[Sex cases of sudden death after snorting heroin analyzed. Reduced tolerance in periodic abuse a danger both in snorting and injecting].

Heroin injection entails a risk of infection and can result in sudden collapse and death. During the past few years alternative routes of heroin use have been introduced. During 1997-1998 we observed six deaths which occurred suddenly following heroin snorting. These victims were all temporary drug users in good health and physical condition. They all died with low morphine concentrations; however, three had relatively high blood alcohol concentrations and two were under the influence of medicinal drugs. Temporary use of heroin is characterized by low drug tolerance; snorting of heroin appears to entail the same risk of sudden death as injection.