New-onset bronchospasm or recrudescence of asthma associated with cocaine abuse.
OBJECTIVE
To determine whether the occurrence of new-onset bronchospasm or the recrudescence of asthma is associated with the use of cocaine.


METHODS
A consecutive sample of patients presenting to an inner-city adult ED with new-onset bronchospasm or recrudescence of bronchospasm after > 5 years were prospectively enrolled in a case-control prevalence study. The bronchospasm patients were queried as to their exposure to illicit drugs, and urine was obtained to screen for cocaine and its metabolite, benzoylecgonine. An age- and sex-matched control group was composed of randomly chosen subjects without respiratory complaints or a history of asthma. The control group was also screened by urine toxicology for cocaine and its metabolite, benzoylecgonine.


RESULTS
In the asthma group, 21/59 (36%) had a urine toxicologic screen positive for cocaine metabolite (benzoylecgonine). Of the 21 with a positive screen for cocaine, 8 denied illicit drug abuse. Among the 13 patients reporting drug use, 10 said that they smoked crack and 3 snorted cocaine. In the control group, 8/53 (15%) were positive. Multivariate logistic regression analysis, with adjustment for age and sex, indicated that the use of cocaine was associated with a 3-fold higher prevalence of new-onset bronchospasm or recrudescence of asthma (OR = 3.28, 95% CI: 1.26 to 8.50).


CONCLUSIONS
There appears to be an association between cocaine use and new-onset bronchospasm or recrudescence of asthma in this inner-city ED population. Further study is necessary to determine the basis for this association.
Osborn
H H
HH
New York Medical College, Lincoln Medical and Mental Health Center, Department of Emergency Medicine, Bronx 10457, USA. osborn@mem.po.com
Tang
M
M
Bradley
K
K
Duncan
B R
BR
D000328:Adult; D000368:Aged; D001249:Asthma / Q000453:epidemiology / Q000209:etiology* / Q000652:urine; D001986:Bronchial Spasm / Q000453:epidemiology / Q000209:etiology* / Q000652:urine; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003042:Cocaine / Q000652:urine; D015897:Comorbidity; D016001:Confidence Intervals; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D016017:Odds Ratio; D015995:Prevalence; D011446:Prospective Studies; D012008:Recurrence; D019966:Substance-Related Disorders / Q000150:complications* / Q000453:epidemiology / Q000652:urine; D014504:Urban Health / Q000706:statistics & numerical data*
D003042:Cocaine