Illicit drugs are a truly global phenomenon. As a result of this and the illicit nature of the trade, reliable statistics are hard to obtain. An estimated 3 per cent of the global population (185 million people) consumes drugs annually. 1 By far the most widely abused substance is cannabis, followed by amphetaminelike stimulants. 1 The lungs are unique in their exposure to the environment and the circulation; they are susceptible to damage from illicit drugs that are used by intravenous injection and by inhalation. 2 Thoracic complications are the most common complications associated with illicit drug use and consist of infective and non-infective complications affecting the pleura pulmonary parenchyma, soft tissues, heart and mediastinum.