Mortality from asthma has been increasing, raising questions about the increasing prevalence and severity of asthma, as well as about the potential effects of changes in the medical management of asthma. Leikauf et al attribute the increasing prevalence and mortality to be more likely related to environmental than genetic factors. Cialis pills Canada Asthma deaths are particularly high in lower socioeconomic groups, which may be accounted for by several factors, including crowded living conditions, poor access to health care, and lack of patient education about asthma.
Another important consideration is that of illicit drug use, particularly crack cocaine use, which is a major social problem in the United States, particularly in large urban populations. A number of cases illustrating a temporal association between heavy crack use and severe acute exacerbation of asthma, including fatal asthma, have been reported.
The increase in cocaine use seems to parallel the increase in asthma morbidity and mortality, suggesting there may be an association between the two. Levenson et al reviewed cases of asthma deaths in the Chicago area. Their findings were that 29 of 92 cases (31.5%) were confounded by substance abuse (including cocaine) or alcohol use. Thus far, the prevalence of cocaine use among patients presenting with acute asthma is unknown, and crack cocaine may be unrecognized as a precipitant for asthma exacerbations.
This study addresses the prevalence of illicit drug use—particularly cocaine—among adults presenting to an inner-city emergency department (ED), and the relationship of cocaine use and severity of asthma exacerbation. A secondary aim was to assess the frequency of use of various treatment modalities for asthma, particularly inhaled corticosteroids (ICS) and P2-agonists, with reference to the 1997 National Asthma Education and Prevention Program (NAEPP) guidelines.
Materials and Methods
We conducted a prospective study to determine the prevalence of cocaine use and its impact on severity in adult patients presenting to an inner-city ED with acute asthma exacerbation.
