Recreational Drug-induced Cardiopulmonary Injury

Recreational substance abuse and associated emergency department visits are rising in prevalence, with ever-increasing numbers of overdose-related fatalities. Recreational substances are primarily administered through intravenous and inhalational routes, which are favored owing to their quick and intense onset of action but are associated with higher risks of unintentional overdose and cardiopulmonary complications. Acute insults to the cardiopulmonary system range from infectious to inflammatory to thermal types, with long-term consequences that include emphysema, pulmonary fibrosis, pulmonary hypertension, heart failure, and cardiomyopathy. Varying imaging features and patterns can be seen at cross-sectional imaging (ie, CT and MRI), depending on the type of recreational substance used, the route of administration, and the chronicity of usage-factors that can aid radiologists in the timely identification of patients at risk for cardiopulmonary complications.