Substance misuse can have a wide range of physical effects, depending on the substance involved and many other factors. One possible risk is hypoxemia, which affects how the body processes vital oxygen intake.

But what Is hypoxemia, and what are the risk factors involved?

What is Hypoxemia?

Hypoxemia is a medical condition characterised by low oxygen levels in the blood. In technical terms, hypoxemia is defined as a condition where arterial oxygen tension (PaO2) is below normal (with normal oxygen tension being 80–100 mmHg, a standard unit of pressure.)

The terms hypoxemia and hypoxia are often used interchangeably, but they actually refer to different conditions. While hypoxemia describes low oxygen levels in the blood, hypoxia is defined by a reduced level of tissue oxygenation.

Hypoxemia can certainly lead to hypoxia as blood is one of the main ways in which oxygen is delivered around the body. The two conditions do not always exist together, though, and hypoxia can also occur when the tissues do not properly utilise the oxygen that is delivered.

It is important that blood is delivered effectively via the blood and used properly in the organs, as oxygen is needed for many vital functions within the body. Hypoxemia can have a number of cause but may be affected by respiratory disorders, cardiovascular conditions and, in some cases, substance misuse.

What Causes Hypoxemia?

There can be a number of causes of low blood oxygen levels, but there are two main bodily systems that help our body get the oxygen it needs. These are the respiratory system, which deals with breathing, and the cardiovascular or circulatory system, which consists of the heart, blood vessels and blood. Issues with either of these systems can lead to hypoxemia.

If you cannot bring in enough oxygen through breathing, or the oxygen is not delivered properly through the circulatory system, this can cause problems associated with hypoxemia. This can involve diseases or conditions affecting the respiratory or cardiovascular systems but can also involve environmental factors such as poor air quality.

Some specific issues that can cause hypoxemia include (but are not limited to):

  • Respiratory Conditions: Chronic obstructive pulmonary disease (COPD), asthma, pneumonia, and pulmonary embolism.
  • Cardiovascular Problems: Congenital heart defects and heart failure impacting oxygen circulation.
  • Environmental Factors: High altitudes, carbon monoxide poisoning, and low air quality.
  • Other Causes: Anaemia, obesity, hypoventilation syndrome, and sleep apnoea.

Another potential cause of hypoxemia can come from certain types of substance misuse. This applies particularly to substances that depress the central nervous system, including alcohol, opioids and sedatives. The use of these substances affects the central nervous system, breathing and lung function, which can limit the oxygen that you take into the bloodstream.

Smoking tobacco or other substances can also damage the lungs and respiratory system, potentially leading to hypoxemia.

What Are the Symptoms of Hypoxemia?

The symptoms and risks of hypoxemia can vary widely, from relatively mild to extremely serious and potentially life-threatening. This largely depends on how severe the hypoxemia is, although there are other factors, such as any other co-existing health conditions.

Another way of measuring hypoxemia is through blood oxygen saturation levels. Saturation levels of 95%-100% are considered normal, while 90%-95% are low. Levels below 90% will result in hypoxemia and may result in symptoms including:

  • Shortness of breath
  • Rapid heartbeat (tachycardia)
  • Confusion or difficulty concentrating
  • Cyanosis (bluish tint to lips, skin, or nails)
  • Fatigue or weakness

Oxygen saturation levels of less than 80% can compromise the function of vital organs, including the brain and heart, and should be promptly addressed. Continued low oxygen levels may lead to respiratory or cardiac arrest and could potentially prove fatal.

Who Is at Risk of Hypoxemia?

Anyone with compromised respiratory or cardiovascular systems could be at risk of developing this condition, while environmental factors like poor air quality can also affect anyone. Some groups at particular risk, however, can include:

  • Individuals with chronic lung diseases, such as asthma or COPD.
  • Smokers and those exposed to second-hand smoke or pollutants.
  • People with a history of substance misuse, particularly opioid or alcohol abuse, due to respiratory suppression.
  • Post-rehab patients manage long-term physical damage caused by addiction.
  • Elderly individuals and those with weakened immune systems.

Complications and Risks of Untreated Hypoxemia

Prolonged lack of oxygen in the body can lead to severe damage to organs, including the brain, heart and kidneys. Chronic low oxygen levels may also contribute to mental health issues, including anxiety, depression and panic disorders.

Serious cases can lead to a complete failure of the respiratory system, requiring emergency medical intervention.

Diagnosis and Treatment Options for Hypoxemia

There are a number of tests that can be used to check oxygen levels in the blood, including:

  • Pulse oximetry: A non-invasive fingertip sensor to measure oxygen in the blood.
  • Arterial blood gas test: Requires a blood sample to test its oxygen content.
  • Imaging tests: Such as chest X-rays or CT scans for underlying conditions.
  • Six-minute walk test (6MWT): Helps evaluate lung and heart function as you walk on a flat surface – typically a treadmill.

Treatments can include oxygen therapy to stabilise levels of oxygen in the blood and medications such as bronchodilators or steroids to improve breathing. Lifestyle changes such as quitting smoking, weight management and suitable exercise can support lung function in the longer term. Addiction treatment can also help remove elements of substance abuse that can cause or contribute to hypoxemia.

Preventing Hypoxemia in Recovery

As noted, substance misuse can interact with hypoxemia, especially with depressants such as opioids, alcohol and sedatives such as benzodiazepines (benzos). Cutting out these substances can cut the risks of hypoxemia, but this can be difficult to achieve, especially if there is a dependency involved.

Addiction treatment programmes can help individuals take control of their substance misuse, which may be a cause of hypoxemia. A holistic treatment programme like those offered by Ocean Recovery will combine physical detoxification with counselling and therapy to address underlying addiction issues contributing to hypoxemia. They will also promote a healthier lifestyle, which may incorporate quitting smoking, taking part in regular, suitable exercise, breathing exercises, and relaxation techniques to reduce stress.

Hypoxemia can have serious consequences if left untreated but is manageable with proper diagnosis and care. You should always take early symptoms seriously and seek medical evaluation if concerned.

If you are concerned about your substance misuse and its potential link to hypoxemia, contact Ocean Recovery today for expert advice, assessments, and addiction recovery programmes tailored to your own needs.

John Gillen - Director at Ocean Recovery

John Gillen - Author - Last updated: January 17, 2025

John is one UK’s leading professionals in the addiction recovery industry. Pioneering new treatment techniques such as NAD+ and ongoing research into new therapy techniques such as systematic laser therapy, John is committed to providing the very best treatment for people throughout the UK and Europe. During his extremely busy schedule, John likes to regularly update our blog section with the latest news and trends in the industry to keep visitors to our site as well informed as possible on everything related to addiction treatment.