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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.

Author information

1
Institute of Primary Care (IHAMZ), University and University Hospital of Zurich, Zurich, Switzerland.
2
Arud Centre for Addiction Medicine, Zurich, Switzerland.
3
Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland.

Abstract

AIMS:

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.

DESIGN:

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

SETTING:

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

PARTICIPANTS:

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

MEASUREMENTS:

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.

FINDINGS:

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.

CONCLUSIONS:

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.

KEYWORDS:

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

PMID:
30675957
DOI:
10.1111/add.14559

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