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Asthma more common in opioid users

The prevalence of asthma was higher among patients with opioid dependence, according to findings presented at the American Academy of Allergy, Asthma and Immunology Annual Scientific Meeting.

“Opioid drugs such as morphine can directly activate the release of a substance called histamine from cells, specifically mast cells, in our body,” Roshni Naik, MD, assistant professor at Mount Sinai Beth Israel, said in a press release. “Histamine is involved in allergic reactions and contributes to itching, hives and swelling. Since more than half of asthma is allergic in nature, we postulated that opioids may be linked to asthma.”

“While some studies have shown that opioid medication can help with cough and shortness of breath in heart disease and advanced COPD, other studies have shown that opioids such as heroin worsen asthma,” she added.

Naik and colleagues reviewed electronic medical records of 3,502 patients aged 18 to 79 years who were prescribed opioids for a chronic pain condition, such as chronic pain syndrome, osteoarthritis, joint disorder, fibromyalgia, back pain or myalgia and myositis, to determine the prevalence of allergic rhinitis and allergic conjunctivitis.

The researchers found that asthma was present in more patients with an opioid prescription vs. without (15.1% vs. 8.7%; OR = 1.92; 95% CI, 1.56-2.4). Additionally, allergic rhinitis and/or allergic conjunctivitis was present in more patients with an opioid prescription vs. without (10.9% vs. 5.1%; OR = 1.94; 95% CI, 1.51-2.51).

Women are already more likely than men to have asthma, according to the press release. A quarter of women with opioid dependence in the study also had asthma.

“There is no current guideline on how to manage asthmatics on opioid medications,” Naik said in the release. “However, patients with severe asthma should follow up regularly with their primary care doctor or see an asthma specialist to maintain control of their asthma. Patients who are addicted to opioids should seek a healthcare provider in combating their addiction.” – by Alaina Tedesco

Reference:

Naik R, et al. Association of prescription opioid use for chronic pain syndromes with asthma and allergy. Presented at: American Academy of Allergy, Asthma and Immunology Annual Scientific Meeting; Feb. 22-25, 2019; San Francisco.

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