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Toxicity, Heroin: Multimedia
Updated: Aug 12, 2008
Multimedia
![]() | Media file 1: Heroin-related noncardiogenic pulmonary edema. |
![]() | Media file 2: Track marks in a heroin intravenous drug user. |
![]() | Media file 3: Necrotizing fasciitis in a heroin user. |
![]() | Media file 4: Endocarditis-related septic pulmonary emboli in a heroin user. |
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References
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Further Reading
Keywords
heroin toxicity, heroin, heroin poisoning, heroin overdose, heroin addiction, heroin use, heroin dependence, dope, smack, skag, junk, mud, shill, big H, horse, white stuff, brown sugar, black tar, Lady Jane, body stuffers, body packers, intravenous drug use, intravenous drug abusers, IVDA, skin-popping, diacetylmorphine, narcotic, mainlining, opioid








Multimedia: Toxicity, Heroin