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Heroin insufflation as a trigger for patients with life-threatening asthma.

Authors
Krantz-AJ; Hershow-RC; Prachand-N; Hayden-DM; Franklin-C; Hryhorczuk-DO
Source
Chest 2003 Feb; 123(2):510-517
NIOSHTIC No.
20040050
Abstract
STUDY OBJECTIVES: To determine the prevalence of self-reported, heroin-associated asthma symptoms among inner-city patients treated for life-threatening asthma, and to compare the rates of drug use between ICU patients with asthma and ICU control patients with diabetic ketoacidosis (DKA). DESIGNS: Study 1 was a sequential case series of patients requiring ICU admission for asthma (January to June 1999). Study 2 was a retrospective, case-control study of drug use among asthma patients and control subjects with DKA requiring ICU care (1997 to 1998). SETTING: Inner-city, public hospital ICU. PATIENTS: Twenty-three patients (26 ICU admissions) with asthma (age range, 16 to 50 years) admitted to the ICU from January to June 1999, and 84 patients (104 ICU admissions) with asthma and 42 patients with DKA (age range, 15 to 50 years) admitted to the ICU during 1997 to 1998. Outcomes studied: Self-reported, heroin-associated exacerbations, history of heroin or cocaine use, and urine drug screen (UDS) results. Measurements and results: In the sequential ICU admissions, 13 of 23 patients (56%) described asthma exacerbations associated with heroin insufflation. In the case-control study, asthmatics were significantly more likely to report heroin use (41.3% vs 12.5%; p = 0.006) and had a significantly higher prevalence of UDS results positive for opiates (60% vs 7%; p = 0.001) compared to subjects with DKA. The rates of cocaine use by history and UDS results did not differ significantly between the two groups. CONCLUSIONS: At least since 1997, heroin insufflation is a common asthma trigger in this inner-city ICU and should be considered in the care of patients with life-threatening asthma.
Keywords
Humans; Men; Women; Age-groups; Case-studies; Epidemiology; Drug-abuse; Drugs; Respiratory-system-disorders; Pulmonary-system; Pulmonary-system-disorders; Pulmonary-function; Urinalysis; Substance-abuse; Author Keywords: asthma; cocaine; heroin; substance abuse; Bronchial-asthma
Contact
Anne Krantz, MD, MPH, Division of Occupational Medicine, Cook County Hospital, 1900 W Polk, Room 500, Chicago, IL 60612
CODEN
CHETBF
Publication Date
20030201
Document Type
Journal Article
Email Address
akrantz@uic.edu
Funding Type
Grant
Fiscal Year
2003
NTIS Accession No.
NTIS Price
Identifying No.
Grant-Number-T42-OH-008672
Issue of Publication
2
ISSN
0012-3692
Source Name
Chest
State
IL
Performing Organization
University of Illinois-Chicago
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