The face of hillbilly heroin and other images of narcotic abuse.

The nationally recognized popularity of recreational intranasal oxycodone abuse among rural Appalachians is apparent to West Virginian healthcare providers. Three recent cases of narcotic-induced injury at WVU Ruby Memorial Hospital demonstrate the facial bone necrosis associated with "hillbilly heroin" abuse as well as other imaging features of narcotic-induced intracranial ischemia. This paper shows how diagnostic imaging may facilitate clinical evaluation of patients with narcotic abuse.