Abstract
Histopathological study of lungs in cases of fatal narcotism, addicts with death due to other causes, nonaddict controls, nonnarcotic drug overdose-hypersensitivity deaths, and nonaddicts with fatal liver disease, was made to (1) determine possible meehanism(s) involved in heroin-induced pulmonary edema, and (2) identify risk factors. Maximum number of narcotics overdose deaths in Maryland during 1968 to 1971 occurred from June to October. Allergic diathesis was considered, but rates of such allergies as asthma and those related to food and drugs were not significant for overdose cases. Significant lung abnormalities differentiated cases of fatal narcotism from fatal bronchial asthma, drug-anaphylaxis, and nonnarcotic drug overdose. Acute inflammatory response was apparent in overdose cases, but in the absence of vasculitis, an Arthus-fike reaction seemed unlikely. Anaphylactic-like response in overdose cases also appeared unlikely.
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