When a doctor prescribes medication to help treat an illness or chronic issue, the potential for negative side effects can cause worry. In many cases, drugs can cause physical and even mental health side effects that are discomforting or even dangerous – often to the point that you may wonder if it’s worth continuing the medication at all. Worse, medications can cause toxicity that can exacerbate their negative side effects.
Breathing problems are a common negative side effect of many drugs, including prescription medications. In fact, there are several drug-induced respiratory problems. Learn more about drug-induced respiratory problems and how you can potentially avoid them.
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This question can be answered in a number of ways. Certainly, there are many substances – some considered street drugs and others considered legitimate medications – that can cause issues ranging from temporary shortness of breath to respiratory failure. Short-term respiratory issues and long-term respiratory disorders must also be considered separately.
Since there are so many nuances to this topic, it’s important to explore several classes of drugs, several types of medications, and several types of respiratory issues.
How Can Drugs Lead to Shortness of Breath?
There are a number of respiratory issues that drugs and prescription medications may cause, but shortness of breath (dyspnea) is one of the most immediately noticeable. Characterized by a tightening feeling in the chest, difficulty inhaling, wheezing, and quick or shallow breathing, shortness of breath can be frightening, not to mention painful. Shortness of breath can occur when substances scar and severely damage the lungs, which strains the cardiopulmonary system. This scarring is typically caused by substances that must be inhaled, but there can be other causes of shortness of breath (dyspnea).1
These are a few of the most common drug classifications that can lead to respiratory distress.
Opiates/Opioids
Opiate drugs and medications like morphine, codeine, and heroin are naturally derived from the opium poppy plant. Opioid medications are synthetic drugs created with a very similar chemical structure so they will interact with the same chemical receptors as opiates and provide the same effects. Opioids like oxycodone are primarily used to treat severe chronic pain, especially for those with a terminal illness. As they slow the central nervous system’s functions, they can also cause slower and less effective breathing.2
Inhalants
Some substances that haven’t been designed for human consumption may be inhaled to achieve a high. These substances are very likely to cause harm to the lungs and affect breathing. Inhalants can include gasoline, glue, lighter fluid, nitrous oxide, and even cleaning fluid.
Recreational Substances
Many other recreational substances that are legal can cause shortness of breath and lung damage. This is especially true when taken in large doses over a long period of time. Some of these substances include alcohol, cigarettes, and marijuana.
Street Drugs
Many illegal street drugs can negatively affect the lungs if taken consistently over time.
Some of these drugs include:
Cocaine – Since cocaine is typically snorted, it can cause direct chemical damage to the airways and lungs.
Crack Cocaine –This drug is even more damaging to the lungs as it is vaporized and inhaled into the lungs.
Methamphetamine – Meth is composed of several caustic substances that can cause lung damage, potentially including anhydrous ammonia, drain cleaner, battery acid, and more.
Heroin – As mentioned, opiates inhibit the central nervous system, cause constriction of the blood vessels, and reduce your immune system’s ability to fight infections. Even more adverse effects may occur when heroin is smoked.2
Types of Drugs Associated with Respiratory Issues
Not all drugs that affect the respiratory system are illegal street drugs. In fact, research suggests that there are over 100 legal prescription medications that negatively affect the lungs. 3 Two major classes of medications that can negatively affect the respiratory system in multiple different ways include chemotherapy medications and immunotherapy medications, both used to treat cancer.
Chemotherapy and Its Effect on the Respiratory System
Chemotherapy has been a successful way to treat many types of cancer, helping improve the prognosis for most people. Unfortunately, as chemotherapy medications must be powerful enough to kill cancer cells, it has many of its own adverse effects. A notable side effect is how drugs used in chemotherapy, such as bleomycin, cyclophosphamide, and methotrexate, can cause respiratory problems.
One issue that arises after chemotherapy is pulmonary fibrosis, where scar tissue develops within the air sacs of the lungs. This inhibits normal breathing. Many chemotherapy drugs can also cause infections and inflammation of the lungs, such as bronchitis and pneumonia. Unfortunately, this can become chronic as the immune system weakens due to the strength of the medication.
Pneumonitis, or inflammation of the tissue of the air sacs, is a condition caused by chemotherapy drugs such as docetaxel. It can eventually lead to pulmonary fibrosis, which has lifelong effects. Another form of pneumonitis is radiation pneumonitis, which is caused by radiation therapy – an alternative or accompaniment to chemotherapy. This can occur up to six months after treatment.
Acute respiratory distress syndrome (ARDS) is another dangerous respiratory side effect of chemotherapy. It causes great damage to the air sacs and may even render them incapable of delivering oxygen to the body. People who have taken the drug bleomycin are more likely to develop this condition later on in their lifetime.3
Immunotherapy and Its Effect on the Respiratory System
Immunotherapy is another form of treatment used to fight cancer. It is different in that it uses substances already found in the body or developed in a laboratory to help the immune system fight cancer cells.
Two drugs associated with immunotherapy, interleukin 2 and lymphokine-activated killer, have caused severe respiratory distress. Some patients have even required intubation.4
Other less-severe side effects of this type of treatment include:
Coughing
Breathing issues
Blood in the urine
Frequent perspiration
Swollen lymph nodes
Pain
Constipation or diarrhea
Headaches
Dizziness
Faster heart rate
Seizures
Weight gain or loss
Changes in eyesight
Medications That Cause General Respiratory Problems/Lung Issues
Fortunately, many people will never need to take chemotherapy or immunotherapy drugs. Still, more common medications can cause respiratory problems or lung issues. They include medications available over the counter as well as prescription medications.
Acetaminophen
Acetaminophen can affect the lungs’ ability to fight off oxidative stress. This stress on the lungs can increase your chances of developing asthma or can exacerbate asthma if you already have it. Overall, this medication can make it harder to breathe and function normally.5
NSAIDs
Non-steroidal anti-inflammatory medications, also known as NSAIDs, include aspirin, ibuprofen, and naproxen, and can cause NSAID-exacerbated respiratory disease. Symptoms of this disease include moderate or severe asthma or constant sinus issues. For those with asthma, NSAIDS can make it harder to breathe rather than help ease asthma symptoms.6
Antibiotics
Another type of medication that causes harm to the lungs is antibiotics. One antibiotic, nitrofurantoin, is used to treat urinary tract infections. But for some, it can cause harsh reactions, such as interstitial lung disease. While this is rare, it is still a possibility for those who are taking nitrofurantoin.7
Sulfa Drugs
Sulfa drugs are another medication that may cause respiratory issues. This kind of drug is used to treat those who suffer from sulfa allergies, a type of allergy to certain medications. For people with a sulfa allergy, taking any medication with sulfa in it can cause allergic reactions such as swelling of the face or throat or hives.
For some, the effects are more dangerous, such as blisters on the mouth, skin, or genitals or having trouble breathing normally. These reactions require immediate medical attention. Avoiding sulfa drugs for those with an allergy to them is the best course of action to keep from suffering adverse effects.8
Cardiac Medications
Additionally, certain heart medications can harm the lungs. These medications are important for those with heart issues or heart disease, but side effects may mean you’ll want to find an alternative. The medication amiodarone is prescribed for those with an irregular heartbeat but is most frequently associated with lung issues.9
What Is the Most Common Drug-Induced Respiratory Problem?
Physicians define a drug-induced respiratory issue as any time an individual experiences a negative respiratory system-based reaction to a medication. These reactions can include allergic reactions, damage to lung tissue, inflammation of the lungs, bleeding or inflammation of the air sacs of the lung, or buildup of fluid in the lungs.3
The most common drug-induced respiratory problem is bronchoconstriction, which occurs when the muscles of the bronchus contract. The bronchus is the main airway that leads to the lungs. When this airway contracts, breathing becomes difficult.
Several different drugs can cause bronchoconstriction, but medications used in inhalers are a common cause. You may also experience bronchoconstriction with cholinergic or anticholinesterase agents, medications designed to activate or inhibit the parasympathetic nervous system by affecting the way it interacts with the hormone acetylcholine. Researchers note that these drugs may especially affect individuals who have preexisting bronchial hyperreactivity.10
Which Drugs Might Cause Respiratory Distress?
Respiratory distress, or respiratory depression, is an acute medical condition that involves difficulty breathing normally. Some signs of a person experiencing respiratory distress are headache, feeling woozy, feeling tired, confusion, nausea, blue-tinted skin, and increased heart rate. Without treatment, respiratory distress can lead to dangerous outcomes like heart attack, excessively slowed breathing, brain damage, coma, and even death.
There are several drugs and medications that can cause respiratory distress, especially when they are taken too frequently, in large doses, or combined with other substances. Most often, these drugs are what are known as depressants, as they depress (or lower) neurotransmitter levels and brain activity.
Opioids are the best-known medication type that leads to respiratory distress. While opioid-induced respiratory distress can be a sign of overdose and lead to brain damage and death, even approved levels of opioids can cause distress. When combined with the risk of dependence and withdrawal, many people prefer to avoid opioid painkillers after medical procedures.
What Are 3 Common Medications That May Cause Respiratory Depression?
Respiratory depression is another way to describe the slower and less effective breathing that can occur after taking a medication. Respiratory depression allows too much carbon dioxide to enter the body while reducing the amount of oxygen in the body. If not treated, respiratory depression can be fatal or lead to other issues, such as a lack of oxygen flowing to the brain, increased levels of acid found in the blood as a result of higher carbon dioxide levels, or the general inability to breathe.
There are several medications that have been linked to respiratory depression, but the most common sources of respiratory depression are opioids: fentanyl, oxycodone, and codeine. Another common class of medications linked to respiratory depression is benzodiazepines, which include midazolam and diazepam (otherwise known as Valium).12
Polypharmacy, or taking multiple medications, can inhibit kidney and liver function in addition to causing respiratory depression.
Other contributing factors to developing respiratory depression include:
Age of 55+
Obesity
Compromised immune system
Smoking
Prescriptions of multiple opioids, benzodiazepines, antidepressants, or psychotropic drugs
Four Factors Contributing to Respiratory Disorders
Respiratory disorders are issues involving the lung, which can cause individuals to have difficulty breathing normally. A few common respiratory disorders are chronic obstructive pulmonary disorder (COPD), asthma, emphysema, pleural effusion, and chronic bronchitis.
While medications may lead to respiratory disorders, other common causes are environmental. One cause is poor air quality or air pollution, which can include smoking. In addition, if a person has allergies to specific pollens, chemicals (even cleaning products), or dust, breathing disorders are more likely. Viral infections and bacterial infections, including sinusitis and pneumonia, are another main cause of respiratory disorders, as the infection affects normal lung function.
Alternatives to Drugs Causing Respiratory Complications
The Detox Shoppe at Alternative To Meds Center
While you may not be able to avoid life saving medications like heart medications, chemotherapy drugs, and rescue inhalers, the overprescription of pain medications and the proliferation of OTC medications are phenomena that could contribute to unnecessary respiratory issues. In some cases, there may be safer, drug-free alternatives available.
Our program focuses on restoring natural mental health without relying on drugs to feel your best. If you’re already experiencing the many issues associated with street drugs and pharmaceuticals, we can help you eliminate those toxic compounds and their effects via our Detox Shoppe. To learn more about Alternative to Meds Center, the Detox Shoppe, and our approach to treating individuals who are experiencing unwanted side effects from drugs or even prescribed medications, contact our Sedona treatment center today.
1. Berliner, D., Schneider, N., Welte, T., & Bauersachs, J. (2016). The Differential Diagnosis of Dyspnea. Deutsches Arzteblatt international, 113(49), 834–845. https://doi.org/10.3238/arztebl.2016.0834
2. Radke, J.B., Owen, K.P., Sutter, M.E. et al. (2014). The Effects of Opioids on the Lung. Clinic Rev Allerg Immunol 46, 54–64 (2014). https://doi.org/10.1007/s12016-013-8373-z
4. Lagan, J., Naish, J. H., Fortune, C., Campbell, C., Chow, S., Pillai, M., … & Miller, C. A. (2022). Acute and chronic cardiopulmonary effects of high dose interleukin-2 therapy: an observational magnetic resonance imaging study. Diagnostics, 12(6), 1352. https://www.mdpi.com/2075-4418/12/6/1352#
5. Dobrinskikh, E., Al-Juboori, S. I., Zarate, M. A., Zheng, L., De Dios, R., Balasubramaniyan, D., … & Wright, C. J. (2021). Pulmonary implications of acetaminophen exposures independent of hepatic toxicity. American Journal of Physiology-Lung Cellular and Molecular Physiology, 321(5), L941-L953. https://doi.org/10.1152/ajplung.00234.2021
6. Baldo, B. A., Pham, N. H., Baldo, B. A., & Pham, N. H. (2021). Non-steroidal anti-inflammatory drugs (pp. 439-471). Springer International Publishing. Retrieved May 10, 2024, from https://link.springer.com/chapter/10.1007/978-3-030-51740-3_9
7. Naureen, S., Faruqi, S., Jawad, N., Kennan, N., & Hart, S. (2023). Long term nitrofurantoin induced interstitial lung disease: a case series and literature review. Sarcoidosis, Vasculitis, and Diffuse Lung Diseases, 40(4). https://doi.org/10.36141/svdld.v40i4.13827
8. Distefano, G., Fanzone, L., Palermo, M., Tiralongo, F., Cosentino, S., Inì, C., … & Basile, A. (2020). HRCT patterns of drug-induced interstitial lung diseases: a review. Diagnostics, 10(4), 244. https://doi.org/10.3390/diagnostics10040244
9. Vasić, N. R., Milenković, B. A., Pešut, D. P., Stević, R. S., & Jovanović, D. M. (2014). Drug induced lung disease-amiodarone in focus. Medicinski pregled, 67(9-10), 334-337. https://doi.org/10.2298/MPNS1410334V
11. Fernández-Liz, E., Barceló-Colomer, M. E., Gómez-Ganda, L., Varon-Galcera, C., Lalueza-Broto, P., Medel-Rebollo, F. J., … & Martín-Gracia, E. (2022). Prevalence of gabapentinoids and central nervous system depressant drugs, and their association with risk factors for respiratory depression in primary care patients. Clinical Drug Investigation, 42(5), 417-426. Retrieved May 10, 2024, from https://link.springer.com/article/10.1007/s40261-022-01144-8
12. Boon, M., van Dorp, E., Broens, S., & Overdyk, F. (2020). Combining opioids and benzodiazepines: effects on mortality and severe adverse respiratory events. Annals of Palliative Medicine, 9(2), 54257-54557. Retrieved May 10, 2024, from https://apm.amegroups.org/article/view/35734/html
This content has been reviewed and approved by a licensed physician.
Dr. Samuel Lee
Dr. Samuel Lee is a board-certified psychiatrist, specializing in a spiritually-based mental health discipline and integrative approaches. He graduated with an MD at Loma Linda University School of Medicine and did a residency in psychiatry at Cedars-Sinai Medical Center and University of Washington School of Medicine in Seattle. He has also been an inpatient adult psychiatrist at Kaweah Delta Mental Health Hospital and the primary attending geriatric psychiatrist at the Auerbach Inpatient Psychiatric Jewish Home Hospital. In addition, he served as the general adult outpatient psychiatrist at Kaiser Permanente. He is board-certified in psychiatry and neurology and has a B.A. Magna Cum Laude in Religion from Pacific Union College. His specialty is in natural healing techniques that promote the body’s innate ability to heal itself.
Lyle Murphy is the founder of the Alternative to Meds Center, a licensed residential program that helps people overcome dependence on psychiatric medication and addiction issues using holistic and psychotherapeutic methods.
Medical Disclaimer: Nothing on this Website is intended to be taken as medical advice. The information provided on the website is intended to encourage, not replace, direct patient-health professional relationships. Always consult with your doctor before altering your medications. Adding nutritional supplements may alter the effect of medication. Any medication changes should be done only after proper evaluation and under medical supervision.
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