Bronchial hyperreactivity in patients who inhale heroin mixed with cocaine vaporized on aluminum foil.
BACKGROUND
In our area, inhaling heroin mixed with cocaine vaporized on aluminum foil, known as rebujo, is becoming more and more common.


OBJECTIVE
To define the prevalence and the characteristics of bronchial disease (wheezing, bronchial hyperreactivity [BHR], and asthma) present in subjects inhaling heroin mixed with cocaine vaporized on aluminum foil.


METHODS
Ninety-one subjects who inhaled the drug mixture were included in the study: 62 subjects were from a drug rehabilitation center (INH-I group), and 29 subjects were among patients admitted to our hospital for a variety of reasons (INH-II group). A questionnaire was completed in both groups, as well as IgE determination and lung function tests (spirometry and methacholine challenge). The control group consisted of 122 individuals who did not inhale the drug mixture, and were chosen randomly from the general population (NO-INH group). All subjects were tobacco smokers.


RESULTS
In the INH-I group, there was a 41.9% prevalence of wheezing over the past 12 months, a 44.4% prevalence of BHR, and a 22.02% prevalence of asthma, defined as wheezing plus BHR. In the NO-INH group, these values were 32.78% (p = 0.22), 15.57% (p < 0.0001), and 8.19% (p < 0.01), respectively. Of the subjects who inhaled the drug mixture and denied having symptoms prior to the use of the drug mixture, 31.4% had wheezing develop after commencing use of the drug, following a mean latency of 4.09 months. Wheezing remitted in only 7.6% after discontinuation of the drug.


CONCLUSIONS
(1) There is a real increase in BHR in subjects who inhale heroin mixed with cocaine vaporized on aluminum foil; and (2) this BHR is associated with wheezing that develops after a variable period of latency, once drug inhalation begins, and persists despite discontinuation of the drug.
Boto de los Bueis
Ana
A
Sección de Respiratorio, Hospital Juan Ramón Jiménez, Huelva, Spain.
Pereira Vega
Antonio
A
Sánchez Ramos
José Luis
JL
Maldonado Pérez
José Antonio
JA
Ayerbe García
Rut
R
García Jiménez
Domingo
D
Pujol de la Llave
Emilio
E
D000280:Administration, Inhalation; D000328:Adult; D016535:Bronchial Hyperreactivity / Q000139:chemically induced* / Q000503:physiopathology; D001985:Bronchial Provocation Tests; D003042:Cocaine / Q000008:administration & dosage / Q000009:adverse effects*; D019970:Cocaine-Related Disorders / Q000503:physiopathology / Q000534:rehabilitation; D004347:Drug Interactions; D005260:Female; D003932:Heroin / Q000008:administration & dosage / Q000009:adverse effects*; D006556:Heroin Dependence / Q000503:physiopathology / Q000534:rehabilitation; D006801:Humans; D008297:Male; D016210:Methacholine Chloride; D012135:Respiratory Sounds / Q000503:physiopathology; D013030:Spain
D016210:Methacholine Chloride; D003932:Heroin; D003042:Cocaine