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Opioids and Lung Health

Evidence suggests a relationship between opioid misuse, tobacco dependence and respiratory diseases.

Opioid misuse is a threat to lung health. Individuals who have an opioid use disorder (OUD) and use tobacco are at risk. Concurrently addressing tobacco use and OUD can save lives and help people overcome both the addiction to tobacco and opioids.  

Underlying Respiratory Diseases at the Heart of Opioid Deaths

  • Misuse of prescription or synthetic opioids can suppress breathing and block air from entering the lungs, leading to hypoxia and suffocation. It can also exacerbate asthma symptoms.1,2,3
  • Having an existing lung disease is a leading indicator for death from an opioid overdose. Due to decreased lung capacity, individuals who have an existing lung disease are more likely to die from an overdose than their counterparts without existing lung disease.4

The Strong Connection Between Tobacco Use and Opioid Addiction

  • People with substance use disorders (SUDs), smoke at high rates. Early studies have shown that over half of individuals with SUD smoke cigarettes.5,6,7 One particular study found smoking prevalence to be as high as 95 percent in individuals with an OUD.8
  • Research shows that there is a link between nicotine and opioid addiction. Their overlapping pathways have been found to be mutually reinforcing, meaning that one addiction can encourage the other.9,10,11
  • Tobacco use is a significant threat to patients with SUD. One study suggests that individuals who smoke and have a SUD are more likely to die from a tobacco-related disease than their underlying SUD.12

Helping Patients with SUDs Quit Smoking

  • Individuals with behavioral health conditions want to and are able to quit smoking.13,14 The relationship between cigarette smoking and SUDs presents an opportunity to integrate treatments for opioid and tobacco dependence. Research suggests that incorporating smoking cessation into treatment programs for SUDs could improve substance use recovery outcomes and may increase long-term abstinence from substances, including opioids.15,16,17
  • Tobacco-free campus policies make patients less likely to smoke alone or with staff members and more likely to receive tobacco-related services.18 Evidence-based treatments for tobacco dependence, including FDA-approved medication and counseling, can be utilized concurrently with treatment for SUDs. However, in 2018, only 67 percent of substance use treatment facilities screened for tobacco use, 49.8 percent provided cessation counseling, 28 percent offered nicotine replacement therapy and 22.3 percent offered non-nicotine tobacco cessation medications.19

For more information:

    Last updated October 8, 2019.

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