[Foil Smoking/Heroin Inhalation].

Foil Smoking/Heroin Inhalation Abstract. Foil smoking is generally heroin consumption by inhalation. By heating an aluminum foil with a fire lighter the heroin on top of the foil starts melting and the smoke is then inhaled using a straw. Foil smoking is the second most common form of heroin consumption after the intravenous use. In contrast to the IV administration, heroin inhalation effects are delayed by a few minutes and the risk of transmission of HIV, Hepatitis or other infectious diseases is not relevant. Severe bronchospasms can occur in patients with or without prior pulmonary disease such as asthma bronchiale. One cerebral consequence of foil smoking is leukoencephalopathy, a spongiform degeneration of the white matter. This is likely triggered by the pyrolysate generated during the heating process. Multiple drug use and concomitant cigarette smoking in heroin addicts make cause-effect relationships difficult to assess. In general, the history of inhalative heroin consumption should be considered in patients presenting with any unkown pulmonary disease with severe bronchospasms as may happen in a severe asthma exacerbation.