Exploring perspectives on chronic obstructive pulmonary disease in people who smoke heroin: a qualitative study

Background

Smoking rather than injecting heroin has become more common over the last twenty years. Although there is an increasing body of evidence describing high levels of COPD in heroin smokers, there is limited evidence documenting the impact this has on this population group.

Aim. We aimed to describe the experiences of heroin smokers with COPD in Liverpool, UK

Design and Setting Participants were purposefully sampled for this qualitative study. Participants included were adults enrolled in an opioid replacement clinic run by Addaction in Liverpool, UK and whom had already engaged with spirometry testing for COPD as part of a previous study

Methods. We preformed semi-structured interviews with participants with spirometrically-confirmed COPD in opioid replacement clinics in Liverpool, UK. Data were analysed using a framework analysis approach.

Results. We invited 16 potential participants of whom 10 agreed to take part and were interviewed. Three themes common to all interviews were identified: functional measures of lung health that impacted on their activities of daily living, inhaler and medication perceptions with erratic use that was not concordant with their prescription, and the impact of difficulties accessing care.

Conclusion. These findings, along with previous studies highlighting the prevalence of COPD in this population, warrant efforts to integrate community COPD and opioid replacement services to improve outcomes for this vulnerable population.