Correlation Between Respiratory Conditions & Substance Abuse
Respiratory conditions include a number of different conditions and disorders that affect the organs in the body that make gas exchange possible, including the lungs, trachea, nasal passages, etc. These conditions range from relatively mild conditions such as the common cold to more serious and life-threatening conditions such as lung cancer.
What Are the General Classes of Respiratory Disorders?
According to the book Functional Respiratory Disorders, respiratory disorders are categorized in four general classes:
- Obstructive respiratory conditions that block the respiratory system, such as bronchitis, asthma, emphysema, etc.
- Respiratory conditions that restrict the respiratory system’s ability to function, such as fibrosis or pleural effusion
- Vascular conditions that affect the respiratory system, such as pulmonary embolisms, pulmonary edema, and pulmonary hypertension
- Environmental conditions, infections, and other conditions, such as pneumonia, tuberculosis, asbestosis, cancers, etc.
A number of different drugs of abuse can lead to issues with the respiratory system. A few of these are discussed next.
- For more information on respiratory conditions in general or specific disorders, interested readers can check out Encyclopedia Britannica.
- The National Institute on Drug Abuse provides information regarding drug abuse’s effects on the respiratory system.
- The American Lung Association offers information regarding respiratory disorders, smoking, and abuse of other drugs.
The majority of damage to the respiratory system from tobacco products obviously occurs from smoking them. Damage to the respiratory system from tobacco products is typically slow and progressive. The respiratory system will continuously cleanse itself with mucus, trapping dirt and microbes and then tiny hairs in the system known as cilia, sweeping them toward the mouth where the mucus is eventually eliminated. Smoking destroys this cleansing system, and individuals must cough up the mucus (hence, the smoker’s cough). Of course, not all of the mucus is eliminated, and excess mucus accumulates, clogging the respiratory system along with waste materials and microbes collecting in the system. As one continues to smoke, the tissues of the respiratory system lose their elasticity, the walls of the respiratory system are thickened, and many of the small structures rupture.
Cigarettes also contain hundreds of toxic chemicals, and the act of the smoking tobacco products also induces very toxic chemicals into the lungs. These all increase the risk of respiratory conditions. These carcinogens also lead to changing structural conditions at the cellular level and can eventually result in the development of a number of different cancers.
Tobacco use is linked to:
- Lung cancer: Researchers report that 80 percent of all lung cancer cases are related to cigarette smoking and that less than 15 percent of lung cancer patients live five years after their initial diagnosis.
- Chronic obstructive pulmonary disease (COPD): COPD is an obstructive disease of the lungs that makes it very difficult to breathe and typically results in long-term disabilities. It is progressive, beginning with difficulties moving, and later, it totally restricts individuals from any type of physical activity. Researchers believe that 80 percent of COPD cases are related to cigarette smoking. COPD includes familiar conditions, such as bronchitis, which is a long-term inflammation of the bronchi or the large passages in the lungs, and emphysema, which is a chronic condition that affects the air sacs in the lungs (alveoli).
- Asthma: This is a chronic lung disease that makes breathing very difficult. Cigarette smoke irritates the air passages in the lungs. There are a number of suspected causes for asthma, such as airborne pollutants or airborne allergens; however, it is known that cigarette smoking can produce asthma and, of course, makes asthma worse.
In addition, tobacco use can lead to various other cancers, including tracheal cancer, as well as an increased susceptibility for infections, such as pneumonia. Individuals who are chronically exposed to secondhand smoke may develop any of the above conditions as well.
The majority of these conditions are chronic conditions that develop over lengthy periods of time. Individuals can reduce the risk for many of these conditions, such as asthma, COPD, and infections, by simply quitting smoking. Cancer risk can also be reduced significantly by quitting smoking; however, individuals diagnosed with metastatic lung cancer may find that their cancer does not go away once they stop smoking.
Marijuana and Cannabis Products
A number of studies have attempted to investigate the respiratory effects of smoking cannabis products. The research is somewhat mixed and at this point much of it is inconclusive.
A recent large review study looking at the available research published in The Annals of the American Thoracic Society produced the following findings regarding marijuana and respiratory disorders:
- Poor evidence to suggest that smoking only cannabis products leads to a significantly increased risk for lung cancer. However, the researchers concluded that more research needs to be performed.
- A probable increased risk to develop bronchitis but less evidence to suggest an increased risk to develop emphysema.
- A potential increased risk to develop respiratory infections, such as pneumonia or from lowered immune system functioning.
- A much smaller risk to increase other chronic respiratory conditions compared to individuals who use tobacco.
More targeted research needs to be performed in this area to determine specific issues associated with marijuana use and respiratory disorders. Chronic and heavy smokers of marijuana are at greater risk to develop respiratory issues.
Individuals who snort or smoke cocaine may be leaving themselves open to a number of different respiratory issues. Because cocaine is a powerful stimulant, its use results in a number of effects to both the respiratory and cardiovascular system that include the constriction of veins and arteries, hardening of cellular walls and organs, and death of cells within the bodily tissues.
Snorting cocaine can result in a number of respiratory issues that include:
- Tissue damage in the nasal passages and the development of necrosis in these passages
- Ischemic damage in the nasal passage and trachea (tissue damage due to loss of oxygen)
- An increased risk for infections in the nasal passages
Smoking cocaine is associated with hemorrhages in the lungs, pulmonary edema (fluid retention in the lungs), swelling of the lungs (these three are sometimes referred to as “crack lung”), and an increased risk of lung infections. This type of damage may be permanent in chronic users. In addition, smoking crack can lead to pulmonary barotrauma or ruptures of the air sacs in the lungs. When chronic, this condition can result in reduced lung functioning. Finally, those who smoke crack have increased rates of emphysema, bronchitis, and asthma. The evidence that smoking crack cocaine is associated with increased risk for lung cancer is scant at this time.
Opioid or narcotic drugs include a number of prescription painkillers, morphine, and heroin. These drugs are central nervous system depressants that reduce activity in the brain and spinal cord and specifically bind to receptors in the brain that are associated with the perception of pain. Their action reduces the perception of pain in individuals and also produces a number of euphoric effects. As central nervous system depressants, these drugs have the function of suppressing respiration or breathing.
Chronic users of opioid drugs may develop several different types of respiratory issues:
- Pulmonary edema: This is the increase of fluid in the lungs. This lead to potentially fatal issues if left unchecked and can also result in the development of other respiratory diseases.
- Decreased immunity: Opioid drugs may result in decreased immune resistance, which can result in the development of respiratory diseases, such as pneumonia.
- Pulmonary issues: An exacerbation of existing pulmonary disorders can occur, such as bronchitis and emphysema.
- Hypoxia: There is an increased probability for the development of issues with hypoxia (poor oxygen intake) in elderly individuals or individuals with other pulmonary issues, such as obstructive sleep apnea.
Inhalant abuse consists of individuals, mostly younger individuals, who inhale the fumes of many common household products in order to achieve their euphoric effects. These products can include such things as paint thinner, other solvents, lighter fluid, computer cleaners, etc. Research has indicated that the majority of individuals who use inhalants are under the age of 25.
Even in this otherwise normally healthy group, chronic inhalant use is associated with a number of ill health effects.
This can include issues with the respiratory system, such as:
- Bronchitis, asthma, and sinusitis
- Increased risk for developing pneumonia
- Other significant damage to the lungs, such as damage to the alveoli
Obviously, individuals developing respiratory conditions as a result of drug use or who exacerbate existing respiratory problems as a result of drug use should address their substance use. The treatment protocol for dealing with individuals who have substance use disorders and any type of respiratory issue is to follow the standard treatment procedures to address both issues. This means having the individual get involved in an active and professionally supervised substance use disorder treatment program and concurrently having medical treatment for the respiratory issues. In some cases, respiratory damage incurred by the use of drugs may not be reversible (e.g., lung cancer), whereas in other cases, there may be a chance to regain some level of functioning with abstinence from the specific drug.