A 46-year-old man of Iranian origin presented with a 4-day history of colicky 
abdominal pain and absolute constipation on a background of several weeks of 
irritability and malaise. He had smoked 10 g of opium per week for a year and a 
half. On examination, he had diffuse abdominal tenderness and faecal loading. 
This was cleared, but the abdominal pain, nausea and vomiting persisted. He had 
extravascular haemolytic anaemia with punctate basophilic stippling on blood 
film. The patient's serum lead concentration was substantially elevated and he 
perhaps demonstrated Burton's line. The patient underwent chelation therapy and 
has recovered clinically and biochemically. Public health experts were notified 
and conducted an assessment of the risk to the patient and others; their lead 
exposure questionnaire was subsequently amended. This is an important case 
report of a UK resident describing lead toxicity secondary to the inhalation of 
opium.