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Chronic obstructive pulmonary disease ( COPD ) is one of the leading causes of mortality in the 21st century and is also associated with a high prevalence of comorbidity . It is a progressive illness , but early intervention improves quality of life ( National Institute for Clinical Excellence , 2021 ).

The main causative factor of COPD is smoking tobacco , and the
With poor respiratory health so prevalent among people who use substances we should seize the opportunity for intervention , as Dr Abida Mohamed explains
level of smoking is higher among people who are in substance misuse services than the general population ( PHE , 2021 ). Poor respiratory health was also found to be more prevalent among opioid users ( Hulin , 2019 ).
In the National Drug Treatment Monitoring System ( NDTMS ) 2020-21 report , 68 per cent of people entering substance misuse treatment in England smoked tobacco . In the 2016 NDTMS report , 45 per cent of people treated for illicit opioid use smoked crack cocaine and 17 per cent smoked cannabis ( Hulin , 2019 ). Despite the high levels of smoking , only 2 per cent of people were recorded as having been offered referrals for smoking cessation interventions ( PHE , 2021 ).
Alcohol , although not a direct cause of COPD , can weaken immune systems , and research has shown that it reduces the production of antioxidants that protect the lung ( Kershaw , 2008 ).
WHAT IS COPD ? The research confirms that COPD should be considered a serious health risk as it is the second highest cause of emergency admission in hospitals in the UK . So , what exactly is COPD , and what can we do about it ?
COPD comprises emphysema and chronic bronchitis , which are both thought to be directly linked to inhalation of substances , commonly tobacco , but can also include a wider range of inhaled toxins . There are several mechanisms by which opioids may contribute to the cause or consequences of respiratory disease , including suppression of neural respiratory drive , increased airway resistance and as an irritant stimulating histamine release .
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