Heroin Insufflation as a Trigger for Patients With Life-Threatening Asthma*

Krantz, Anne; Hershow, Ronald C.; Prachand, Nikhil; Hayden, Dana M.; Franklin, Cory; Hryhorczuk, Daniel O.

doi:10.1378/chest.123.2.510

Cited by 64 publications

(42 citation statements)

References 20 publications

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“…42 These cases were characterized by preexisting asthma, the sudden onset of symptoms, relatively prolonged intubation, and eosinophilia. Krantz et al 48 examined the prevalence of drug use in asthmatic patients who had been admitted to the ICU and compared the pattern of drug use in these patients to patients in the ICU who had been admitted for diabetic ketoacidosis. The authors observed that asthmatic patients in the ICU were more likely to have used heroin than were the diabetic ketoacidosis patients in the ICU.…”

Section: Heroin and Asthmamentioning

confidence: 99%

“…The authors observed that asthmatic patients in the ICU were more likely to have used heroin than were the diabetic ketoacidosis patients in the ICU. 48 Levine et al 16 reported a surprisingly high prevalence of heroin use among adults who were admitted to an inner-city hospital for asthma exacerbation. Heroin appeared to be a risk factor for intubation.…”

Section: Heroin and Asthmamentioning

confidence: 99%

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“Dangerous Relationships”: Asthma and Substance Abuse

Caponnetto

Auditore²,

Russo

et al. 2013

Journal of Addictive Diseases

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Commonly abused drug are cocaine, marijuana, cigarettes, heroin, and alcohol. The review emphasizes the importance for clinicians to be alert to the possibility of this substance as a precipitating factor for acute asthma. Substance use disorders to characterize illnesses associated with drug use. The use of drugs of abuse increases risk of developing more severe symptoms, higher frequency of exacerbations and having and significant effect on care resources due to clinicians visits and frequent hospital admissions. Abused drug has been shown to accelerate the decline in lung function and to increase numbers of life-threatening asthma attacks, and greater asthma mortality.

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Section: Heroin and Asthmamentioning

confidence: 99%

Section: Heroin and Asthmamentioning

confidence: 99%

“Dangerous Relationships”: Asthma and Substance Abuse

Caponnetto

Auditore²,

Russo

et al. 2013

Journal of Addictive Diseases

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show abstract

“…This observation has also been supported by anecdotal evidence from clinical colleagues, although there is little published research in this area. 6 Previous studies have reported an association between drug misuse and asthma exacerbations [7][8][9][10] and respiratory disease and lower quality of asthma care among drug misusers. 11 Other previous studies also suggest a possible association between asthma mortality and drug misuse.…”

mentioning

confidence: 99%

Prevalence of common chronic respiratory diseases in drug misusers: a cohort study

Palmer

Jaffray

Moffat

et al. 2012

Primary Care Respiratory Journal

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“…Severe asthma exacerbations related to the use of opioids such as heroin and morphine (a heroin metabolite) have received attention as a public health issue. The possible mechanisms have been thought to be sensitization against opioid antigen and pharmacological degranulation of mast cells independent of opioid receptors [44,45]. The results of the current study suggest the possibility that opioid use exacerbates allergen-induced asthma attacks through MOR activation.…”

Section: Discussionmentioning

confidence: 63%

The Involvement of µ-Opioid Receptors in the Central Nervous System in the Worsening of Allergic Airway Inflammation by Psychological Stress in Mice

Okuyama

Wada

Sakurada

et al. 2010

Int Arch Allergy Immunol

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Background: Psychological stress has a recognized association with asthma symptoms. However, the mechanisms linking stress to the exacerbation of asthma are not well defined. µ-Opioid receptors (MOR) have been shown to be involved in the shift of the immune system toward a Th2-predominant response caused by psychological stress. Objective: To test the hypothesis that MOR play a role in the worsening of allergic airway inflammation evoked by psychological stress. Methods: Sensitized mice were exposed to restraint stress followed by antigen challenge. The levels of corticosterone and ovalbumin (OVA)-specific IgE in the blood and the levels of inflammatory cells and cytokine contents in bronchoalveolar lavage fluid were compared between stressed and nonstressed mice. The effects of MOR gene deletion and MOR antagonists/agonists were also investigated. Results: Stress exposure was confirmed by an increase in corticosterone levels. Although OVA-specific IgE levels were not significantly different, the numbers of inflammatory cells and Th2 cytokine levels after antigen challenge in stressed mice were significantly higher than in nonstressed mice. MOR gene deletion ameliorated the stress-induced worsening of antigen-induced airway inflammation, and the administration of morphine, a MOR agonist, reproduced the stress-induced antigen-induced airway inflammation. Selective blocking of MOR in the central nervous system (CNS) significantly reduced stress-induced inflammatory exacerbation, but the blocking of peripheral MOR did not. Conclusions: MOR in the CNS are involved in psychological stress-induced aggravation of allergic airway inflammation.

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Heroin Insufflation as a Trigger for Patients With Life-Threatening Asthma*

Cited by 64 publications

References 20 publications

“Dangerous Relationships”: Asthma and Substance Abuse

“Dangerous Relationships”: Asthma and Substance Abuse

Prevalence of common chronic respiratory diseases in drug misusers: a cohort study

The Involvement of µ-Opioid Receptors in the Central Nervous System in the Worsening of Allergic Airway Inflammation by Psychological Stress in Mice

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