Heroin inhalation and asthma.

Opiate addiction is an increasing social problem, and there has been a change from taking opiates intravenously to inhaling them in many areas of Britain. Three patients with asthma who required mechanical ventilation soon after heroin inhalation were described. Two subsequently died of acute severe asthma. The patients were reluctant to admit to their addiction and persisted inhaling heroin despite medical advice and counselling. Opiate inhalation can provoke life threatening asthmatic attacks and should be considered in patients at risk of abusing drugs who have poorly controlled asthma.