Complications Due To Smoking Inhaling

The fastest delivery of large amounts of drug directly to the brain is through smoking (inhaling). Drugs taken in this way go directly to the lungs and are absorbed along with oxygen directly into the blood heading for the brain. The two terms, smoking and inhaling, as a means of drug intake, are clearly differentiated when, on the one hand, material is actually burned and the resulting smoke is taken into the lungs—as with TOBACCO or MARIJUANA—or on the other hand, when fumes from volatile substances are inhaled, such as glue or gasoline. They may be confused or used interchangeably, however, when material is vaporized through heat and the vapor is inhaled—as with cocaine FREEBASE (crack).

Smoking. Smoke from any material will act as an irritant to the lungs and bronchial system, eventually causing problems that can range from chronic bronchitis to emphysema or cancer of the mouth, throat and/or lungs. Both tobacco and marijuana contain a number of tars and potential carcinogens (cancer-triggering substances) and both produce potentially toxic concentrations of carbon monoxide. While it has been argued that tobacco is the worst danger because it is smoked very frequently, it has also been pointed out that the use mode of marijuana is worse—holding the smoke in the lungs for a long time. The argument is moot, since both can produce profound damage. As a vasoconstrictor, nicotine in tobacco promotes mouth ulceration and gum disease. It can be said that people who smoke lose their teeth, while those who don't, don't. Besides its irritant effects, the smoking of tobacco may also promote respiratory disease by weakening the immune system and by paralyzing the cilia (the tiny hairlike organs) in the lungs that push out foreign matter.

Inhalation (Sniffing). The inhalation (sniffing) of volatile hydrocarbons, such as solvents, can cause death by asphyxiation or suffocation, can impair judgment, and may produce irrational, reckless behavior. Abnormalities also have occurred in liver and kidney functions, and bone-marrow damage has occurred. These may be due to hypersensitivity to the substances or chronic heavy exposure. Chromosome damage and blood abnormalities have been reported, and solvents have been cited as a cause of gastritis, hepatitis, jaundice, and peptic ulcers—such effects are due more to the actions of the drugs than to the route of administration. Chronic users have developed slow-healing ulcers around the mouth and nose, loss of appetite, weight loss, and nutritional disorders. Irreversible brain damage has been reported, too. Many deaths attributed to solvent inhalants are caused by suffocation when users pass out with the plastic bags containing the substance still glued to their noses and mouths. There is also a very real danger of death from acute solvent poisoning or aerosol inhalation. The mere provision of adequate ventilation and the avoidance of sticking one's head in a plastic bag are by no means sufficient safeguards against aerosol dangers.

Other hazards may include freezing the larynx or other parts of the airway when refrigerants are inhaled, and potential spasms as these areas de frost. Blockage of the pulmonary membrane, through which oxygen is absorbed into the lungs, can occur. Death may also result from the ingestion of toxic ingredients along with the aerosol substance. The possibility is made more likely by the fact that commercial products not produced for human consumption are not required to list their ingredients on the label. Individual substances may produce a spectrum of toxic reactions depending on their contents. These have included gastric pain, headaches, drowsiness, irritability, nausea, mucous-membrane irritation, confusion, tremors, nerve paralysis, optic-nerve damage, vomiting, lead poisoning, anemia, and so on. The inhaling of aerosol fluorocarbons can cause ''sudden-sniffing death'' (SSD), wherein the heart is hypersensitized to the body's own hormone epinephrine (adrenaline), leading to a very erratic heartbeat, increased pulse rate, and cardiac arrest.

The inhaling of amyl, butyl or isobutyl nitrites can cause intense headaches, an abrupt drop in blood pressure, and loss of consciousness through orthostatic hypotension (increased heart rate and palpitations), with a threat of myocardial infarction (heart attack).

COMPLICATIONS DUE TO INJECTION

The injection of drugs generally involves the use of the hypodermic needle, first invented in the early nineteenth century and used initially for the medical delivery of the opiate painkiller MORPHINE, for the rapid control of intense PAIN. This combination was first used extensively for battlefield wounds during the Crimean War (1853-1856) and the American Civil War (1861-1865). As its name implies, the hypodermic needle pierces the skin— the dermis. Hypodermic injections may be subcutaneous, directly beneath the skin surface; intramuscular, into the muscle tissue; or intravenous, into a blood vessel. (Note: Although a number of injection-related medical complications are directly skin-related, these are discussed in the article Complications: Dermatological.

While the hypodermic needle is the primary means of drug injection, drug addicts who do not have access to hypodermics have made use of a number of ingenious, and often very dangerous, substitutes. Nonhypodermic-needle means of injection may involve such paraphernalia as lancets or scalpels, or any small sharp blade to make an open ing, and the insertion of an eyedropper, tubing and bulb, or any means of squirting the drug into the resultant wound. In extremes, addicts have used such implements as a pencil, ballpoint or fountain pen, or the sharpened end of a spoon.

Intra-arterial Injection. Injections are never made intentionally into arteries. Accidental intra-arterial injection will produce intense pain, swelling, cyanosis (blueness), and coldness of the body extremity injected. Intra-arterial injection resulting in these symptoms is a medical emergency and, if untreated, may produce gangrene of the fingers, hands, toes, or feet and result in loss of these parts.

Transmittal of Disease through Injection. The greatest number and variety of medical complications of drug use caused by the mode of administration occur as a result of injection. Among the highest risk, and that with the most frequent fatal and disabling consequences is the transmittal of disease through the use of unsterile needles and the sharing of such needles.

Human Immunodeficiency Virus (HIV). Needle-using drug abusers comprise one of the primary high-risk populations for contracting human immunodeficiency virus (HIV). The primary recognized routes of transmission for HIV are (1) sexual contact through unprotected anal or vaginal inter-course—particularly if there are damaged tissue or sores present that provide direct access to the bloodstream; (2) contact with infected blood through needle sharing or through transfusions of blood or blood products; and (3) in utero or at-birth transmission from a mother to her baby.

Acquired Immunodeficiency Syndrome (AIDS), the most severe and life-threatening result of HIV infection, involves the destruction of a person's immune system and the development of cancers and infections that can no longer be fought off.

The incidence of HIV infection among needle-using drug abusers is closely related to local use traditions, habits, and the prevalence of HIV infection among other addicts. The highest incidence is in areas such as New York City, where there is a tradition of needle sharing or where ''shooting galleries''—places where users can rent or share ''works''—are commonly utilized and where there was a high prevalence of HIV among the homosexual population. Users in other geographical locations, such as San Francisco, seem to be more conservative in their social-usage patterns, and when they do share needles, tend to keep the same

''shooting partners'' over a longer period of time. HIV-prevention efforts in some areas have focused on Needle and Syringe Exchange, while others, particularly where needle exchange is not legalized, have community-outreach workers teaching users how to sterilize their needles between each use with household bleach. The gist of both campaigns is that users who share their needles or who use dirty needles are at risk for contracting HIV through their drug use. Those who use sterile needles are not. Both approaches are considered stopgap, however, and are apt to be condemned as ''encouraging of drug abuse.''

All needle-using drug abusers are considered at extremely high risk for HIV infection, and HIV screening is performed routinely at most drug-treatment centers. The virus has a very long incubation period and may be present for seven or more years before active symptoms of opportunistic disease appear. Early symptoms may include: a persistent rash or lesion; unexplained weight loss; persistent night sweats or low-grade fever; persistent diarrhea or fatigue; swollen lymph glands: DEPRESSION or states of mental confusion. Hepatitis and Other Liver Disorders. Hepatitis B, and related strains, often referred to as serum (fluid-related) hepatitis, are the most common medical complication of needle drug use. Like HIV, hepatitis can spread in other ways than needle use, such as sexual intercourse or other direct sharing of blood and bodily fluids. Several strains, however, can be spread by contaminated foods, particularly shellfish, or by unhygenic practices in food handling. Current research indicates that some forms of hepatitis spread via an anal/oral progression— so it is recommended that hands are washed thoroughly after all bowel movements or any other anal-area or fecal-matter handling, as a means of prophylaxis.

Unlike AIDS, hepatitis is often not fatal if it is detected and treated at an early stage. Symptoms of all forms of hepatitis include fatigue, loss of appetite, pain in the upper abdomen, jaundice—yellow skin and a yellowish-to-chartreuse tinge to the sclerae (white of the eye), general itching, dark urine reaching the color of cola drinks with light-tan to cream-colored feces, and mental depression. Gamma globulin injection can provide short-term immunity to all forms of hepatitis and can reduce the symptoms of serum hepatitis if it is given during the gestation period. Treatment includes bed rest, nutritional support, and avoidance of alcohol or any other substance that may further irritate the liver. Caregivers should wear rubber gloves for handling patients. Patients with any form of hepatitis should avoid preparing food for others and use separate towels, bedlinens, and eating utensils until symptoms disappear. Toilet seats and any spilled bedpan matter should be disinfected and hands should then be washed thoroughly with soap. Condoms should be used for any genital contact.

Hepatitis can cause hepatic fibrosis—the development of fibrous tissue in the liver. It can also cause or exacerbate cirrhosis (scarring of the liver), although this is most often a result of chronic alcohol abuse. Symptoms of cirrhosis include jaundice (yellowish skin and eye whites), fatigue, ankle swelling, enlargement of the abdomen, and a full feeling in the right upper abdomen. Tetanus and Malaria. According to Senay and Raynes, the first case of tetanus associated with needle-using substance abuse was reported in England in 1886. By the 1990s, between 70 and 90 percent of tetanus cases have occurred to drug abusers. As a medical complication to drug injection, tetanus most often occurs from ''skin-pop-ping''—which is cutaneous injection. A majority of cases occur in women, and this is attributed to less-substantial venous development than in men and a smaller population with tetanus immunization.

Malaria (caused by the Plasmodium parasite) was first reported among drug users in the United States in 1926. It affects intravenous drug abusers and was brought to this country by needle-sharing sailors who had been exposed to malaria in Africa. The initial outbreak in New Orleans spread to New York City in the 1930s and resulted in several hundred deaths from tertian malaria among drug abusers. A second outbreak occurred in the 1970s, as a result of malaria-infected veterans returning from Vietnam.

The spread of both these diseases among needle-sharing drug abusers has been kept somewhat in check, particularly on the East Coast and in Chicago, by the inclusion of 15 to 30 percent quinine (a natural antimalarial), as filler, to stretch profits in illicit opioid drug mixtures in those areas. Quinine (an alkaloid from chinchona bark) is a protoplasmic poison that prevents the germination of the fastidious tetanus anaerobe, Clostridium tetani, under the skin and in adjacent muscle tissue. Although the quinine amount is not sufficient to erad icate malaria once it has taken hold in the body, it does help prevent the disease by killing the malarial parasites in the hypodermic syringe.

Anxiety Away

Anxiety Away

The strategies revealed within Anxiety Away are fast acting, simple and guaranteed to work even if you have suffered from anxiety for a long time!

Get My Free Ebook


Post a comment