article · BMJ Open
People with heroin use disorder often experience substantial respiratory issues, and methadone treatment can worsen lung impairment. A cross-sectional study at a medication-assisted therapy clinic at Muhimbili National Hospital in Dar-es-Salaam, Tanzania, evaluated lung function among 302 adult heroin users on stable methadone maintenance. Participants were evaluated via questionnaires and spirometry, with lung impairment defined as a forced expiratory volume in one second below 70 percent. Impairment was identified in 28.5 percent of the participants, with restrictive lung disease presenting as the most common pattern, seen in 13.2 percent of the cohort. Statistical analysis identified three primary predictors of impaired lung function: being underweight, living with HIV, and having a documented history of pulmonary tuberculosis. The high prevalence points to an urgent clinical need to integrate routine lung function testing into standard addiction treatment programmes.
Heroin dependence and its treatments carry significant respiratory risks that are frequently overlooked. By establishing that nearly three in ten patients on methadone maintenance suffer from lung impairment, this research highlights the necessity of monitoring respiratory health alongside addiction care. Identifying vulnerabilities such as low weight, HIV, and previous tuberculosis allows clinicians to target screening and interventions to those at the greatest risk.
The findings support the clinical integration of routine spirometry screening protocols within medication-assisted therapy facilities. The immediate application lies in healthcare delivery and clinical workflow adaptation by public health authorities and clinic managers, rather than a commercial product. The abstract does not indicate a commercialisation pathway.
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OBJECTIVE: Heroin users have a high burden of respiratory morbidity, including premature lung function impairment. Further, methadone treatment has been found to aggravate lung function impairment and can independently cause asthma. However, the lung function status among heroin users on medication-assisted therapy (MAT) in Tanzania is yet to be studied. This study aimed to assess the magnitude, pattern and factors associated with lung function impairment among heroin users on MAT. DESIGN: This was a quantitative, analytical cross-sectional study. SETTING: This study was conducted at MAT Clinic at Muhimbili National Hospital in Dar-es-Salaam, Tanzania. PARTICIPANTS: Individuals aged 18 years or above with heroin use disorder on stable dose of methadone without heroin withdrawal symptoms (Maintenance Phase of Treatment) were recruited. METHODS: Participants were enrolled through systematic sampling technique. Data were collected using a questionnaire, and lung functions were measured using a spirometer. Lung function impairment was defined as the percentage of participants with forced expiratory volume in 1 s (FEV1) <70%. Risk factors associated with lung function impairment were assessed via univariate binary logistic regression. RESULTS: We enrolled 302 participants into the study (mean age of 42.78±7.56 years). Lung function impairment was observed in 28.5% of participants, with an average age of 44±8 years. Restrictive lung disease was the most common pattern of lung function impairment affecting 13.2% of the participants. The predictors of lung function impairment were being underweight (OR) 4.73, 95% CI) 2.61-8.59, p<0.001), living with HIV infection (OR 2.61, 95% CI 1.20 to 5.66, p=0.016) and having a history of pulmonary tuberculosis (OR 2.48, 95% CI 1.48 to 4.17, p=0.001). CONCLUSION: Heroin users on MAT have a high magnitude of lung function impairment. Routine lung function testing is recommended.
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DOI: 10.1136/bmjopen-2025-104144
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