The respiratory health of opiate misusers

Problem

Due to risks associated with injecting opiates, there has been a gradual increase in the rates of opiate inhalation since the 1990s. This has led to growing concerns over the potential impact this could have on individuals' respiratory health, particularly when considering other factors such as the high rates of tobacco smoking in this population and barriers to accessing usual healthcare.

Approach

A systematic review of the literature on the association between opiate misuse and respiratory health was undertaken (Prospero ID=CRD42017059953). Electronic searches of MEDLINE, Embase, PsycINFO, CINAHL and the Cochrane Library databases were undertaken for all English language studies published between 1980-2017. All study designs excluding case studies were considered for inclusion. The researchers conducted independent assessment of the inclusion criteria and critical appraisal of the studies.

Findings

Following removal of duplicates, 21246 articles were retrieved form the electronic searches, with 35 studies considered for inclusion in the narrative synthesis. Further hand searching and analysis are being undertaken so these figures are subject to change. Whilst it was difficult to draw firm conclusions regarding the association between opiate misuse and respiratory health, three key themes emerged: 1) increased prevalence of COPD and Asthma within the opiate misuse population; 2) increased hospitalisations with acute asthma; 3) feasibility of screening in community substance misuse services.

Consequences

Further research is required to determine the impact of opiate misuse on such conditions as asthma and COPD. Confounding factors such as tobacco smoking and poly-drug use need to be controlled for in future research in order to fully understand the impact of opiates on respiratory health.