Prescription opioid use in advanced COPD: benefits, perils and controversies

In the ancient Roman literary masterpiece Metamorphoses, the poet Ovid writes that the god of sleep, Somnus (who had a twin brother named Thanatos, or Death), lived in a dark cave and "in front of the cave mouth a wealth of poppies flourish" [1]. This verse demonstrates that our ancestors recognised links between sleep, death and the poppy plant (from which opium is derived). Present-day population-based studies show that opioid drugs are used frequently [2, 3] and in other potentially concerning ways [2] among individuals with chronic obstructive pulmonary disease (COPD), including those with nonpalliative disease [2]. Several guidelines [4–6] support using opioids for refractory respiratory symptoms in advanced COPD, which is a commonly encountered and challenging problem. The report by Politis et al. [7] in the European Respiratory Journal describes a case of respiratory depression in an individual with advanced COPD following receipt of prescription opioids for dyspnoea, providing a timely reminder of the serious negative respiratory effects opioids can potentially have in vulnerable COPD patients.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: COPD and smoking Original Articles: Correspondence Source Type: research