Is Asthma More Common In People With Chronic Opioid Dependence?

By Kelly Burch 02/26/19

A new study examined whether asthma rates are higher in those with chronic opioid dependence.

Image: 
woman with chronic opioid dependence reaching for her inhaler

People with chronic opioid dependence experience asthma at nearly double the rate of the general population, according to a new study. 

The study, published in The Journal of Allergy and Clinical Immunology, examined asthma rates among chronic opioid users in a New York City hospital. Researchers found that among people who were opioid-dependent, the asthma rate was 17.2%, compared to 8.3% in the general population.

The results confirmed what researchers expected to see, study author Dr. Roshni Naik said in a press release

“While some studies have shown that opioid medication can help with cough and shortness of breath in heart disease and advanced chronic obstructive pulmonary disease, other studies have shown that opioids such as heroin worsen asthma. We hypothesized that there is higher prevalence of asthma among patients with opioid dependence who are addicted or dependent on prescription painkillers or heroin,” Naik said. 

How opioids affect breathing depends on which opioids a person is using. 

“The effects of opioid use on respiratory conditions are mixed—while licit opiates help with cough and the dyspnea of heart disease and chronic obstructive pulmonary disease, illicit opiates may exacerbate asthma,” study authors wrote. 

Naik explained in the press release how opioids can affect a person’s breathing. “Opioid drugs such as morphine can directly activate the release of a substance called histamine from cells, specifically mast cells, in our body. Histamine is involved in allergic reactions and contributes to itching, hives and swelling. Since more than half of asthma is allergic in nature, we postulated that opioids may be linked to asthma.” 

Naik said that doctors and patients need to openly discuss opioid use (whether legal or illegal) and symptoms of asthma in order to make a comprehensive care plan.  

“There is no current guideline on how to manage asthmatics on opioid medications. However, patients with severe asthma should follow up regularly with their primary care doctor or see an asthma specialist to maintain control of their asthma. Patients who are addicted to opioids should seek a healthcare provider in combating their addiction.”

Researchers also found that there were gender-based differences in how opioid use affected asthma. In general, women experienced asthma at higher rates, with the condition affecting 9.7% of women and just 6.9% of men in the general population.

Among people who are opioid-dependent, asthma affected 25% of females and 13.9% of males. This shows that women are more likely than men to have their breathing affected by opioid use.

“This suggests that women may also be disproportionately affected with asthma in the setting of opioid dependence,” researchers wrote.

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Kelly Burch writes about addiction and mental health issues, particularly as they affect families. Follow her on TwitterFacebook, and LinkedIn.

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