Neri Serneri G G, Modesti P A
Clinica Medica I, Università degli Studi di Firenze.
Ann Ital Med Int. 1991 Jul-Sep;6(3):313-24.
Aside from disease induced by the direct pharmacological effect of heroin or cocaine, the occurrence of several medical complications not directly related to the drug itself is becoming an increasingly serious problem. In addition to the well-known occurrence of infective diseases, including AIDS, related to the i.v. use of heroin, heroin addicts also seem significantly more at risk for chronic nephropathy. Amyloidotic nephropathy is especially frequent in addicts who use heroin by subcutaneous route (skin popping); it seems to be mediated by an immunologic mechanism. Amyloidotic nephropathy is the main cause of renal failure among drug addicted subjects. Cardiovascular and cerebrovascular diseases are the most frequent medical complications observed in cocaine users. However, the occurrence of infective disease, such as endocarditis or hepatitis related to the parenteral use of the drug, is becoming frequent in these patients. Pulmonary disease is also common due to the route of administration of crack. These medical complications of drug addiction belong to the specific field of internal medicine and should be promptly recognized and treated by the physician.
除了由海洛因或可卡因的直接药理作用引起的疾病外，几种与药物本身无直接关联的医学并发症的出现正成为一个日益严重的问题。除了与静脉注射海洛因相关的包括艾滋病在内的众所周知的感染性疾病外，海洛因成瘾者患慢性肾病的风险似乎也显著更高。淀粉样变性肾病在通过皮下途径（皮肤注射）使用海洛因的成瘾者中尤为常见；它似乎是由一种免疫机制介导的。淀粉样变性肾病是药物成瘾者肾衰竭的主要原因。心血管和脑血管疾病是可卡因使用者中最常见的医学并发症。然而，与该药物非肠道使用相关的感染性疾病，如心内膜炎或肝炎，在这些患者中也越来越常见。由于快克的给药途径，肺部疾病也很常见。药物成瘾的这些医学并发症属于内科的特定领域，医生应及时识别并治疗。
