Half of Heroin Smokers Screen Positive for COPD

Screening of people who smoked heroin and accessed services at community drug centers found about half had chronic obstructive pulmonary disease (COPD) or asthma-COPD overlap, according to a study published online in CHEST.

Some 753 people, or 73% of 1082 people approached at UK National Health Service drug centers in Liverpool, England, completing screening. Participants were heroin smokers prescribed opiate substitution therapy.

“Just under half of this large population had fixed airflow obstruction with a forced expiratory volume in the first second of expiration/forced vital capacity <0.7 consistent with COPD or asthma-COPD overlap, with the proportion increasing to just over half when airflow obstruction was assessed using lower limit of normal,” researchers wrote. “Local service providers and commissioners should consider screening community drug service clients for COPD.”

Overall, 35% of participants had COPD; the rate increased to 39% when researchers used lower limit of normal, according to the study. A further 15% had features of both asthma and COPD, or asthma-COPD overlap.

Compared with participants with normal spirometry results, those with COPD were more breathless and had worse health. Participants with COPD had smoked cigarettes, heroin, and crack for longer. They were also more likely to still be smoking heroin.

“Feedback [in reaction to study procedures] was strongly positive,” researchers wrote, “with 92% of respondents happy for other healthcare appointments to be colocated with drug key worker appointments.”

Anchoring respiratory health screening to drug center appointments, they concluded, is an appropriate way to screen difficult-to-reach populations for COPD.

—Jolynn Tumolo

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