AN OUTBREAK of infections among people using legal highs has been reported by doctors.

More than 100 patients in the East of Scotland have been treated for the skin infection in the last six months, with many needing to stay in hospital for some time, and it is understood at least one person has had to have a limb amputated.

The problem is associated with the injection of legal highs often known as 'Burst' - a practice which seems to have become popular in the Edinburgh and Musselburgh area.

Jim Sherval, consultant in public health for NHS Lothian, said the frequency with which people were injecting the drug was leading to the infections.

While heroin users may inject around four times a day, he said anecdotal evidence suggests it is not unusual for people to inject Burst and similar products 10 times a day and as often as 30 times in extreme cases.

The legal high is based around a stimulant called ethylphenidate.

Mr Sherval said: "It is a stimulant. It is a sociable drug so people are injecting together more and they are sharing equipment."

So far 125 cases of the "soft tissue infection" have been treated in NHS Lothian since October last year. The infection starts with redness and swelling of the skin, but can develop to become a weeping wound. Many of the cases seen are described as "severe" and have required surgery.

Mr Sherval said the legal highs involved were "positively dangerous".

He said: "They may be legal, but they are absolutely not safe. They are very dangerous drugs and even if you swallow this particular drug it can also cause behaviour problems.

"People can behave very aggressively and that is causing difficulties for their friends and families and also when they appear at accident and emergency departments there is very violent, aggressive behaviour. It is difficult to manage."

Professor David Goldberg, epidemiologist for Health Protection Scotland (HPS), said surveys currently being undertaken suggest the habit of injecting the highs was concentrated in the Lothian area but this did not mean it would not spread.

The health board has written to retailers supplying the substances about the impact they are having in the hope of reducing their availability.

A report about the issue published by HPS said: "During this outbreak, updates and advice have been circulated to healthcare and drugs agency colleagues on the appropriate investigation and management of infections in people who inject drugs.

"NHS Lothian is working closely with the police, councils and other agencies to pursue the best options for preventing, controlling and treating the use of new psychoactive substances, including any potential legal avenues."

The community affected by the outbreak involves people who have used heroin in the past or are still addicted to the drug.

David Liddell, director of the Scottish Drugs Forum, said: "We have across Scotland a significant vulnerable population of older drug users who are either outside of treatment or on the edges of treatment services and we need to look at how we engage with this population more than we are doing just now."