BACKGROUND AND AIMS There are growing concerns over the respiratory health of people who use illicit opioids due to high rates of opioid inhalation and tobacco smoking in this group. This study aimed to summarize the evidence relating illicit opioid use with poor respiratory health. METHODS A systematic review of the literature on the association between illicit opioid use and respiratory health was undertaken in accordance with PRISMA guidance (Prospero ID=CRD42017059953). Electronic searches of MEDLINE, Embase, PsycINFO, CINAHL and the Cochrane Library databases were undertaken (English language, published January 1980 - November 2018). All study designs excluding case studies were considered. Studies were undertaken in community and hospital settings in the US (n= 23), UK (n=7), Australia (n=7), Netherlands (n=2), Canada (n=2), Ireland (n=1), Spain (n=1) and Iran (n=1). Measurements of respiratory disease, including asthma and chronic obstructive pulmonary disease (COPD) and related symptoms were extracted. Data on respiratory related deaths and hospital admissions were also extracted. Meta-analysis of prevalence data was undertaken using a random effects meta-analysis model with parameters estimated using Markov chain Monte Carlo simulation. RESULTS Meta-analyses estimated prevalence of asthma in people who inject illicit opioids as 8.5% (95% predictive interval (PrI): 0.2%, 74.0%) and as 20.2% (95% PrI: 4.2%, 59.2%) in people who inhale illicit opioids. Prevalence of COPD in people who inject illicit opioids was estimated as 2.7% (95% (PrI): 0.0%, 50.4%) and as 17.9% (95% PrI: 0.6%, 89.5%) in people who inhale illicit opioids. There was evidence of moderate to extreme heterogeneity across studies. CONCLUSIONS There is evidence of increased burden of respiratory diseases in people who use illicit opioids. Due to heterogeneity of study design and samples it is difficult to gain accurate estimates of the prevalence of respiratory disease in this population.

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使用非法阿片类药物的人群中呼吸系统疾病的患病率：系统评价

背景和目的 由于该群体中阿片类药物吸入率和吸烟率高，因此对使用非法阿片类药物的人的呼吸系统健康越来越关注。本研究旨在总结与非法使用阿片类药物与呼吸系统健康不佳相关的证据。方法 根据 PRISMA 指南（Prospero ID=CRD42017059953）对有关非法阿片类药物使用与呼吸系统健康之间关联的文献进行了系统审查。对 MEDLINE、Embase、PsycINFO、CINAHL 和 Cochrane 图书馆数据库进行了电子搜索（英语，1980 年 1 月至 2018 年 11 月出版）。考虑了不包括案例研究的所有研究设计。研究在美国 (n=23)、英国 (n=7)、澳大利亚 (n=7)、荷兰 (n=2)、加拿大 (n=2)、爱尔兰 (n=1) 的社区和医院环境中进行), 西班牙（n=1）和伊朗（n=1）。提取呼吸系统疾病的测量值，包括哮喘和慢性阻塞性肺疾病 (COPD) 及相关症状。还提取了与呼吸系统相关的死亡和住院数据。使用随机效应荟萃分析模型对流行数据进行荟萃分析，其中使用马尔可夫链蒙特卡罗模拟估计参数。结果 荟萃分析估计，在注射非法阿片类药物的人群中，哮喘患病率为 8.5%（95% 预测区间 (PrI)：0.2%、74.0%），在注射非法阿片类药物的人群中为 20.2%（95% PrI：4.2%、59.2%）。吸入非法阿片类药物。在注射非法阿片类药物的人群中，COPD 的患病率估计为 2.7%（95%（PrI）：0.0%、50.4%），在吸入非法阿片类药物的人群中为 17.9%（95% PrI：0.6%、89.5%）。有证据表明研究之间存在中度至极端异质性。结论 有证据表明，使用非法阿片类药物的人呼吸系统疾病负担增加。由于研究设计和样本的异质性，很难准确估计该人群中呼吸道疾病的患病率。