An urban drug user is at risk for having unrecognized COPD. Drummond et al reported risk factors for unrecognized COPD. The authors are from the Johns Hopkins University in Baltimore.


Patient selection: urban drug user


Risk factors for COPD may include:

(1) cigarette smoking

(2) inhalational drug abuse (crack, etc)

(3) environmental smog or smoke

(4) occupational exposures


Factors associated with unrecognized COPD in this population:

(1) no or mild symptoms including dyspnea

(2) HIV-infection with (a) viral load > 200,000 copies per mL or (b) with antiretroviral therapy (ART)

(3) not having spirometry performed


Other factors not listed in the study:

(1) A person who is frequently intoxicated may not care (impaired perceptions).

(2) Symptoms may be ascribed to something else (COPD not considered).

(3) An addict may have minimal medical contact and probably does not have a family physician.


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