OPRM1 and Respiratory insufficiency due to muscle weakness: Alcohol use is well known to cause hepatic dysfunction, compromise immune defenses, disrupt coagulation, and delay wound healing, as shown in prior studies by Khan et al and Eliasen et al5-50 In contrast, opioid use is associated with immune suppression through mu-opioid receptor modulation, as well as respiratory depression, sedation, and decreased renal perfusion, as described by Luo et al51 Despite these differing mechanisms, both alcohol and opioid use lead to comparable vulnerabilities in organ systems, particularly affecting cardiopulmonary and infectious outcomes.