Mycobacterium avium complex is the most common of nontuberculous mycobacterium capable of causing disease in humans. The manifestations can vary from asymptomatic exposure to hypersensitivity pneumonitis to advanced fibrocavitary disease. We describe the case of a 37-year-old male with advanced cavitary disease from Mycobacterium avium complex. The patient had no previous history of pulmonary disease, but did have a history of snorting crushed Lortab (hydrocodone/acetaminophen) tablets and we postulate that possible injury to the lung from talc or other chemicals in the tablets may have predisposed him to develop Mycobacterium avium pulmonary disease.