The opacity of spiral galaxy disks, from counts of distant galaxies, is compared to HI column densities. The opacity measurements are calibrated using the "Synthetic Field Method" from Gonzalez et al. (1998, ApJ, 506, 152), Holwerda et al. (2005a, AJ, 129, 1381). When compared for individual disks, the HI column density and dust opacity do not seem to be correlated as HI and opacity follow different radial profiles. To improve statistics, an average radial opacity profile is compared to an average HI profile. Compared to dust-to-HI estimates from the literature, more extinction is found in this profile. This difference may be accounted for by an underestimate of the dust in earlier measurements due to their dependence on dust temperature. Since the SFM is insensitive to the dust temperature, the ratio between the SFM opacity and HI could very well be indicative of the true ratio. Earlier claims for a radially extended cold dust disk were based on sub-mm observations. A comparison between sub-mm observations and counts of distant galaxies is therefore desirable. We present the best current example of such a comparison, M 51, for which the measurements seem to agree. However, this remains an area where improved counts of distant galaxies, sub-mm observations and our understanding of dust emissivity are needed.