Patients treated for drug addiction have high asthma and COPD prevalence rates. The relative contributions of cigarette smoking, smoking intensity and possible smoking of other substances has not been described. We aimed to describe the prevalence and determinants of asthma and COPD in patients prescribed methadone as opioid substitution therapy (OST). In a cross-sectional study of an anonymised patient-level primary care dataset of UK inner-city general practices (n = 46), 321,395 patients aged ≥18 years were identified. A total of 676 (0.21%) had a record of a methadone ever issued in primary care. The association between respiratory disease and methadone prescribing was examined using logistic regression. Models were adjusted for potential effects of clustering by practice. A total of 97.3% of patients prescribed methadone were cigarette smokers, either current (81.2%) or ex-smokers (16.1%). The prevalences of asthma and COPD were higher in methadone patients (14.2% and 12.4%, respectively) compared to non-methadone patients (4.4% and 1.1%, respectively). Methadone was an independent determinant of asthma, adjusting for smoking status (OR 3.21; 95% CI: 2.52, 4.10) or for smoking intensity (3.08; 2.27, 4.19), and of COPD, adjusting for smoking status (6.00; 4.61, 7.80) or for smoking intensity (5.80; 4.12, 8.17). COPD and asthma prevalence were substantially higher in those prescribed methadone compared to those never prescribed methadone. Prescription of methadone was an independent predictor for both COPD and asthma, even after adjustment for smoking status and smoking intensity. Possible explanations include confounding by association with smoking of heroin or crack cocaine, both of which may have a causal association with COPD and asthma.

中文翻译：

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阿片类药物依赖患者的COPD和哮喘：基层医疗的横断面研究。

接受药物成瘾治疗的患者哮喘和COPD患病率较高。尚未描述吸烟，吸烟强度和可能吸烟其他物质的相对贡献。我们的目的是描述以美沙酮作为阿片类药物替代疗法（OST）的患者的哮喘和COPD的患病率和决定因素。在一项对英国市中心一般实践（n = 46）的匿名患者一级初级保健数据集的横断面研究中，确定了321395名年龄≥18岁的患者。共有676名（0.21％）的患者曾记录过在基层医疗机构中分发的美沙酮。呼吸道疾病与美沙酮处方之间的关联使用逻辑回归分析。通过实践调整了模型对聚类的潜在影响。总共97。处方美沙酮的患者中有3％是吸烟者，目前（81.2％）或前吸烟者（16.1％）。与非美沙酮患者（分别为4.4％和1.1％）相比，美沙酮患者（分别为14.2％和12.4％）的哮喘和COPD患病率更高。美沙酮是哮喘的独立决定因素，可根据吸烟状况（OR 3.21; 95％CI：2.52，4.10）或吸烟强度（3.08; 2.27，4.19）进行调整，而对COPD则可根据吸烟状况进行调整（6.00; 4.61，7.80） ）或吸烟强度（5.80; 4.12，8.17）。与未处方美沙酮相比，处方美沙酮的COPD和哮喘患病率明显更高。即使调整吸烟状况和吸烟强度，美沙酮的处方也是COPD和哮喘的独立预测指标。