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How to Manage COPD and Opioid Withdrawal Symptoms

How to Manage COPD and Opioid Withdrawal Symptoms

Two experts weigh in on what you need to know.

Q: I’ve been diagnosed with COPD (I don’t smoke!) and was given a prescription for a bronchodilator and a corticosteroid. Is there anything else I could be doing to help improve my breathing? — Jeremy F., Houston, TX

A: Absolutely. Start with deep breathing exercises (through your nose) along with meditation. That style of deep breathing acts as a mini meditation, plus it gets more oxygen and nitric oxide into your lungs, which improves lung function and helps drain your lymphatic system, clearing toxins from your body and calming your stress response.

Deep breathing also helps another result of COPD—moderate cognitive impairment. In a recent study, from Trinity College in Dublin, researchers found a neurophysiological link between breathing and attention. Turns out deep breathing directly affects the levels of a natural chemical messenger in the brain, noradrenaline (also called norepinephrine), which keeps the brain sharp.

Now add in meditation: A recent seven-year follow-up study from the University of California Davis found that people who meditated regularly developed their ability to sustain attention for longer periods of time than those who didn’t and helped prevent  “typical patterns of age-related decline.”

Other mind/body practices are also powerful tools for managing COPD. In a recent study in China, one doctor decided to test his theory that tai chi could be substituted for traditional western pulmonary rehabilitation (PR). For his COPD patients who didn’t have consistent access to medications, he found tai chi was the equivalent to the benefits of conventional PR after 12 weeks and better than PR after 24 weeks.

Deep breathing exercises, meditation, tai chi (and yoga) will all improve your health. Also, check out yoga and meditation streaming options provided by Sharecare, a free app for iOS and Android.

Q: I’m getting a knee replacement soon and I’m worried about getting hooked on pain meds following the surgery—withdrawal is awful. It’s happened to me before. Are there any new treatments for opioid withdrawal that I should know about? — Cassie F., Hillsdale, FL

A: Two things you need to do right away are: 1) get in touch with a pain management specialist, especially if you’ve been addicted to opioids before; and 2) ask your orthopedic surgeon about getting regional (in this case the knee) anesthetics during the operation that let you wake up without (so much) pain. They may make other pain meds unnecessary (or far less necessary) post-op.

Withdrawal symptoms can include anxiety, agitation, sleep problems, muscle aches, sweating, nausea, diarrhea and drug craving. And says the FDA, “these symptoms … occur both in patients who have been using opioids appropriately as prescribed and in patients with opioid use disorder.” But with wise pain management including the regional anesthetics, non-opioid pain relievers, physical therapy, following an anti-inflammatory Mediterranean diet and practicing stress management techniques before and after surgery, you may be able to avoid the addiction/withdrawal problem completely.

If not, there are two newly available medications that can make withdrawal from opioids less grueling.

There’s an FDA-approved generic version of the opioid-based (and potentially addictive) buprenorphine-naloxone film. That should make this remedy more widely available and less expensive. There’s also lofexidine, a non-opioid treatment that reduces the release of norepinephrine—a neurotransmitter that is thought to play a role in many of the symptoms of opioid withdrawal. Although it has been around for 20 to 25 years in the UK, it just received FDA approval. It provides a 14-day treatment. Both meds work about 40 percent of the time, but hopefully you won’t need to try them.

Potential aids: Just last year the FDA granted marketing authorization of the first electro-stim ear device to help reduce the symptoms of opioid withdrawal (Innovative Health Solutions’ NSS-2 Bridge) and now there’s another player in the market, the auricular (outer ear) neuro-stimulator (Drug Relief, by DyAnsys, Inc.). These are both a little pricey and may or may not have solid science behind them, but even a placebo works three out of ten times.

Medically reviewed in January 2020.

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