A fatal case of spongiform leukoencephalopathy linked to "chasing the dragon"

J Toxicol Clin Toxicol. 2003;41(6):887-91. doi: 10.1081/clt-120025358.


Background: "Chasing the dragon" involves placing heroin on aluminum foil, heating it from below with a flame, and inhaling the pyrolysate through a straw. It has rarely been associated with the development of a progressive spongiform leukoencephalopathy.

Case report: A 43-year-old woman presented with 2 weeks of bizarre behavior, forgetfulness, and slowed speech and movements. Serum, cerebrospinal fluid, and head computed tomography (CT) scan were normal. The patient progressed to coma and expired during week 4 of hospital admission. The family confirmed that she "chased the dragon." Cause of death at post mortem examination was spongiform leukoencephalopathy.

Conclusion: The diagnosis of heroin pyrolysate-induced spongiform leukoencephalopathy should be considered in a patient with a history of "chasing the dragon" and neurobehavioral changes, including confusion, apathy, cerebellar signs, and motor restlessness.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Behavior
  • Brain / pathology
  • Canavan Disease / chemically induced*
  • Canavan Disease / pathology
  • Canavan Disease / psychology
  • Coma / chemically induced
  • Coma / pathology
  • Fatal Outcome
  • Female
  • Heroin Dependence / complications*
  • Humans
  • Tomography, X-Ray Computed