Urban Drug Users Have Increased Risk of Undiscovered Obstructive Lung Diseases

Urban populations with a history of current or former drug use are at a greater risk of undiscovered obstructive lung diseases (OLDs), such as asthma and chronic obstructive pulmonary disease (COPD). That is according to recent research published in the International Journal of Chronic Obstructive Pulmonary Disease.

Due to race, behavioral and socioeconomic characteristics, urban drug users are at a higher risk of developing OLDs. However, OLDs are frequently unrecognized and under treated in this population. However, little data exists related to the prevalence and risk factors of OLDs in urban drug users.

Researchers out of Baltimore, Md., conducted a cross-sectional analysis of the Acquired Immunodeficiency Syndrome Linked to the Intravenous Experience (ALIVE) study, an observational study of current and former injection drug users among persons with HIV in Baltimore. Researchers then grouped ALIVE participants with spirometry-defined airflow obstruction by the presence or absence of a physician-diagnosed OLD. Further, regression models were used to identify independent risk factors of unrecognized OLDs.

While the urban population is a poorly studied group, research has found that there is an increased risk of human immunodeficiency virus (HIV) infection, which is associated with an increased prevalence of OLDs.

Of the 1,083 participants evaluated, 176 (16 percent) met the spirometric criteria for an OLD, while only 88 of those (8 percent) were diagnosed by a physician. Further, as severity of airflow obstruction increased, the prevalence of an unrecognized OLD decreased. Independent risks were identified as absence of respiratory symptoms and less severe dyspnea, while the use of antiretroviral therapy (ART) in the subset of HIV infected patients was also associated with an increased prevalence of unrecognized OLDs.

Through this analysis, researchers also looked to determine the characteristics associated with the lack of physician-diagnosed OLDs. However, it remains unclear what patient characteristics may be associated with unrecognized OLDs, especially in these high-risk populations.

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