An epidemic of heroin overdose is described which occurred over a seventeen-month period and involved 149 patients who were predominately young, black or Puerto Rican males. The major complications were pulmonary edema (48 per cent), pneumonia (30 per cent), cardiac arrhythmias (4 per cent) and death (8.7 per cent). Hypoxia appeared to be the cause of the pulmonary edema and cardiac arrhythmias. A treatment protocol is outlined with emphasis on the need for oxygen therapy.
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