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

Details

• Personal Author:
  Franklin C ; Hayden DM ; Hershow RC ; Hryhorczuk DO ; Krantz AJ ; Prachand N
• Description:
  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. [Description provided by NIOSH]
• Subjects:
  Aging Asthma Asthma, Occupational Case Reports Epidemiology Lung Men Occupational Health Respiratory System Respiratory Tract Diseases Safety Substance-Related Disorders Urine Women

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• Keywords:
  Age-groups Author Keywords: Asthma Bronchial-asthma Case-studies Cocaine Drug-abuse Drugs Heroin Humans Pulmonary-function Pulmonary-system Pulmonary-system-disorders Respiratory-system-disorders Substance-abuse Substance Abuse Urinalysis

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• ISSN:
  0012-3692
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  Illinois ; OSHA Region 5
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  123
• Issue:
  2
• NIOSHTIC Number:
  nn:20040050
• Citation:
  Chest 2003 Feb; 123(2):510-517
• Contact Point Address:
  Anne Krantz, MD, MPH, Division of Occupational Medicine, Cook County Hospital, 1900 W Polk, Room 500, Chicago, IL 60612
• Email:
  akrantz@uic.edu
• Federal Fiscal Year:
  2003
• Performing Organization:
  University of Illinois at Chicago
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  Chest
• End Date:
  20290630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:126ddf95c85980b4140636892233d0f31277091b1b79fe7d404778b26b6c1a8dcdee50eaa5eb3f28d69147d73c84e7b7b37c02376ff895db52dc440831740784
• Download URL:
  https://stacks.cdc.gov/view/cdc/193044/cdc_193044_DS1.pdf
• File Type:
  [PDF - 124.26 KB ]