Can cutting back on smoking cigarettes help some drug users quit opioids? Researchers with the Ottawa Hospital Research Institute think so.
After a six-month trial involving 80 smokers — all drug users — in one of the city's poorest neighbourhoods, their findings are about to be published in the medical journal BMJ Open, an online publication of the British Medical Journal.
The researchers set up shop in a building behind the Shepherds of Good Hope shelter on Murray Street and began recruiting participants in 2016.
Participants smoked on average 20 cigarettes a day when they entered the program. Within six months, they had reduced that average to nine cigarettes a day.
"The majority who followed [the program] not only reduced their tobacco, but also other drugs," said Dr. Smita Pakhale, a respirologist and lead researcher on the project, called PROMPT.
Fentanyl, OxyContin, heroin
While they curbed their smoking habit, nearly one in five participants said they also reduced their use of such highly addictive drugs as fentanyl, OxyContin and heroin. Some were able to quit the drugs altogether.
Many participants reported improving their socio-economic condition by reconnecting with family, finding jobs, taking courses and enrolling in drug treatment programs. They also improved their general health through better diet and exercise.
"The fog was out of their head so they started making all these changes," Pakhale said.
The program provided participants with one-on-one counselling as well as free smoking cessation aids such as the nicotine patch.
'I can do this'
Participant Tara Finnessy is one such success story: on methadone for a drug addiction when she entered the PROMPT program in 2016, Finnessy said quitting smoking — an addiction she'd had since she was 11 — changed her entire perspective.
"When I started to reduce and started to feel better, it started to tell my mind that I can do this," said Finnessy. "And if I can do this, in this area which has always been the most difficult, it started getting me thinking about other areas of my life."
Finnessy said she soon changed her diet, stopped drinking, curbed her medical marijuana consumption and weaned herself off methadone.
"So it just made all these things fall into line and made me look at myself in a much different light," Finnessy said.
Pakhale said a big part of the program's apparent success is rooted in neurobiology.
"This is not black magic. It's not voodoo," Pakhale said. "It's the neurobiology of that addiction."
'King of addictions'
Pakhale calls tobacco smoking the "king of addictions" for its grip on the brain's neuro-receptors. Smoking cigarettes activates those receptors by releasing dopamine, causing pleasure.
"That's how people get addicted and stay addicted. These are the same dopamine pathways that reinforce the other addictions," Pakhale explained.
Ironically, not smoking can achieve the same effect.
"It started to give me a good feeling the way the cigarettes did," Finnessy said. "I started feeling better — less depression, I no longer take anti-depressants, I exercise."