Abstract

It has been identified in recent years that heroin smoking is associated with early onset and severe COPD. Heroin smokers are recognised to be difficult to engage with, underserved and associated with an increasing burden both on the people affected and the NHS (Nightingale et al, 2020). Several studies have recommended linking copd screening to community drug screening programmes ( Burhan et al 2019; Nightingale et al 2020).
The Liverpool Community Respiratory team (CRT) is a multiprofessional team supporting patients with COPD exacerbations to reduce hospital admissions and length of stay. The Liverpool CRT have begun working with a local community drug service, Brook Place, to pilot COPD optimisation clinics for heroin smokers considered to be high risk of COPD.

Although data will not be available until July. CRT have recognised that having spirometry testing situated at the clinic would be advantageous as most of this client group are socially and financially deprived and travelling to outpatient clinics is challenging. Working with staff from drug services, that service users are familiar with has also helped break down some of the barriers associated with this client group accessing traditional medical model, services. The psychological impact of working with people who often have tragic life stories may have been underestimated when starting this project.

References
Burhan H, Young R, Byrne T, Peat R, Furlong J, Renwick S, Elkin T, Oelbaun S, Walker P (2019) Screening heroin smokers attending community drug services for COPD. Chest. 155(2) 279-287

Nightingale R, Mortimer K, Giorgi E, Walker P, Strolbrink M, Byrne T, Marwood K, Morrison-Griffiths S, Renwick S, Rylance J, Burhan H (2020) Screening Heroin smokers attending community drug clinics for change in lung function. Chest 157(3) 558-565.