الفهرس 
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Abstract
Thoracic complications of illicit drug use may be organized on the basis of the organ system involved, and such categorization will facilitate rapid recognition of complications and allow accurate diagnosis. Appropriate treatment planning in a patient with respiratory manifestations associated with inhalation abuse require familiarity with the wide spectrum of pathologic conditions associated with such abuse, which represents one of the most serious medical and social problems of our time.
This work aimed to study the pulmonary complications of addiction among patients selected from Poison Control Center of Ain Shams University Hospitals. In duration between June 2016 to June 2018. Some patients with pulmonary complications referred to Abbasia Chest Hospital.
Inclusion criteria:
• All patients who agreed to participate in this study after taking a written consent (A written consent was taken from patient himself or relatives of first degree if patient was disoriented).
• All patients ≥ 18 year who met the medical definition of addiction according to American Psychiatric Association (DSM-IV).
Exclusion criteria:
• All patients who refused to participate in this study.
• All patients with negative Drug screen test.
• All patients with drug overdose without any pulmonary complications
All the patients were subject to the following:
1. Full history taken including smoking index
2. History of drug addiction as regard type of the drug, method and rout of addiction.
3. Thorough clinical examination (General and Local).
4. Radiological examination including:
• Plain chest x-ray, posteroanterior view
• CT chest if indicated.
• Echocardiography if indicated.
• Duplex if indicated (Venous)
• CT pulmonary angiography if indicated
5. Routine laboratory investigation:
• Complete blood count (CBC)
• Blood chemistry (including serum creatinine, blood urea nitrogen and liver function: Alanine transaminase (ALT) and aspartate aminotransferase (AST).
6. Arterial blood gases (ABG) if indicated.
7. Viral markers: hepatitis B virus (HBV Surface Antigen), hepatitis C virus (HCV Antibody) and HIV (Antibody)
8. Drug screen test: Using one step drug screen test device (urine)
9. Pulmonary function test if possible (spirometer)
10. Quantitative culture if there are signs of infection.
11. Sputum Ziehl-Neelsen stain for three successive days.
12. GeneXpert of sputum or body fluid if indicated.
13. Fiberoptic bronchoscopic work up if needed
One hundred addict patients with drug overdose without any pulmonary complications were excluded from the study.
The most commonly abused drugs that affect the respiratory system are cannabis then opioids. The most common among opioids was morphine
The most common pulmonary complication among all addicts was pulmonary TB.
Pulmonary TB was the most common pulmonary complication among cannabis addicts (inhalation drug addicts) (44.4%) as well as PSA (50.0 %).
The most common pulmonary complication among opiate addicts was Parenchymal lung diseases (48.0%).
Parenchymal lung diseases were the most common pulmonary complication among IV drug addicts representing 65.0%.
Airway diseases were the most common pulmonary complication among oral drug addicts (77.8%).
Among patients with pleural disease 60.0% were inhalational drug addicts (cannabis addicts).
All patients with malignancy were cannabis addicts
In comparison of IV and inhalational drug addicts the parenchymal lung diseases (pneumonia and abscess) were more common among IV drug addicts (65.0%) than inhalational drug addicts (23.8%).
Anemia was common among patients and represents 88% of all addicts.
HCV positive was more common among IV drug addicts (heroin and morphine) than inhalation drug addicts.
Infective endocarditis was discovered in 3.5% of all patients who done Echo (Tricuspid valve involvement in IV heroin addict with HIV positive).
Mortality represents only 3.0% of all patients.
Drugs which are inhaled are those most likely to result in respiratory complications.