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August 23, 1976

Roentgenographic Aspects of Narcotic Addiction

Author Affiliations

From the Department of Radiology, Montefiore Hospital and Medical Center-Morrisania City Hospital Affiliation, and the Albert Einstein College of Medicine, Bronx, NY.

JAMA. 1976;236(8):963-965. doi:10.1001/jama.1976.03270090057039

THE MEDICAL complications of narcotic addiction may be divided into two major categories: (1) untoward reactions to the drug itself, and (2) various infectious complications due to nonsterile equipment used for intravenous administration of narcotics.

Drug Reactions  The most conspicuous roentgenographic changes are encountered in the lungs, ie, the development of acute pulmonary edema (Fig 1 and 2). Although initially emphasized after intravenous use of heroin, the occurrence of pulmonary edema has also been noted with morphine, opium, methadone,1 propoxyphene hydrochloride (Darvon), chlordiazepoxide hydrochloride (Librium),2 and various other drugs. The roentgenographic findings typically consist of an alveolar pattern, with ill-defined, fluffy coalescent densities radiating from the lung roots peripherally, sometimes in a symmetric fashion, but often with localized variations. In milder cases, there may only be a coarse mottling of the lungs.Since physical findings of pulmonary edema after narcotic abuse may be absent, the radiologist can make