The Major Medical Complications of Heroin Addiction

Abstract

Article1 July 1967The Major Medical Complications of Heroin AddictionDONALD B. LOURIA, M.D., F.A.C.P., TERRY HENSLE, B.S., JOHN ROSE, B.S.DONALD B. LOURIA, M.D., F.A.C.P.Search for more papers by this author, TERRY HENSLE, B.S.Search for more papers by this author, JOHN ROSE, B.S.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-67-1-1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptAn estimated 60,000 to 120,000 persons in the United States are addicted or habituated to opiates, the former defined as physical dependence on the drugs, the latter as chronic use without actual physical dependence. Additional thousands use opiates illicitly, intermittently or occasionally. Approximately 90% of the narcotic addicts or habitués take heroin, almost all the rest using hydromorphone (Dilaudid®), meperidine (Demerol®), metopon, morphine, codeine, or methadone (1). The heroin that reaches the illicit user usually originates in the mid-East or Far East, is converted into morphine, and then in illegal laboratories is acetylated to diacetylmorphine (heroin). From these laboratories, usually...References1. Traffic in Opium and Other Dangerous Drugs for the Year Ended Dec. 31, 1964. U. S. Government Printing Office, Washington, D. C., 1965. Google Scholar2. HELPERN M: Interim report on narcotic program, Aug. 12, 1963. Summarized in NAPAN (National Association for the Prevention of Addiction to Narcotics) Newsletter 2: no. 2, 1964. Google Scholar3. COHENKAYE DND: Staphylococcal endocarditis in a heroin addict with Marfan's syndrome. Report of a case. New York J. Med. In press. Google Scholar4. HELPERNRHO MY: Deaths from narcotism in New York City. Incidence, circumstances, and postmortem findings. New York J. Med. 66: 2391, 1966. MedlineGoogle Scholar5. SIEGELHELPERNEHRENREICH HMT: The diagnosis of death from intravenous narcotism. With emphasis on the pathologic aspects. J. Forensic Sci. 11: 1, 1966. MedlineGoogle Scholar6. LUTTGENS WF: Endocarditis in "main line" opium addicts. Arch. Intern. Med. (Chicago) 83: 653, 1949. CrossrefGoogle Scholar7. HUSSEYKELIHERSCHAEFERWALSH HHTFBFBJ: Septicemia and bacterial endocarditis resulting from heroin addiction. JAMA 126: 535, 1944. CrossrefGoogle Scholar8. WILDER RM: Staphylococcus bacterial endocarditis. Amer. J. Med. 23: 325, 1957. CrossrefMedlineGoogle Scholar9. WILSON RM: Candidal endocarditis. JAMA 177: 332, 1961. CrossrefMedlineGoogle Scholar10. OERTHERGOODMANLERNER FJJLAM: Infections in paregoric addicts. JAMA 190: 683, 1964. CrossrefMedlineGoogle Scholar11. ANDRIOLEKRAVETZROBERTSUTZ VTHMWCJP: Candida endocarditis. Clinical and pathologic studies. Amer. J. Med. 32: 251, 1962. CrossrefMedlineGoogle Scholar12. JOACHIMPOLAYES HSH: Subacute endocarditis and systemic mycosis (monilia). JAMA 115: 205, 1940. CrossrefGoogle Scholar13. WIKLERWILLIAMSDOUGLASSEMMONSDUNN AEGEDCWRC: Mycotic endocarditis: report of a case. JAMA 119: 333, 1942. CrossrefGoogle Scholar14. ZIMMERMAN LE: Candida and aspergillus endocarditis. Arch. Path. (Chicago) 50: 591, 1950. MedlineGoogle Scholar15. HENDERSONNICKERSON JJF: Bacterial endocarditis with Candida albicans superinfection. Canad. Med. Ass. J. 90: 452, 1964. MedlineGoogle Scholar16. LOURIASTIFFBENNETT DBDPB: Disseminated moniliasis in the adult. Medicine (Balt.) 41: 307, 1962. CrossrefGoogle Scholar17. ROMANSKYHOLMES MJJR: Successful short term therapy of enterococcal and staphylococcal endocarditis with ristocetin, in Antibiotics Annual 1957-1958. Medical Encyclopedias, Inc., New York, 1958, p. 187. Google Scholar18. MCMILLANWILBUR RLEL: Staphylococcic endocarditis superimposed on syphilitic aortic endocarditis. JAMA 109: 1194, 1937. CrossrefGoogle Scholar19. OLSSONROMANSKY RAMJ: Staphylococcal tricuspid endocarditis in heroin addicts. Ann. Intern. Med. 57: 755, 1962. LinkGoogle Scholar20. KEARNS JJ: Malignant endocarditis due to Bacillus pyocyaneus. Arch. Path. (Chicago) 21: 839, 1936. Google Scholar21. WILHELMHIRSHHUSSEYDOWLING FHLHHHF: The treatment of acute bacterial endocarditis with penicillin. Ann. Intern. Med. 26: 221, 1947. LinkGoogle Scholar22. LERNERWEINSTEIN PIL: Infective endocarditis in the antibiotic era. New Eng. J. Med. 274: 199, 1966. CrossrefMedlineGoogle Scholar23. MERCHANTLOURIAGEISLEREDGCOMBUTZ RKDBPHJHJP: Fungal endocarditis. Review of the literature and report of three cases. Ann. Intern. Med. 48: 242, 1958. LinkGoogle Scholar24. OSLER W: Oedema of the left lung in morphia poisoning. Montreal General Hosp. Rep. 1: 291, 1880. Google Scholar25. SILBERCLERKIN REP: Pulmonary edema in acute heroin poisoning. Amer. J. Med. 27: 187, 1959. CrossrefMedlineGoogle Scholar26. SPAIN DM: Patterns of pulmonary fibrosis as related to pulmonary function. Ann. Intern. Med. 33: 1150, 1950. LinkGoogle Scholar27. VONGLAHNHALL WCJW: The reaction produced in the pulmonary arteries by emboli of cotton f