ABSTRACT
This chapter provides an update on the pulmonary and thoracic effects of illicit drug use at the exclusion of systemic bacterial infection, abused drug-induced human immunodeficiency virus or HVC infection, and the risks associated with illicit manufacture of abused substances. The treatment of heroin-induced pulmonary oedema includes supportive care, and administration of the specific narcotic antagonist naloxone which is administered intramuscularly. Inhaling cocaine and marijuana also predisposes drug users to upper respiratory tract infections, including sinusitis and rarely invasive pulmonary aspergillosis. Cocaine inhalation has been linked to alveolar haemorrhage independently and through anti-basement membrane antibody syndrome. Thoracic complications are the most common, consisting of infective and non-infective complications affecting the pleura pulmonary parenchyma, soft tissues, heart and mediastinum. Infective complications include acute non-cardiac pulmonary oedema, pulmonary granulomatosis, alveolar haemorrhage, precocious emphysema, bullous pulmonary damage, airway complications, pneumothorax and pneumomediastinum.
