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Addiction. 2019 Jan 24. doi: 10.1111/add.14559. [Epub ahead of print]

Chronic obstructive pulmonary disease (COPD) among opioid-dependent patients in agonist treatment. A diagnostic study.

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Institute of Primary Care (IHAMZ), University and University Hospital of Zurich, Zurich, Switzerland.
Arud Centre for Addiction Medicine, Zurich, Switzerland.
Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland.



To estimate the prevalence of chronic obstructive pulmonary disease (COPD) and related risk factors in people in opioid agonist treatment (OAT), to compare airflow limitation severity and age-specific COPD prevalence rates with those in the general population, and to assess the OAT patients' willingness to adopt life-style changes and to use therapeutic offers for COPD management.


Cross-sectional study in a random sample of OAT patients.


Out-patient centres for substance addiction medicine in Zurich, Switzerland.


A total of 125 participants, recruited from November 2016 to April 2017 through invitation letters followed by phone or personal contact.


Standardized questionnaires about drug use, smoking habits and medical history, completed during face-to-face interviews or from medical records. Spirometry without and-depending on the result-with bronchodilation.


Almost one-third [30.3%; 95% confidence interval (CI) = 22.6-39.0%] of the 119 participants with valid spirometry tests were diagnosed with COPD. Among males aged 30-59 years, the age-adjusted prevalence of at least moderate airflow limitation (GOLD grade ≥ 2) was 2.4 (95% CI = 1.3-4.4) times as high as in the ever-smoking Swiss population in the same age group. Smoking tobacco (92.0%) and substance inhalation (cannabis = 97.6%, cocaine = 69.6%, heroin = 68.0%) were highly prevalent among all participants. The participants expressed considerable interest in life-style changes and use of therapeutic offers for COPD management, with smoking cessation being least (20.2% of tobacco smokers interested) and pharmacological treatment to alleviate COPD symptoms most popular.


In Switzerland, COPD prevalence and multiple risk factors for COPD appear to be high among people in OAT compared with the general population. Individuals in OAT appear to develop COPD at a younger average age compared with the general population and are open to life-style changes and other COPD management approaches.


Case finding; chronic obstructive pulmonary disease; opioid agonist treatment; opioid dependence; opioid substitution treatment; people with opioid use disorder; screening; spirometry


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