A life-threatening condition called sepsis kills hundreds of people in American jails and prisons each year, a USA TODAY investigation has found, but inmates with a history of drug use are at particular risk.

“Chronic intravenous drug use,” “extensive drug history,” and “suspected illicit drug withdrawals” are just some of the notes USA TODAY found among in-custody death records of inmates who died with sepsis between 2015 and 2023.

Dirty needles can introduce bacteria and viruses straight into the bloodstream, putting drug users at higher risk for infection, doctors say. Sometimes, these infections lead to sepsis, an extreme immune system reaction to infection that quickly causes organ failure and death when left untreated.

That can easily happen behind bars, where inmates told USA TODAY their medical concerns are often doubted and care is delayed.

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