Here, we report a case of crack cocaine pipe aspiration in a young, healthy female. There are case reports of aspiration of the crack pipe itself, as well as ingestion/aspiration of the steel wool material. Injuries including burning of the fingers, lips, and mouth with the pipe have been reported. Crack pipes are often a combination of a glass stem and some sort of metallic mesh, frequently steel wool, to place the crack rock against as it is melted. These pipes are dangerous, and the British Columbia CDC has even made safer brass screens available through their Harm Reduction Program. While respiratory failure, arrhythmia, and cerebrovascular ischemia are well known to clinicians, there are consequences to its method of administration as well.
The health risks associated with crack use are not limited to the effects of the drug itself. Despite its decline in use, crack cocaine continues to be an important drug of abuse.
Furthermore, the Center for Disease Control and Prevention (CDC) has demonstrated an association between cocaine use and heroin use, which itself has increased by more than 150% over the past 12 years. While this number has fallen over the last decade, it has been stable since 2009. In a 2014 report by the Substance Abuse and Mental Health Services Administration, 1.5 million people were current users of cocaine, with crack representing 354,000 of those individuals. In particular, crack cocaine is long past its boom days during the “crack epidemic,” but it is nonetheless the drug of choice for many consumers and purveyors of the illicit drug. As prescription pain reliever use has increased, there has been a commensurate decline in cocaine use.
Though relatively uncommon, this case highlights a possible complication associated with crack cocaine abuse that may require emergent intervention.Īccording to the United Nations Office on Drugs and Crime, 5% of the world population aged 15 to 64 used some sort of illicit drug in 2013. The patient signed out against medical advice soon after. An urgent bronchoscopy revealed a metallic foreign body impacted into the left lower lobe bronchus proper, soon after the takeoff of the superior segment, which was removed with forceps. A chest X-ray revealed an 8 mm radiopaque foreign body overlying the region of the left lower lobe bronchus, with a confirmatory computed tomography scan of the chest. A 42-year-old female presented with a two-day history of gradually worsening cough and a history of “food aspiration.” Her lung examination revealed wheezing and fine crackles with diminished air entry at the left base. We report a case of less recognized complication, the aspiration of a metallic object used as a screen for crack cocaine abuse. Inhalation of cocaine derivatives is associated with a number of pulmonary and systemic complications.
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