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Clinical Investigations: DRUGS |

Bronchial Hyperreactivity in Patients Who Inhale Heroin Mixed With Cocaine Vaporized on Aluminum Foil*

Ana Boto de los Bueis, MD; Antonio Pereira Vega, MD; José Luis Sánchez Ramos, MD; José Antonio Maldonado Pérez, MD; Rut Ayerbe García, MD; Domingo García Jiménez, MD; Emilio Pujol de La Llave, MD
Author and Funding Information

*From the Sección de Respiratorio (Drs. Boto de los Bueis, Pereira Vega, Maldonado Pérez, Ayerbe García, García Jiménez, and Pujol de La Llave), and Unidad Docente de Medicina Familiar y Comunitaria de Huelva (Dr. Sánchez Ramos), Hospital Juan Ramón Jiménez, Huelva, Spain.

Correspondence to: Antonio Pereira Vega, MD, Comisión de Docencia, Hospital Juan Ramón Jiménez, Ronda Norte, s/n 21005, Huelva, Spain; e-mail: apv01h@nacom.es/docencia@hjrj.sas.cica.es



Chest. 2002;121(4):1223-1230. doi:10.1378/chest.121.4.1223
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Background: In our area, inhaling heroin mixed with cocaine vaporized on aluminum foil, known as rebujo, is becoming more and more common.

Aim: 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.

Materials and 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.

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