Respiratory Complications of Cocaine Abuse

  • Joshua A. Perper
  • David H. Van Thiel
Part of the Recent Developments in Alcoholism book series (RDIA, volume 10)


Upper respiratory and pulmonary complications of cocaine addiction have been increasingly reported in recent years, with most of the patients being intravenous addicts, users of freebase, or smokers of “crack.”

The toxicity of cocaine is complex and is exerted via multiple central and peripheral pathways. Recurrent snorting of cocaine may result in ischemia, necrosis, and infections of the nasal mucosa, sinuses, and adjacent structures.

Pulmonary complications of cocaine toxicity include pulmonary edema, pulmonary hemorrhages, pulmonary barotrauma, foreign body granulomas, cocaine related pulmonary infection, obliterative bronchiolitis, asthma, and persistent gas-exchange abnormalities.

Respiratory manifestations are nonspecific and include shortness of breath, cough, wheezing, hemoptysis, and chest pains. Severe respiratory difficulties have been reported in neonates of abusing mothers.

In the absence of a cocaine-abuse history, it may be difficult to recognize the etiological role of cocaine, especially in the absence of needle tracks pointing to previous intravenous drug abuse and/or negative toxicology.


Pulmonary Edema Bronchiolitis Obliterans Cocaine Abuse Cocaine User Dental Erosion 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer Science+Business Media New York 1992

Authors and Affiliations

  • Joshua A. Perper
    • 1
  • David H. Van Thiel
    • 2
  1. 1.Allegheny County Coroner’s Office, Departments of Pathology and Epidemiology, School of Medicine and School of Public HealthUniversity of PittsburghPittsburghUSA
  2. 2.Department of SurgeryUniversity of Pittsburgh School of MedicinePittsburghUSA

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