Prevalence of heroin use and heroin-related asthma symptoms among inner-city asthmatics

OBJECTIVES – The objectives of this study were to examine drug use and drug-related asthma symptoms, and clinical correlates to drug use, in patients seeking asthma treatment in an inner-city emergency department (ED).

METHODS –Subjects between 18 and 55 years old presenting to the ED with acute asthma exacerbation were interviewed about demographics, asthma history, asthma treatment, drug use, and relationships between drug use and asthma symptoms. Severity on presentation and other clinical characteristics were collected. The prevalence of drug use was determined, and clinical characteristics between users and non-users compared.

RESULTS – 134 of 140 eligible patients participated. Participants were 54% male with a mean age of 41 years. Of 132 subjects who provided information, 29% reported recent (21%) or ever (8%) heroin use, and recent (15%) or ever (46%) cocaine use (including 10 subjects who reported both). Heroin was used by insufflation in 93% of users. 89% of the heroin users reported that heroin insufflation made their asthma symptoms worse; 90% said that their disease improved during periods of abstinence. Compared to non-users, heroin users had lower predicted peak flows (42% vs. 62%, p=0.004, controlled for cigarette smoking), were more likely to have been intubated (p=0.0245), and were more likely to utilize the ED as their source for asthma care (p=0.0059).

CONCLUSION – In an inner-city ED, heroin insufflation in asthmatics was common, and was associated with some measures of severity.