The Drug-Induced Respiratory Disease Website and App

Frequency - Incidence

Incidence of respiratory adverse event(s) due to the specific drug as assessed by number of reported/published cases in the literature. Red digits in stars indicate: 0 = Very rare, questionable signal · 1 = < 10 cases · 2 = 10-50 cases · 3 = 50–100 cases · 4 = 100-200 cases · 5 = >200 cases

Evidence level/grade

Evidence level for respiratory adverse event(s) due to the specific drug as estimated using Hill’s (1965), Naranjo’s (1981), and Bégaud’s (1985) criteria applied to published cases. Blue digits in stars indicate: 0 = Questionable · 1 = Low · 2 = Moderate · 3 = Robust · 4 = Definite · 5 = Unquestionable, pathognomonic

II.a

Pulmonary edema, noncardiogenic (NCPE)

Publications

Hegazy Y, Puri P, Durrani R, Patrizi SE, Ghallab M

Heroin-Induced Non-cardiogenic Pulmonary Edema: A Rare but Serious Complication.

Cureus. 2025;17(3):e81548

Winklhofer S, Surer E, Ampanozi G, Ruder T, Stolzmann P, Elliott M, Oestreich A, Kraemer T, Thali M, Alkadhi H, Schweitzer W

Post-mortem whole body computed tomography of opioid (heroin and methadone) fatalities: frequent findings and comparison to autopsy.

European radiology. 2014;24(6):1276-82

Jakhar JK, Dhattarwal SK, Aggarwal AD, Chikara P, Khanagwal VP

Heroin body packer's death in Haryana; India: a case report.

Journal of forensic and legal medicine. 2013;20(6):693-6

Dinis-Oliveira RJ, Santos A, Magalhães T

"Foam Cone" exuding from the mouth and nostrils following heroin overdose.

Toxicology mechanisms and methods. 2012;22(2):159-60

Milroy CM, Parai JL

The histopathology of drugs of abuse.

Histopathology. 2011;59(4):579-93

Mell HK, Sztajnkrycer MD

Clinical images in medical toxicology: heroin overdose with non-cardiogenic pulmonary edema.

Clinical toxicology (Philadelphia, Pa.). 2006;44(4):399

SILBER R, CLERKIN EP

Pulmonary edema in acute heroin poisoning; report of four cases.

The American journal of medicine. 1959;27(1):187-92

Sterrett C, Brownfield J, Korn CS, Hollinger M, Henderson SO

Patterns of presentation in heroin overdose resulting in pulmonary edema.

The American journal of emergency medicine. 2003;21(1):32-4

Sporer KA, Dorn E

Heroin-related noncardiogenic pulmonary edema : a case series.

Chest. 2001;120(5):1628-32

Dettmeyer R, Schmidt P, Musshoff F, Dreisvogt C, Madea B

Pulmonary edema in fatal heroin overdose: immunohistological investigations with IgE, collagen IV and laminin - no increase of defects of alveolar-capillary membranes.

Forensic science international. 2000;110(2):87-96

Karch SB

Diphenhydramine toxicity: comparisons of postmortem findings in diphenhydramine-, cocaine-, and heroin-related deaths.

The American journal of forensic medicine and pathology. 1998;19(2):143-7

Raijmakers PG, Groeneveld AB, de Groot MC, Teule GJ, Thijs LG

Delayed resolution of pulmonary oedema after cocaine/heroin abuse.

Thorax. 1994;49(10):1038-40

Wang ML, Lin JL, Liaw SJ, Bullard MJ

Heroin lung: report of two cases.

Journal of the Formosan Medical Association = Taiwan yi zhi. 1994;93(2):170-2

Sternbach G

William Osler: narcotic-induced pulmonary edema.

The Journal of emergency medicine. 1983;1(2):165-7

—

Heroin pulmonary edema.

JAMA. 1968;206(1):125-6

Steinberg AD, Karliner JS

The clinical spectrum of heroin pulmonary edema.

Archives of internal medicine. 1968;122(2):122-7

Stern WZ, Spear PW, Jacobson HG

The roentgen findings in acute heroin intoxication.

The American journal of roentgenology, radium therapy, and nuclear medicine. 1968;103(3):522-32

Katz S, Aberman A, Frand UI, Stein IM, Fulop M

Heroin pulmonary edema. Evidence for increased pulmonary capillary permeability.

The American review of respiratory disease. 1972;106(3):472-4

Frand UI, Shim CS, Williams MH Jr

Heroin-induced pulmonary edema. Sequential studies of pulmonary function.

Annals of internal medicine. 1972;77(1):29-35