The article presents a case of severe necrotizing fasciitis and rhabdomyolysis-induced acute tubular necrosis resulting from the injection of heroin laced with a plant-fertilizer known as „Pure by Magic“. We also review the literature data regarding the renal adverse effects of heroin. Due to the diversity of adulterants used by drug dealers for cutting heroin and the variety of substances patients mix the heroin with before injecting themselves, the effects of this practice are often unknown and the treatment lacks of antidote, being strictly symptomatic.