potential long-term effects associated with repetitive episodes or complications arising from drug use. These effects may vary depending on individual circumstances and the overall health of the person involved. Possible long-term effects may include:

  • Organ Damage: Prolonged drug use, including the use of contaminated drugs, can lead to organ damage. The kidneys, liver, and cardiovascular system can be particularly affected.
  • Infections: The use of contaminated drugs increases the risk of infections, including bacterial infections and endocarditis, a serious infection of the heart valves.
  • Damage to Veins and Blood Vessels: Repeated injections and the use of unsterile needles can cause damage to veins and blood vessels, potentially leading to blood clots, collapsed veins, and other complications.

It is crucial for individuals who engage in drug use to seek appropriate medical care and support to address their substance abuse and reduce the risk of long-term health complications.

By understanding the potential health risks and long-term effects of cotton fever, individuals can make informed decisions about their well-being and seek the necessary support to address substance abuse and related complications.

Treatment and Prevention

When it comes to cotton fever, seeking prompt medical help is crucial for proper diagnosis and treatment. Additionally, taking proactive steps to prevent cotton fever can significantly reduce the risk of experiencing this condition.

Seeking Medical Help

If you suspect you or someone you know may be experiencing cotton fever, it is essential to seek medical attention immediately. Cotton fever can mimic symptoms of other illnesses, so it is important to inform healthcare professionals about any recent drug use or exposure to contaminated materials.

Medical professionals can conduct a thorough evaluation, including a physical examination and relevant tests, to determine the cause of the symptoms. They may also provide appropriate treatment to alleviate discomfort and manage any complications that may arise.

Preventing Cotton Fever

Prevention is key when it comes to cotton fever. By implementing certain precautions, individuals can minimize the risk of developing this condition. Here are some preventive measures to consider:

  • Proper drug preparation: If you are using drugs, ensure that the preparation process is carried out in a clean and sterile environment. Avoid using materials or equipment that may be contaminated, such as cotton filters or unsanitary needles. Proper hygiene practices can significantly reduce the risk of cotton fever.
  • Education and awareness: Educating yourself and others about the risks of cotton fever is crucial. By understanding the causes and symptoms of this condition, individuals can make informed decisions and take necessary precautions to prevent it. Spreading awareness can help create a supportive environment and encourage individuals to seek help if needed.
  • Access to resources: Individuals struggling with drug addiction may benefit from access to resources and support systems. Providing information on available treatment options, counseling services, and support groups can be instrumental in preventing cotton fever and addressing underlying substance abuse issues. Encourage individuals to seek professional help and offer support during their recovery journey.

By seeking medical help promptly and taking preventive measures, individuals can reduce the risk of cotton fever and its associated complications. Remember, open communication, education, and support are vital in addressing the challenges posed by this condition and promoting overall well-being.

Accessing Harm Reduction Resources

If you or someone you know is struggling with addiction and at risk of experiencing cotton fever, it's important to know that there are harm reduction resources available in many communities. These resources can help reduce the risk of infection and other health complications associated with IV drug use.

One such resource is a needle exchange program, which provides clean needles and other injection supplies to users free of charge. Needle exchange programs can also offer HIV and hepatitis C testing, referrals to medical care, and counseling services.

Another option is a safe injection site, where users can inject drugs under medical supervision in a clean and safe environment. Safe injection sites can also provide access to medical care, addiction treatment services, and other support resources.

To find harm reduction resources in your community, you can reach out to local health departments or community organizations that specialize in addiction and harm reduction. They may be able to provide information on where to access these resources or connect you with local programs.

Remember, accessing harm reduction resources can help protect your health and reduce the risk of experiencing cotton fever or other negative effects of IV drug use. Don't hesitate to seek out these resources if you need them.

Educating Others

It is essential to spread awareness and support individuals who may be at risk or affected by cotton fever. By educating others about cotton fever, we can help prevent its occurrence and provide resources for those in need.

Spreading Awareness

One of the primary ways to combat cotton fever is by spreading awareness about its dangers and how it occurs. By educating parents, families, and teachers about cotton fever, we can help them recognize the signs and symptoms and take appropriate action.

Here are some key points to consider when spreading awareness about cotton fever:

  • Explain what cotton fever is and how it occurs, emphasizing that it is a potential health risk associated with contaminated drug use.
  • Discuss the symptoms of cotton fever, such as high fever, chills, and muscle aches, to help individuals identify potential cases.
  • Emphasize the importance of seeking medical help immediately if cotton fever is suspected. Provide information on where to go for medical assistance.
  • Share informative resources and articles on cotton fever to further educate individuals.

By spreading awareness, we can help prevent cotton fever and ensure that individuals have the knowledge they need to take appropriate action if they suspect an infection.

Supporting Individuals in Recovery

Supporting individuals in recovery from drug use is vital for their well-being and preventing future cases of cotton fever. Here are some ways you can provide support:

  • Encourage open communication: Create a safe and non-judgmental environment where individuals feel comfortable discussing their challenges or experiences. This can help them seek help if they suspect cotton fever or want assistance in overcoming drug use.
  • Provide resources: Share information about local support groups, counseling services, and treatment centers that can assist individuals in their recovery journey.
  • Offer emotional support: Be understanding and empathetic towards individuals in recovery. Let them know that they are not alone and that you are there to support them throughout their journey.
  • Educate about prevention methods: Inform individuals about strategies to prevent cotton fever and the importance of using sterile materials when preparing drugs.
  • Promote healthier alternatives: Encourage individuals to explore healthier alternatives to drug use and provide information about support programs that can assist in their recovery process.

By supporting individuals in recovery and promoting a supportive environment, we can help reduce the risk of cotton fever and aid in their overall well-being.

Remember, education and support are crucial in addressing cotton fever and its associated risks. By spreading awareness and providing assistance, we can make a positive impact on individuals' lives and contribute to a healthier and safer community.


Can cotton fever be fatal?

In most cases, cotton fever is not fatal. However, in rare cases, it can lead to more serious health complications such as sepsis or endocarditis.

Can you get cotton fever from smoking drugs?

No, cotton fever is only associated with injecting drugs into your bloodstream.

How long does cotton fever last?

The symptoms of cotton fever usually last for a few hours to a day. However, in some cases, they can persist for longer periods of time.

Can you get cotton fever from using clean equipment?

While using clean equipment can reduce your risk of getting cotton fever, it is still possible to contract the bacteria that causes it. It's important to always use new cotton balls or filters and sterile equipment when injecting drugs.

Is there any way to test for cotton fever?

There is no specific test for cotton fever. If you experience flu-like symptoms after injecting drugs, it's possible that you have contracted the bacteria that causes it. Seeking medical attention if your symptoms persist or worsen is always recommended.


Cotton fever is a common term used to describe flu-like symptoms that occur shortly after injecting drugs into your bloodstream. It's caused by bacteria that can grow on cotton balls or other materials used to filter drugs. The best way to prevent cotton fever is to avoid injecting drugs altogether, but if you are an IV drug user, there are steps you can take to reduce your risk. If you do get cotton fever, rest and stay hydrated, take over-the-counter pain relievers, and apply a cold compress to your forehead to help alleviate your symptoms.


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