Does smoking after treatment for opioid addiction lead to relapse?
Is there any clinical evidence that continuous tobacco use after buprenorphine and naloxone (Suboxone) treatment for opioid addiction encourages relapse?—TIM KRENIK, MSPAS, PA-C, Albuquerque, N.M.
Cigarette smokers do appear to have higher rates of relapse after treatment for opioid addiction than nonsmokers, although the reasons for this are not clear. Anecdotally, I know of patients who—although they remain smokers—have conquered opioid addiction and remained "clean" for years. Some cite fear of opioid relapse as a reason for not quitting, but as more and more drug rehabilitaiton centers become smoke-free, it is clear that terminating all addictions at once is possible (if not preferable).—Reuben W. Zimmerman, PA-C (141-3)