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The Drug-Induced Respiratory Disease Website

Philippe Camus, M.D.

Dijon, France

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Heroin (intravenous)

5

II.a Pulmonary edema, noncardiogenic (NCPE)

5
Last update : 02/05/2019
 
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Identify causative drugs
Diagnosing DIRD
1
Drug and radiation history
2
Drug singularity - Correct identification of the drug
3
Consistent timing of exposure v. onset of symptoms
4
Clinical, imaging, BAL, pathological pattern consistent with the specific drug
5
Careful exlusion of another cause
6
Remission of symptoms with removal of drug
7
Recurrence with rechallenge (rarely advisable)
8
Causality assessment
More detailed checklist
See also under
Abused drugs/substances (illicit-, street drugs - IV/inhaled)
5
Heroin (inhaled, insufflated, snorted)
4
Methadone
5
Opiates - Opioids - Opium
5

Publications

Heroin-Induced Non-cardiogenic Pulmonary Edema: A Rare but Serious Complication.
Cureus 2025 Mar;17;e81548 2025 Mar
Post-mortem whole body computed tomography of opioid (heroin and methadone) fatalities: frequent findings and comparison to autopsy.
European radiology 2014 Jun;24;1276-82 2014 Jun
Heroin body packer's death in Haryana; India: a case report.
Journal of forensic and legal medicine 2013 Aug;20;693-6 2013 Aug
"Foam Cone" exuding from the mouth and nostrils following heroin overdose.
Toxicology mechanisms and methods 2012 Feb;22;159-60 2012 Feb
The histopathology of drugs of abuse.
Histopathology 2011 Oct;59;579-93 2011 Oct
Clinical images in medical toxicology: heroin overdose with non-cardiogenic pulmonary edema.
Clinical toxicology (Philadelphia, Pa.) 2006;44;399 2006
Patterns of presentation in heroin overdose resulting in pulmonary edema.
The American journal of emergency medicine 2003 Jan;21;32-4 2003 Jan
Heroin-related noncardiogenic pulmonary edema : a case series.
Chest 2001 Nov;120;1628-32 2001 Nov
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 May 15;110;87-96 2000 May 15
Diphenhydramine toxicity: comparisons of postmortem findings in diphenhydramine-, cocaine-, and heroin-related deaths.
The American journal of forensic medicine and pathology 1998 Jun;19;143-7 1998 Jun
Delayed resolution of pulmonary oedema after cocaine/heroin abuse.
Thorax 1994 Oct;49;1038-40 1994 Oct
Heroin lung: report of two cases.
Journal of the Formosan Medical Association = Taiwan yi zhi 1994 Feb;93;170-2 1994 Feb
William Osler: narcotic-induced pulmonary edema.
The Journal of emergency medicine 1983;1;165-7 1983
Heroin pulmonary edema. Evidence for increased pulmonary capillary permeability.
The American review of respiratory disease 1972 Sep;106;472-4 1972 Sep
Heroin-induced pulmonary edema. Sequential studies of pulmonary function.
Annals of internal medicine 1972 Jul;77;29-35 1972 Jul
Heroin pulmonary edema.
JAMA 1968 Sep 30;206;125-6 1968 Sep 30
The roentgen findings in acute heroin intoxication.
The American journal of roentgenology, radium therapy, and nuclear medicine 1968 Jul;103;522-32 1968 Jul
The clinical spectrum of heroin pulmonary edema.
Archives of internal medicine 1968 Aug;122;122-7 1968 Aug
Pulmonary edema in acute heroin poisoning; report of four cases.
The American journal of medicine 1959 Jul;27;187-92 1959 Jul

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