heroin and Pneumonia

The Office of the Chief Medical Examiner of Maryland recorded a total of 149 drug abuse deaths of teenagers aged 13-19 years between 1991 and 2006. Of these deaths, 96 (64.4%) were caused by the use of narcotic drugs only, 29 (19.5%) by both narcotics and cocaine, four (2.7%) by both narcotics and methylenedioxymethamphetamine, six (4.0%) by cocaine only, and 14 (9.4%) by volatile substances (e.g., butane, Freon, nitrous oxide, and propane). The annual death rate from drug abuse for teenagers increased from 1.4 deaths per 100,000 population in 1991 to 2.7 deaths per 100,000 population in 2006 (chi-square test for time trend, p<0.01). The increase in teenager drug abuse deaths occurred in 1999 and since has remained at a higher rate. Further analysis revealed that the increase in drug abuse deaths was attributable to a large degree to narcotic drugs, particularly heroin/morphine and methadone, and was confined to teenagers residing in the suburban and rural areas.

Topics: Adolescent; Age Distribution; Black People; Butanes; Cause of Death; Chlorofluorocarbons, Methane; Cocaine; Female; Forensic Pathology; Forensic Toxicology; Hepatitis B Antibodies; Heroin; HIV Antibodies; Humans; Male; Maryland; Methadone; Morphine; Myocarditis; N-Methyl-3,4-methylenedioxyamphetamine; Narcotics; Nitrous Oxide; Pneumonia; Propane; Retrospective Studies; Sex Distribution; Substance-Related Disorders; White People

This article reports the case of a patient demonstrating acute bilateral pneumonitis almost completely confined to the upper lobes as a result of inhaling heroin. We attribute this distribution to the patient performing the Valsalva manoeuvre immediately after inhaling heroin. This pattern has not been reported before and we believe it may be seen more frequently owing to a switch amongst drug users from intravenous to inhaled heroin.

Topics: Acute Disease; Acute Lung Injury; Administration, Inhalation; Blood Gas Analysis; Female; Heroin; Heroin Dependence; Humans; Middle Aged; Pneumonia; Radiography, Thoracic; Valsalva Maneuver

This paper describes injection risk in an out-of-treatment population of young heroin users in Hanoi, Vietnam, including use of a soft-tissue portal known as a "cay ma" (injection sac).. Data from a large cross-sectional survey (N=1270) are used to describe the prevalence of this practice and its association with disease. Additionally, data from an ethnographic substudy on injectors serve to elaborate injectors' rationales for this injection practice.. This practice was common in this sample, appearing soon after initiation of habitual injection. Injectors report that this allows rapid and reliable access to a vein; strategic advantages in a dense urban environment where rapid injection, typically in public settings, is necessary to avoid discovery or arrest. Additionally, this practice is believed to mitigate risk for vein damage from co-morbid promethazine hydrochloride injection.. This practice may draw lymphocytes to injection sites, thereby increasing risk for transmission of bloodborne pathogens. Structural and behavioral interventions are needed for young heroin users in Vietnam.

Topics: Adolescent; Adult; Anthropology, Cultural; Blood-Borne Pathogens; Cross-Sectional Studies; Female; Health Surveys; Hepatitis B; Heroin; Heroin Dependence; HIV Infections; Humans; Injections, Subcutaneous; Male; Narcotics; Pneumonia; Substance Abuse, Intravenous; Vietnam

To investigate spiral CT findings of pulmonary infection induced by intravenous injection of heroin.. The clinical data and spiral CT findings of 21 patients with pulmonary infection due to intravenous injection of heroin were analyzed retrospectively.. Pulmonary lesions were detected in all these cases in the initial examination by spiral CT plain scan, including pneumatocele in 13 (61.9%), pulmonary cavity in 13 (61.9%), pulmonary consolidation in 15 (71.4%), and plural lesions in 8 cases (38.1%) of which 7 (33.3%) had plural effusion and 1 (0.48%) had encapsulated hydropneumothorax. Three cases had only one of the lesions and 18 had at least 2 of them. The CT images in each case were compared with X-ray film, and the latter displayed abnormalities in 20 cases (95.2%). X-ray failed to detect the lesions in 1 case (4.8%), in which pneumatocele was found in CT images.. The pulmonary lesions of pulmonary pneumatocele, cavity, consolidation, and plural lesions are specific CT manifestations of hematogenous pulmonary suppurative infection induced by intravenous injection of heroin.

Topics: Adult; Heroin; Heroin Dependence; Humans; Injections, Intravenous; Male; Pneumonia; Retrospective Studies; Tomography, Spiral Computed

To estimate the range and severity of heroin overdose related morbidity.. Cross-sectional survey.. Sydney, Australia.. 198 heroin users.. Sixty-nine per cent had experienced a heroin overdose, 28% in the preceding 12 months. Of those who had overdosed, 79% had experienced at least one overdose-related morbidity symptom. An ambulance had attended overdoses for 59% of subjects, 33% had required hospital treatment for overdose, and 14% had experienced overdose-related complications of sufficient severity to be admitted to a hospital ward. Indirect overdose-related morbidity included: physical injury sustained when falling at overdose (40%), burns (24%) and assault while unconscious (14%). Direct overdose-related morbidity included: peripheral neuropathy (49%), vomiting (33%), temporary paralysis of limbs (26%), chest infections (13%) and seizure (2%).. There appears to be extensive morbidity associated with non-fatal overdose. This is clearly an area that requires more research to document the prevalence and nature of these harms, and factors associated with them.

Topics: Adolescent; Adult; Age of Onset; Cross-Sectional Studies; Drug Overdose; Female; Heroin; Heroin Dependence; Humans; Length of Stay; Male; Middle Aged; Narcotics; New South Wales; Paralysis; Peripheral Nervous System Diseases; Pneumonia; Sex Factors; Time Factors; Vomiting

Topics: Administration, Intranasal; Adult; Biopsy; Drug Hypersensitivity; Female; Heroin; Heroin Dependence; Humans; Lung; Lung Volume Measurements; Narcotics; Pneumonia

To study the incidence and risk factors for pneumonia in a cohort of HIV infected and non-infected drug users (DU).. A prospective epidemiological study.. Injecting and non-injecting DU who attended the Municipal Health Service in Amsterdam for follow-up visits in the study.. 203 HIV infected and 437 non-infected DU were followed for a total of 1749 person-years. HIV infected DU reported 111 episodes of pneumonia, which required hospitalization in 29 cases, and HIV negative DU reported 55 episodes, which required hospitalization in nine cases. The incidences among HIV positive and HIV negative DU were 0.19 and 0.05 per person-year respectively. With multivariate Poisson regression current injecting (RR 2.13), recent seroconversion (RR 3.92), asthmatic constitution (RR 2.72), CD4+ cell count between 200-500 (RR 1.67 compared to > 500), CD4+ cell count less than 200 (RR 2.23 compared to > 500) and a previous history of pneumonia (RR 2.43) were independently associated with self-reported pneumonia among HIV infected DU. Among HIV negative DU heroin smoking (RR 1.87), asthmatic constitution (RR 3.62) and a previous history of pneumonia (RR 2.84) were independently associated with self-reported pneumonia. Also a higher Quetelet Index (QI) appeared to be protective (QI > or = 21 RR 0.42, QI 19-21 RR 0.82 compared to QI < 19) among HIV negative DU. Risk factors for reported and hospitalized cases of pneumonia were comparable among HIV positive DU.. HIV infected DU are at increased risk for pneumonia and the rate increases with lower CD4 cell counts. Also behavioural characteristics, such as injecting drug use and smoking heroin, and clinical history variables, such as a history of pneumonia or an asthmatic constitution, are risk factors for pneumonia among DU. Pneumococcal vaccination should not only be focused on HIV positive DU but also on the identified risk groups among HIV negative DU.

Topics: Adult; CD4 Lymphocyte Count; Female; Heroin; HIV Seropositivity; Humans; Incidence; Male; Netherlands; Pneumonia; Prospective Studies; Regression Analysis; Risk; Risk Factors; Substance-Related Disorders

Complications resulting from drug abuse more frequently affect the lung than any other organ. The spectrum of pulmonary complications associated with drug abuse is wide. The current practice of using mixtures of drugs is mainly responsible for the increase in pulmonary complications. The chief complications observed in a series of 241 drug abuse patients were aspiration pneumonitis (12.9 percent), pulmonary edema (10.0 percent), and pneumonia (7.5 percent).

Topics: Adult; Alcoholism; Barbiturates; Cannabis; Cocaine; Coma; Female; Heroin; Humans; Lung Abscess; Lung Diseases; Male; Pneumonia; Pneumonia, Aspiration; Pulmonary Atelectasis; Pulmonary Edema; Pulmonary Embolism; Pulmonary Fibrosis; Substance-Related Disorders

Topics: Aneurysm, Infected; Arterial Occlusive Diseases; Cardiomegaly; Edema; Endocarditis, Bacterial; Hand; Heroin; Humans; Injections, Intra-Arterial; Injections, Intravenous; Ischemia; Lung Diseases; Lymphadenitis; Pneumonia; Pneumonia, Aspiration; Pulmonary Edema; Pulmonary Embolism; Substance-Related Disorders; Tuberculosis, Pulmonary; Vascular Diseases; Venous Insufficiency

Topics: Adult; Alcoholism; Child; Female; Hepatitis A; Heroin; Humans; Liver Cirrhosis; Liver Diseases; Lung Diseases; Male; Middle Aged; Oxygen Inhalation Therapy; Pneumonia; Respiratory Insufficiency; Syndrome

Topics: Adolescent; Adult; Anti-Bacterial Agents; Arrhythmias, Cardiac; Black or African American; Body Temperature; Coma; Drug Combinations; Ethnicity; Female; Heroin; Humans; Hypoxia; Male; Nalorphine; New York City; Pneumonia; Puerto Rico; Pulmonary Edema; Retrospective Studies; Substance-Related Disorders

Topics: Acute Kidney Injury; Administration, Oral; Adolescent; Alkaline Phosphatase; Amenorrhea; Amphetamine; Barbiturates; Cannabis; Child; Cocaine; Eosinophilia; False Positive Reactions; Female; Hepatic Encephalopathy; Hepatitis B; Heroin; Humans; Injections, Intravenous; Injections, Subcutaneous; Juvenile Delinquency; Lysergic Acid Diethylamide; Peptic Ulcer; Pneumonia; Pseudotumor Cerebri; Substance Withdrawal Syndrome; Substance-Related Disorders

Topics: Adult; Aneurysm; Aneurysm, Infected; Endocarditis, Bacterial; Female; Heroin; Humans; Hypertension, Pulmonary; Injections, Intravenous; Lung Diseases; Male; Methylphenidate; Middle Aged; Pneumonia; Pneumonia, Aspiration; Pulmonary Edema; Pulmonary Embolism; Radiography; Substance-Related Disorders; Thrombophlebitis; Thrombosis; Tuberculosis, Pulmonary; Vascular Diseases

Topics: Acute Disease; Adolescent; Adult; Chemical and Drug Induced Liver Injury; Duodenal Ulcer; Female; Heart Failure; Heroin; Humans; Jaundice; Male; Maryland; Middle Aged; Neurotic Disorders; Pneumonia; Pulmonary Edema; Pulmonary Fibrosis; Radiography; Sarcoidosis; Substance-Related Disorders; Tetanus

Topics: Adolescent; Adult; Female; Heroin; Humans; Injections; Lung; Lung Abscess; Male; Morphine Dependence; New York City; Pleural Effusion; Pneumonia; Pseudomonas Infections; Pulmonary Edema; Radiography; Spondylitis; Substance-Related Disorders; Tetanus; United States