Narcotic Septal Perforations Due to Drug Addiction

ANY PHYSICIAN who has had substantial experience with drug addicts is aware of the fact that perforations of the nasal septum occur because of this habit. However, most individuals have a rather vague and sometimes erroneous idea of the actual incidence of this complication. This ambiguity was first brought to the author's attention in 1952 when he conferred with the late Dr. Perry Lichtenstein (then Medical Consultant in the New York District Attorney's Office) about a case of narcotic septal perforation due to heroin which was encountered in a routine physical check-up. Dr. Lichtenstein at that time expressed the opinion that nasal septal perforations were becoming increasingly rare because of the almost exclusive use of heroin instead of cocaine, since the latter material had become more expensive and more difficult to obtain through the usual illicit channels. Dr. Lichtenstein surmised cocaine was usually used in a more concentrated form and