Dr. Peter Chai is an assistant professor in the Emergency Medicine Division of Medical Toxicology at Brigham and Women’s Hospital in Boston. He says that most of the time, when he sees people injecting bleach, it’s usually IV drug users, due to an urban legend that it can clean your blood of impurities after you use heroin and methamphetamine. He says that when people have done this, the side effects are absolutely horrifying.

“Bleach is a caustic agent. It’s the opposite of an acid, because it’s more alkaline. It breaks stuff apart, which is why it works to clean surfaces,” he says. “So when you think about injecting into your veins, it’ll break things apart in your blood.” That usually results in hemolysis, or the red blood cells that carry oxygen in your body breaking apart, so oxygen can’t be carried into your vital organs. This can result in blood clots, liver injury, or most frequently, kidney injury or failure, which could be bad enough that it could be permanent and require dialysis.