Chasing the dragon, related to the impaired lung function among heroin users

Buster, Marcel; Rook, Liesbeth; Brussel, G. H. A. Van; Ree, Jan van; Brink, Wim van den

doi:10.1016/s0376-8716(02)00193-x

Cited by 56 publications

(30 citation statements)

References 27 publications

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“…For example, being a noninjector has been shown to indicate lower levels and shorter duration of drug dependency (34), lower prevalence of and fewer risks for transmission of blood-borne infectious disease (that is, HIV and HCV) (35)(36)(37), and less exposure to overdose risks (38). However, the oral use of opioids, that is, by way of smoke inhalation, can produce its own distinct health problems, such as pulmonary dysfunction, asthma, or leukoencephalopathy (39,40). Evidence from several studies indicates that many opioid users begin with noninjection and eventually switch to injection routes, motivated either by economic (for example, seeking more "efficient" modes of use) or by social network dynamics (32,33,41).…”

Section: Nonopioid Usementioning

confidence: 99%

Illicit Opioid Use and its Key Characteristics: A Select Overview and Evidence from a Canadian Multisite Cohort of Illicit Opioid Users (OPICAN)

2006

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Clinical Implications • Illicit opioid use to a large extent manifests via the illicit use of prescription opioids and typically includes polysubstance use. • Physical and (or) mental health comorbidities are highly prevalent in illicit opioid user populations. • Morbidity and (or) mortality risks are often associated with social marginalization. Limitations • Little is known about the patterns and consequences of illicit opioid use in general populations. • Owing to the marginalized and illegal status of illicit opioid users, information is available only from selective populations with limited potential for generalizability of data. • The OPICAN study specifically builds largely on self-report and may be subject to bias. Objectives: To summarize key characteristics and consequences of illicit opioid use from the literature and to present corresponding data from a multisite sample of illicit opioid users in 5 Canadian cities (OPICAN study). Method: We undertook an overview of recent literature from North America, Australia, and Europe. We obtained data from the multicity OPICAN cohort study, which consisted of an interviewer-administered questionnaire, a standardized mental health instrument (the Composite International Diagnostic Interview Short Form for depression), and saliva-antibody tests for infectious disease (that is, HIV and hepatitis C virus). The baseline sample (n = 679) was collected in 2002. Results: Illicit opioid use in Canada and elsewhere is becoming increasingly heterogeneous in terms of opioid drugs used, with heroin playing an increasingly minor role; further, it predominantly occurs in a context of polydrug use (for example, cocaine-crack or benzodiazepines). Large proportions of illicit opioid users have physical and (or) mental health comorbidities, including infectious disease and (or) depression, and therefore require integrated interventions. Finally, morbidity risks among illicit opioid users are often predicted by social marginalization factors, for example, housing status or involvement in crime. Conclusions: Given the epidemiologic profile and high disease burden associated with contemporary forms of illicit opioid use, more effective treatment approaches are urgently needed in Canada and elsewhere. Specifically, treatment must adjust to the extensive polysubstance use realities, yet it must also more effectively address the complex physical and (or) mental health comorbidities presented by this high-risk population.

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Section: Nonopioid Usementioning

confidence: 99%

Illicit Opioid Use and its Key Characteristics: A Select Overview and Evidence from a Canadian Multisite Cohort of Illicit Opioid Users (OPICAN)

2006

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“…Chronic heroin smokers have been found to have a lower median FEV 1 than predicted (0.26 L) [18] and increased heroin exposure was related to greater decrements in FEV 1 . A dose-dependent relationship between the cumulative cannabis consumption and decline in FEV 1 /FVC ratio over 8-year period was noted [19].…”

Section: Discussionmentioning

confidence: 98%

Hospital Readmissions with Exacerbation of Obstructive Pulmonary Disease in Illicit Drug Smokers

Yadavilli

Collins

Ding

et al. 2014

Lung

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“…Inhalation of heroin by a technique known as "chasing the dragon" [2] has been associated both with the indirect effects of heroin overdose and with direct pulmonary toxicity [3]; moreover, a case of heroin-induced acute eosinophilic pneumonia (AEP) has been reported [4]. We describe the second case of AEP associated with heroin inhalation.…”

Section: Introductionmentioning

confidence: 98%

Eosinophile Pneumonie in Verbindung mit Heroininhalation

Paletas

Vlachaki

Spanos

et al. 2008

Wien Klin Wochenschr

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Drugs are known to be a cause of pulmonary eosinophilia and several case reports of acute eosinophilic pneumonia associated with the use of cocaine have been reported. The changing pattern of heroin use, with a shift from intravenous use to smoking/inhalation of the substance, may lead to increased prevalence of heroin-induced pulmonary eosinophilia. We report on a case of a patient who had been inhaling heroin for about ten years. He presented with fever, cough, dyspnea and pleuritic chest pain. Chest radiograph showed unilateral pleural effusion with segmental atelectasis. Examination of pleuritic fluid aspirate and bronchoalveolar lavage fluid revealed significant eosinophilia. He was diagnosed with acute eosinophilic pneumonia. Rapid remission was achieved after heroin abstinence and initiation of corticosteroid treatment.

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Chasing the dragon, related to the impaired lung function among heroin users

Cited by 56 publications

References 27 publications

Illicit Opioid Use and its Key Characteristics: A Select Overview and Evidence from a Canadian Multisite Cohort of Illicit Opioid Users (OPICAN)

Illicit Opioid Use and its Key Characteristics: A Select Overview and Evidence from a Canadian Multisite Cohort of Illicit Opioid Users (OPICAN)

Hospital Readmissions with Exacerbation of Obstructive Pulmonary Disease in Illicit Drug Smokers

Eosinophile Pneumonie in Verbindung mit Heroininhalation

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