title: Chasing the dragon, related to the impaired lung function among heroin users.
abstract: OBJECTIVE
  To describe the pulmonary function and prevalence of dyspnoea among methadone patients and to study the relation with exposure to heroin by inhaling.
  
  
  METHODS
  A sample of 100 patients from methadone maintenance treatment (84% male, average age 42 years).
  
  
  METHODS
  Questionnaires were used to measure life-time exposure to heroin, cocaine, cannabis, tobacco, and symptoms of dyspnoea. Spirometry was performed and residual difference of measured FEV(1) from the age, sex, height and ethnicity predicted value (delta FEV(1)) was used as a main outcome parameter.
  
  
  RESULTS
  The median delta FEV(1) was -0.26 l (inter quartile range -0.70; +0.12). Twenty per cent experienced dyspnoea while 'walking at a normal pace with someone of their own age'. History of cigarette smoking was reported by 98%; heroin smoking by 88%. Multiple linear regression analysis showed a statistically significant association between heroin-smoking and delta FEV(1), logistic regression analysis showed an association between heroin-smoking and prevalence of dyspnoea.
  
  
  CONCLUSIONS
  Chronic heroin smoking seems to be related to an impaired lung function and higher prevalence of dyspnoea. However, part of the observed lung function impairment will be caused by tobacco smoking. Further research is needed to quantify the effect of heroin smoking and disentangle the effect of smoking heroin and tobacco.
authors.affiliation: Municipal Health Service, Department of Epidemiology, Documentation and Health Promotion, PO Box 2200, 1000 CE, Amsterdam, The Netherlands. mbuster@gggd.amsterdam.nl
authors.forename: Marcel
authors.initials: M
authors.lastname: Buster
authors.forename: Liesbeth
authors.initials: L
authors.lastname: Rook
authors.forename: Giel H A
authors.initials: GH
authors.lastname: van Brussel
authors.forename: Jan
authors.initials: J
authors.lastname: van Ree
authors.forename: Wim
authors.initials: W
authors.lastname: van den Brink
mesh_terms: D000328:Adult; D004417:Dyspnea / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D005541:Forced Expiratory Volume; D003932:Heroin / Q000009:adverse effects*; D006556:Heroin Dependence / Q000534:rehabilitation*; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008297:Male; D008691:Methadone / Q000627:therapeutic use; D009294:Narcotics / Q000627:therapeutic use; D012494:Sampling Studies; D012907:Smoking / Q000009:adverse effects*; D013147:Spirometry; D011795:Surveys and Questionnaires
chemical_list: D009294:Narcotics; D003932:Heroin; D008691:Methadone