Reference

Inhalation of heroin vapor, often referred to as "chasing the dragon," has been linked to a rare and severe condition called leukoencephalopathy, which involves the degeneration of the brain's white matter. Here are the key points explaining this mechanism:

1. Mechanism of Action: The inhalation of heroin vapor causes toxic damage to the white matter of the brain. White matter consists of nerve fibers covered in a protective sheath known as myelin, which is crucial for the proper transmission of nerve signals.

2. Pathophysiology:

   • Vacuolar Degeneration: The vaporized heroin and its impurities can lead to vacuolar degeneration, where small, fluid-filled cavities (vacuoles) form within the white matter. This is indicative of spongiform changes, leading to a sponge-like appearance in affected areas of the brain [source].
   • Mitochondrial Dysfunction: Studies suggest that the toxic metabolites of heroin disrupt the function of mitochondria in brain cells, leading to energy production failure and cell death [source].
   • Oxidative Stress: The inhaled substances can cause oxidative stress and inflammatory responses in the brain, exacerbating neuronal damage [source].

3. Clinical and Radiological Findings:

   • Progressive Symptoms: Affected individuals may present with neurological deficits ranging from motor symptoms, such as ataxia and spasticity, to cognitive impairments and altered mental statuses.
   • Imaging Diagnoses: Neuroimaging, typically MRI scans, reveals extensive white matter abnormalities. These imaging findings are crucial for diagnosis and show characteristic patterns of damage consistent with toxic leukoencephalopathy [source].

4. Epidemiological and Case Studies: Several outbreaks and case studies have documented instances of heroin-induced toxic leukoencephalopathy, underscoring it as a significant health risk associated with heroin vapor inhalation [source].

Here are some illustrative images related to heroin-induced leukoencephalopathy:

Understanding this mechanism underscores the serious neurological risks posed by the inhalation of heroin vapor, highlighting the need for awareness and precaution among users.