The Medical Sequelae of Narcotic Addiction

Article1 July 1967The Medical Sequelae of Narcotic AddictionCHARLES E. CHERUBIN, M.D.CHARLES E. CHERUBIN, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-67-1-23 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptAt the present time the social and psychologic aspects of narcotic addiction are receiving considerable professional and public attention. However, at the same time—perhaps because it is considered a social and not a medical problem—the clinical diseases of drug addicts receive relatively scant notice. There does exist a body of information, although not extensive or entirely satisfactory, on just this aspect of addiction, yet professional workers in the field and physicians in general are seldom acquainted with it.The present report is intended both as a survey of the material to be found in the literature and as a summary...References1. : A Follow-Up Study of Treated Adolescent Narcotic Users. Columbia University Press, New York, 1959. Google Scholar2. DUVALLLOCKEBRILL HJBZL: Followup study of narcotic drug addicts five years after hospitalization. Public Health Rep. 78: 185, 1963. CrossrefMedlineGoogle Scholar3. O'DONNELL JA: A follow-up of narcotic addicts; mortality, relapse and abstinence. Amer. J. Orthopsychiat. 34: 948, 1964. CrossrefMedlineGoogle Scholar4. MASON P: Mortality among young narcotic addicts. Proc. Nat. Acad. Sci. USA 8 (appendix): 4508, 1966. Google Scholar5. PESCOR MJ: Follow-up study of treated narcotic addicts. Public Health Rep. 170 (suppl.): 3, 1943. Google Scholar6. RUDEN E: Zur sterblichkeit der morphinisten. Arch. Psychiat. Nervenkr. 193: 98, 1955. CrossrefGoogle Scholar7. HELPERNRHO MYM: Deaths from narcotism in New York City. Incidence, circumstances, and postmortem findings. New York J. Med. 66: 2391, 1966. MedlineGoogle Scholar8. Office of the Chief Medical Examiner, Courtesy of Dr. Milton Helpern: Records examined by Dr. Florence Kavaler, August 1965. Google Scholar9. DAI B: Opium Addiction in Chicago. The Commercial Press, Shanghai, 1937. Google Scholar10. TREADWAY WL: Further observations on the epidemiology of narcotics addiction. Public Health Rep. 95: 541, 1930. CrossrefGoogle Scholar11. : Traffic in Opium and Other Dangerous Drugs for the Year Ended Dec. 31, 1955. U. S. Government Printing Office, Washington, D. C., 1956. Google Scholar12. : Traffic in Opium and Other Dangerous Drugs for the Year Ended Dec. 31, 1962. U. S. Government Printing Office, Washington, D. C., 1963. Google Scholar13. WINICH C: Narcotic addiction and its treatment. Law Contemp. Prob. 22: 9, 1957. CrossrefGoogle Scholar14. : Vital Statistics of the U. S. U. S. Government Printing Office, Washington, D. C., 1965. Google Scholar15. SIEGELHELPERNEHRENREICH HMT: The diagnosis of death from intravenous narcotism. With emphasis on the pathologic aspects. J. Forensic Sci. 11: 1, 1966. MedlineGoogle Scholar16. TROEN P: Pulmonary edema in acute opium intoxication. New Eng. J. Med. 248: 364, 1953. CrossrefMedlineGoogle Scholar17. SILBERCLERKIN REP: Pulmonary edema in acute heroin poisoning. Amer. J. Med. 27: 187, 1959. CrossrefMedlineGoogle Scholar18. OSLER W: Oedema of left lung—morphia poisoning. Montreal Gen. Hosp. Rep. 1: 291, 1880. Google Scholar19. MCNALLY WD: A case of heroin poisoning. J. Lab. Clin. Med. 2: 570, 1917. Google Scholar20. KACZANDER PV: Morphine-Vergiftungtodliche (Selbstmord). Arch. Toxik. 2: A177, 1931. CrossrefGoogle Scholar21. PRESCOTT AB: Alkaloidal poisons, in Legal Medicine and Toxicology, vol. 2, edited by PETERSON, F., HAINES, W. S., WEBSTER, R. W. W. B. Saunders Co., Philadelphia, 1923, p. 416. Google Scholar22. BURTONZAWADZKIWETHERELLMOY JFSHRTW: Mainliners and blue velvet. J. Forensic Sci. 10: 466, 1965. MedlineGoogle Scholar23. SOLLOMAN TE: A Manual of Pharmacology, 6th ed. W. B. Saunders Co. Philadelphia, 1942, pp. 461, 1046. Google Scholar24. FULTON CC: An analytical study of confiscated samples of narcotic drugs. Int. Microfilm J. Legal Med. 1: Card 2, C-1. Google Scholar25. CLEMMESENLASSEN CNA: Treatment of circulatory shock in narcotic poisoning, with special reference to complicating pulmonary oedema. Danish Med. Bull. 10: 100, 1963. MedlineGoogle Scholar26. NORMAN B: Tetanus after hypodermic injection of morphine. Lancet 1: 873, 1876. Google Scholar27. MELDON A: Death from tetanus induced by a hypodermic injection. Brit. Med J. 2: 709, 1879. Google Scholar28. OSBURNE CA: Tetanus due to puncture of a hypodermic needle in a drug addict. Brit. Med. J. 2: 75, 1892. Google Scholar29. PALMER JF: Tetanus due to puncture of hypodermic needle. Ibid., p. 164. Google Scholar30. DOANE JC: Tetanus as a complication of drug inebriety. JAMA 82: 1105, 1924. CrossrefGoogle Scholar31. FOUNTAIN EM: The early symptoms of tetanus with review of 22 cases. Canad. Med. Ass. J. 64: 58, 1951. MedlineGoogle Scholar32. MULROY RD: Tetanus at Rhode Island Hospital—1930-1950. Rhode Island Med. J. 34: 254, 1951. MedlineGoogle Scholar33. MOORESINGLETON RMAO: Tetanus at John Sealy Hospital. Gynec. Obstet. 69: 146, 1939. Google Scholar34. LEVINSONMARSKESHEIN AKRLMD: Tetanus in heroin addicts. JAMA 157: 658, 1955. CrossrefMedlineGoogle Scholar35. BEDELLPALEY MDSS: Introduction of human tetanus through minor wounds. New York J. Med. 55: 1186, 1955. MedlineGoogle Scholar36. ROUCHE B: A pinch of dust, in Eleven Blue Men. Little, Brown and Co., Boston, 1953, p. 64. Google Scholar37. GREENBERG M: Unpublished monthly reports of the Bureau of Preventable Diseases, New York City Department of Health, May 1959. Google Scholar38. CHERUBIN CE: Urban tetanus: the epidemiology of addict tetanus. Arch. Environ. Health (Chicago). In press. Google Scholar39. ANDRIOLEKRAVETZROBERTSUTZ VTHMWCJP: Candida endocarditis. Clinical and pathologic studies. Amer. J. Med. 32: 251, 1962. CrossrefMedlineGoogle Scholar40. LUTTGENS WF: Endocarditis in "Main Line" opium addicts. Arch. Intern. Med. (Chicago) 83: 653, 1949. CrossrefGoogle Scholar41. HUSSEYKATZ HHS: Infections resulting from narcotic addiction. Amer. J. Med. 9: 186, 1950. CrossrefMedlineGoogle Scholar42. WILDER RM: Staphylococcal bacterial endocarditis—a report of a case in a narcotic addict. Amer. J. Med. 23: 325, 1957. CrossrefMedlineGoogle Scholar43. OLSSONROMANSKY RAMJ: Staphylococcal tricuspid endocarditis in heroin addicts. Ann. Intern. Med. 57: 755, 1962. LinkGoogle Scholar44. OERTHERGOODMANLERNER FJJLAM: Infections in paregoric addicts. JAMA 190: 683, 1964. CrossrefMedlineGoogle Scholar45. LERNEROERTHER AMFJ: Characteristics and sequelae of paregoric abuse. Ann. Intern. Med. 65: 1019, 1966. LinkGoogle Scholar46. SPAIN DM: Patterns of pulmonary fibrosis as related to pulmonary function. Ann. Intern. Med. 33: 1150, 1950. LinkGoogle Scholar47. KRAINERBERMANWISHNICK LESC: Parenteral talcum granulomatoses: complication of narcotic addiction. Lab. Invest. 11: 671, 1962. Google Scholar48. WENDTPUROSHAPIROMATHEWSWOLF VEHEJWPL: Angiothrombotic pulmonary hypertension in addicts. "Blue velvet" addiction. JAMA 188: 755, 1964. CrossrefMedlineGoogle Scholar49. PUROWOLFSKIRGAUDASVASQUEZ HEPLJJ: Experimental production of human "Blue Velvet" and "Red Devil" lesions. JAMA 197: 1100, 1966. CrossrefMedlineGoogle Scholar50. STEIGMANHYMANGOLDBLOOM FSR: Infectious hepatitis (homologous serum type) in drug addicts. Gastroenterology 15: 642, 1950. CrossrefMedlineGoogle Scholar51. APPLEBAUMKAHLSTEIN EM: Artificial transmission of viral hepatitis among intravenous diacetylmorphine addicts. JAMA 147: 222, 1951. CrossrefMedlineGoogle Scholar52. ALTSHULFOSTERPALEYTURNER APDSSL: Incidence of hepatitis among narcotic addicts in Harlem Hospital. Arch. Intern. Med. (Chicago) 89: 24, 1952. CrossrefGoogle Scholar53. CARDONBECK PVRM: Recent occurrence of hepatitis among drug addicts of New York City. New York J. Med. 52: 1037, 1952. MedlineGoogle Scholar54. ALTERMICHAEL AAM: Serum hepatitis in a group of addicts. New Eng. J. Med. 259: 387, 1958. CrossrefMedlineGoogle Scholar55. SCHAFERMOSLEY IAJ: A study of viral hepatitis in penal institutions. Ann. Intern. Med. 49: 162, 1958. Google Scholar56. LEVINEPAYNE RAMA: Homologous serum hepatitis in youthful heroin users. Ann. Intern. Med. 53: 164, 1960. LinkGoogle Scholar57. POTTERCOHENNORRIS HPNNRF: Chronic hepatic dysfunction in heroin addicts. Possible relation to carrier state of viral hepatitis. JAMA 174: 2049, 1960. CrossrefMedlineGoogle Scholar58. NORRISPOTTER RFHP: Hepatic inflammation in narcotic addicts; viral hepatitis a possible cause. Arch. Environ. Health (Chicago) 11: 662, 1965. CrossrefMedlineGoogle Scholar59. KAPLAN N: Chronic liver disease in narcotic addicts. Amer. J. Dig. Dis. 8: 402, 1963. CrossrefMedlineGoogle Scholar60. BROOKSDENEAUPOTTERREINHOLDNORRIS FPGAPJGRF: Liver function tests in morphine-addicted and in nonrhesus monkeys. Gastroenterology 44: 287, 1963. CrossrefMedlineGoogle Scholar61. BOAKCARPENTERMILLER RACMJN: Biologic false-positive reactions for syphilis among narcotic addicts. A report on the incidence of BFP reactions as measured by TPI test. JAMA 175: 326, 1961. CrossrefGoogle Scholar62. BEGGAN AG: Malignant malaria associated with administration of heroin intravenously. Trans. Roy. Soc. Trop. Med. Hyg. 23: 147, 1929. CrossrefGoogle Scholar63. GEIGER JC: Malaria in narcotic addicts (correspondence). JAMA 98: 1494, 1934. CrossrefGoogle Scholar64. HELPERN M: Epidemic of fatal estivo-autumnal malaria. Amer. J. Surg. 26: 111, 142, 1934. CrossrefGoogle Scholar65. MOST H: Falciparum malaria in drug addicts. Amer. J. Trop. Med. 20: 551, 1940. CrossrefGoogle Scholar66. MOST H: Falciparum malaria among drug addicts. Epidemiologic studies. Amer. J. Public Health 30: 403, 1940. CrossrefGoogle Scholar67. SCHOENBACHSPINGARN EBCL: Inoculation malaria and drug addiction. J. Mount Sinai Hosp. N. Y. 8: 998, 1942. Google Scholar68. EISENMANFRASERSLOANISBELL AJHFJH: Urinary 17-ketosteroid excretion during a cycle of addiction to morphine. J. Pharmacol. Exp. Ther. 124: 305, 1958. MedlineGoogle Scholar69. EISENMANFRASERBROOKS AJHFJW: Urinary excretion and plasma levels of 17-hydroxycorticosteroids during a cycle of addiction to morphine. J. Pharmacol. Exp. Ther. 132: 226, 1961. MedlineGoogle Scholar70. OLIVER-SMITH F: Personal communication. Google Scholar71. Joint Clinical Conference on Maternal and Neonatal Narcotic Addiction: March 17, 1966, Bellevue Medical Center, School of Nursing, New York City. Google Scholar72. YERBY AS: Problem of neonatal narcotic addiction. New York J. Med. 66: 1248, 1966. Google Scholar73. STERN R: The pregnant addict. A study of 66 case histories, 1950-1959. Amer. J. Obstet. Gynec. 94: 253, 1966. CrossrefMedlineGoogle Scholar74. SCHOENFELDSAMALA MRR: Absence of anemia in hepatitis due to heroin addiction. Evidence for tendency to erythrocytosis among heroin addicts. J. New Drugs 6: 149, 1966. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: New York, New YorkFrom the Department of Preventive Medicine, and the Department of Medicine, New York Medical College, New York, N. Y.Requests for reprints should be addressed to Charles Cherubin, M.D., Assistant Professor, Department of Preventive Medicine and Department of Medicine, New York Medical College, Fifth Ave. at 106th St., New York, N. Y. 10029. 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