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Emphysema from sources other than cigarettes needs more research.

This case series of heroin smokers who developed early-onset emphysema may offer insights into the development of COPD and emphysema in cigarette smokers who don't smoke opiates.

How might narcotic use contribute to the development of COPD and emphysema? There are several possible explanations. Smokers of heroin and other illicit substances typically take a deep inhalation, combined with a Valsalva maneuver to enhance absorption of the drug into the body. This behavior has been described previously in heroin users and users of other smoked substances. In addition, these agents often burn at a very high temperature, with the potential to cause damage deep within the lung.

The depth of inhalation, dynamic hyperinflation, and barotrauma may be important factors in some patients who develop emphysema related to cigarette smoking or other factors, as well. Physicians should be aware of this problem, and the public must be educated about the dangers associated with the inhalation of these and other burned substances.

Dr. David M. Mannino is the chair of preventative medicine and environmental health in the department of epidemiology at the University of Kentucky in Lexington. He disclosed having served as a consultant for Boehringer Ingelheim GmbH, GlaxoSmithKline, AstraZeneca, Novartis AG, Merck, and Forest Pharmaceuticals, and has received research grants from GSK, Novartis, Boehringer Ingelheim, Forest Pharmaceuticals, and Pfizer. He is also compensated by Up-to-Date, has served as an expert in tobacco-related cases, and is on the board of the COPD Foundation. He made his remarks in an editorial published with the study.

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Title Annotation:VIEW ON THE NEWS
Author:Mannino, David M.
Publication:Internal Medicine News
Date:Dec 1, 2015
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