جستجوی مقالات مرتبط با کلیدواژه « opium addiction » در نشریات گروه « پزشکی »

Atherosclerosis has an essential role in causing cardiovascular diseases. Various factors affect the risk of coronary artery atherosclerosis, and the increase in the carotid intima-media thickness (CIMT) is a primary marker for detecting atherosclerotic changes in the artery wall. Since opioid use is one of the leading social and health problems in many countries, this study aimed to detect the factors influencing the increase in CIMT in opium consumers.

This cross-sectional study was conducted on 350 participants of the phase 2 of the KERCADRS cohort study who visited Besat clinic in Kerman and were divided into addicted and non-addicted groups. The participants in both groups underwent carotid artery ultrasound, and the Philips IU22 ultrasound machine was used to measure the CIMT.

The mean age of the participants was 42.28±12.58 in the addicted group and 35.99±15.38 in the non-addicted group (P=0.001). CIMT was similar in the two groups (P=0.170). Moreover, CIMT had a significant positive correlation with age, waist circumference, systolic blood pressure (SBP), body mass index (BMI), fasting plasma glucose (FPG), and triglyceride in both addicted and non-addicted groups. Age, weight, waist circumference, SBP, and BMI in the multivariate model were significant determinants of CIMT in the addicted group.

The results revealed that age, weight, waist circumference, SBP, and BMI were the factors influencing intima thickness in opium consumers, and no significant relationship was observed between addiction to opium and CIMT.

Common bile duct (CBD) stone is the most common disorder in the biliary tract, which may lead to hospital admission. Opium addiction is one of the most challenging social and health issues in many societies. An important side effect of opium addiction is the Oddi’s sphincter spasm; i.e., it is likely that the prolonged stasis of bile acid increases the risk of gallstone formation in the CBD.

This cross-sectional study was done from April 2019 to November 2019 in Ghaem Hospital in Mashhad, Iran. 400 patients aged 20-80 years were enrolled. All patients had a definite diagnosis of CBD stones and were candidates for endoscopic retrograde cholangiopancreatography (ERCP). Demographic information of patients, history of underlying diseases, liver laboratory disorders, the existence of concomitant gallbladder stones, and opium addiction information were collected.

The average age of the patients with opium addiction was 65.12 years, and it was significantly higher than the mean age of the patients (61.41 years) without opium addiction (P=0.01). 74.3% were hospitalized, and 25.3% were outpatients. 35.5% of the patients were men, and 64.5% were women. Our study showed that 41.5% of the patients with CBD stones were opiumaddicted. The average CBD stone size in patients with opium addiction (10.15±4.85 mm) was larger than in patients without opium addiction, but a t test showed that this difference was not significant (P = 0.9).

In this study of patients with CBD stones referred for ERCP, we observed a high prevalence of opium addiction in patients with CBD stones.

Intraoperative awareness is accidental or unintentional awareness during general anesthesia that occurs when complete anesthesia has not been achieved. The aim of this study was to investigate the occurrence of awareness with recall during general anesthesia in opium-addicted and non-addict patients undergoing abdominal and pelvic surgeries.

The study population consisted of patients undergoing abdominal and pelvic surgeries under general anesthesia in two hospitals in Gorgan, Northeast of Iran. Data were collected 20-36 hours after the surgery using a three-part questionnaire on demographic information, surgery and anesthesia details and anesthesia awareness and recall of events. Data were analyzed in SPSS (version 18) using the Chi-square test.

Of 206 patients, 53.9% were male and 56.3% were undergoing abdominal surgery. None of the patients in the two groups felt hearing, pain, cold or heat during anesthesia, and neither of them dreamed or recalled any event during the anesthesia and surgery period. There was no statistically significant difference between the two groups in terms of anesthesia awareness with recall. According to the patients, the night before the operation, opium addicts were more anxious the night before the surgery and felt more pain right after the surgery.

There is no statistically significant difference in terms of occurrence of anesthesia awareness between opium-addicted and non-addicted patients undergoing pelvic and abdominal surgeries. However, opium addicts experience significantly higher level of anxiety the night before surgery compared to non-addicts. In addition, opium addicts experience more pain immediately after recovery.

Opium addiction, as a major health problem, has been reported in Middle East countries. Recently, contaminated opium has been reported as a probable source of lead poisoning. Thus, the aim of this study is to evaluate blood lead levels (BLL), liver enzymes, and hemoglobin (Hb) concentrations in opium‑dependent addicts with healthy controls.

In a cross‑sectional study, 75 opium‑addicted men (case group) referred to Zahedan Baharan Hospital were evaluated. A group of 75 nonaddicted men were selected as a control group. BLL, Hb, and liver enzymes levels were measured. Body mass index (BMI) was also calculated.

The case group had elevated BLL compared to the controls (19.1 ± 1.6 vs. 9.1 ± 0.4; P < 0.0001). Hb concentrations were significantly lower in the patients compared to the controls (13.3 ± 1.6 vs. 15.1 ± 1.3; P < 0.0001). A positive correlation was found between BLL and opium addict duration in the case group (r = 0.52, P < 0.0001).

Due to the contamination of opium to lead, it seems that opiate addicts are at risk of lead poisoning. Thus, it is recommended that the blood lead level is frequently monitored to control the adverse effects of poisoning and prevent lead accumulation.

Some studies have shown that opium is a potential risk factor for coronary artery disease (CAD). The method of opium use in most of these studies has been evaluated verbally. In the present study, we assessed the urinary morphine concentration to confirm opium addiction. This study aimed to evaluate the association between the urinary morphine concentration and the severity of coronary artery stenosis in opium addicts.

This study was conducted on 200 opium addicts admitted to the angiographic ward of a referral hospital at Kerman University of Medical Sciences. these patients, 134 cases with CAD according to angiographic results were ed for our study. The patients were divided into 2 groups of mild CAD with < 50% stenosis and severe CAD with > 50% stenosis. Opium addiction and its severity were diagnosed based on the DSM IV criteria and confirmed by the measurement of the urinary morphine concentration.

Severe coronary artery stenosis was detected in 77.6% of the opium addicts. A urinary morphine concentration exceeding the median index was associated with higher odds of severe CAD, but this association was not statistically significant (OR = 2.2, 95% CI: 0.62 to 7.9; P = 0.21).

The opium addicts in the current study were at a higher risk for severe CAD, but there was no significant relationship between the urinary morphine concentration and the severity of CAD. This paraclinical test was not an accurate marker for the assessment of the severity of CAD. The role of other alkaloids in opium should be evaluated. (Iranian Heart Journal 2019; 20(4): 64-70)

Coronary artery disease is one of the leading causes of morbidity and mortality in populations. In opium abusers, level of circulating coagulation factors differs from nonabusers. The aim of this study was to evaluate response to thrombolytic therapy in opium abusers vs. non-abusers.

In this prospective observational study, 83 patients (36 opium abusers and 47 nonabusers) with AMI were evaluated for the presence and degree of response to thrombolytic agent. All patients were monitored for electrocardiographic changes and response to thrombolysis 2 hours before and after administration of thrombolytic agent. Serum CPK and LDH were measured 2 hours before and after thrombolysis. Quantitative and qualitative data were analyzed by independent t-test and chi-square using SPSS, respectively.

ST-resolution 2 hours after thrombolysis was 63.8% and 44.4% in opium users and non-users, respectively. Serum level of CPK cardiac biomarker 2 hours after thrombolysis was 980 ± 245 and 847 ± 130 IU/L in opium users and non-users, respectively.

Our data demonstrate that in those patients with opium abuse, electrocardiographic changes after thrombolysis were significantly lower than opium nonusers (P < 0.05). Opium users showed better ST-resolution compared with non-users. Opium addiction had effect on cardiac enzymes despite their effect on response to streptokinase.

Opium addiction is a global problem which has implicated many societies. Opium addiction and drug abuse is related to harmful consequences which affect life style, biochemical factors, and vitamins values, and also is considered as a risk for heart diseases. Folate and B12 levels are related to homocysteine and studies about their levels in opium addicts are controversial; therefore, we designed this study to evaluate B12 and folate values in opium addicts. From the Kerman Coronary Artery Disease Risk Study (KERCADRS) which is a population-based study, we randomly selected 340 men and entered them into two groups: case (n = 170) and control group (n = 170). Then vitamin B12 and folate levels were measured. Opium addiction did not change B12 and folate levels significantly in opium addicts compared to non-addict control subjects. However, only some variables including blood pressure (BP) and diabetes positively and cigarette smoking, triglyceride (TG), alcohol, and cardiovascular disease (CVD) history negatively affected folate, and none of clinical and demographic variables influenced the B12 levels (P > 0.050). TG had significant effects on B12 and folate levels although opium addiction did not show any impact. High TG levels were accompanied by low levels of B12 and folate. Reduced B12 and folate values are accompanied by serum homocysteine elevation. As TG elevates in opium addicts, it can be considered as an important factor which affects vitamins levels and reduces their absorption. Opium addiction elevates homocysteine level, since we can conclude that homocysteine elevation in opium addicts is independent of B12 and folate levels

The present study was carried out aiming to investigate the effects of opium on some biochemical factors in diabetic and non-diabetic male and female rats. This experimental study was carried out on 28 male and 28 female Wistar rats. The animals were divided into diabetic addicted (DA), diabetic non-addicted (DNA), non-diabetic addicted (NDA), and non-diabetic non-addicted (NDNA) groups of male and female. A double dose of opium was intraperitoneally administered to the addicted groups. Peripheral blood samples were collected to measure the creatinine, uric acid, cholesterol, triglycerides (TG), total protein, and albumin levels. Three-way analysis of variance (ANOVA) was used to compare the mean levels of biofactors among the study groups. Cholesterol and total protein were significantly affected by opium and sex, but not diabetes condition, such that there was a decrease of cholesterol and total protein levels in opium-addicted rats compared to non-opium-addicted ones. However, uric acid, TG, albumin, and creatinine were not affected by opium and diabetes conditions. Opium significantly decreased cholesterol and total protein levels. It could be deduced that the effects of opium on cholesterol and total protein are not sex-dependent, moreover, opium consumption may not have significant effects on biochemical factors in diabetic conditions.

The prevalence of opium addiction among Iranians is considerable. Since endogenous opioid systems may be altered as a consequence of addiction, it is very important to determine the plasma and cerebrospinal fluid (CSF) levels of morphine in Iranian patients addicted to opiates who will undergo surgery. We obtained CSF and plasma samples from 50 volunteers with an established opioid addiction pattern. Samples were analyzed using high-performance liquid chromatography (HPLC). Additionally, frequency of nausea and vomiting, baseline heart rate (BHR), and systolic blood pressure (SBP) were recorded within the surgery and postoperatively during a 10-min interval. 84% of participants were men with a median age of 39.08 years. Mean score of body mass index (BMI) was 23.30 and most of the participants (46%) used opium in its traditional inhaled form. A higher concentration of morphine in blood was found in comparison with CSF (P < 0.001) in relation to the way of use. However, no statistically significant differences were found in relation to the type of addictive substance. No other association was found between the levels of morphine and the clinical characteristics of the patients. Moreover, results revealed no difference between hemodynamic-related data with blood and CSF level in opium-dependent patients. Quantification of plasma and CSF morphine, both immediately before initiation of surgery and subsequently on recovery room, showed that although clinical efficacy of systemic morphine was poor in addicted patients, it had no effect on patients’ hemodynamic variable and following complications after surgery.

The study of temperament and problem-solving styles in people with substance abuse is important in promoting the functions of prevention and treatment of this social problem. Therefore, the aim of this study was to compare the nature and problem-solving skills of methadone treated patients with buprenorphine treated patients. This study was performed on 62 patients and 54 patients randomly selected for buprenorphine and methadone treatment, respectively. The data was collected using Cloninger’s Temperament and Character Inventory (TCI) ‎and the Problem-Solving Questionnaire designed by Cassidy and Long. Findings: Novelty seeking (NS) was higher in patients treated with buprenorphine than those treated with methadone and cooperation was higher in methadone treated patients than those treated with buprenorphine. Moreover, helping patients with methadone treatment was more than those treated with buprenorphine. The majority of buprenorphine treated people were adolescents, and therefore, they showed disability in following the norms of the society, and thus, had a weaker sense of cooperation. In addition, NS was related to the consumption of more sedative substances, such as methadone. Additionally, in methadone treated individuals, there is a clear relationship between buprenorphine and more on helping and solving methods. Therefore, in such patients' rehabilitation and treatment programs, consideration of these criteria may increase the success of treatment and patients’ continuation of treatmen

This paper investigated the effectiveness of narrative therapy in groups on psychological well-being and distress among Iranian women with addicted husbands. The research was an experimental study with pretest-posttest control group design along with follow-ups of one month and three months. The statistical population consisted of all the women with addicted husbands who referred to welfare and social service houses of district 10 in Tehran, Iran. Participants were forty-four persons who had mental health score lower than the mean of statistical society. They were selected using the voluntary sampling method, and were also randomly assigned to two groups, experimental and control. After the early loss, each group included twenty persons and was evaluated by Mental Health Inventory (MHI-28). The experimental group received 10 sessions of the group counseling. Data were analyzed with repeated measure ANOVA and Bonferroni post-hoc test. Findings: The results showed that psychological well-being of women who received the sessions of group counseling "narrative therapy" was improved significantly rather than those who did not received that (P < 0.001), and psychological distress of them was reduced significantly in comparison to the women who did not participated in the sessions (P < 0.001). Based on these findings, it seems that narrative therapy in groups is effective in the promotion of psychological well-being of women with addicted husbands, and also could be effective in reducing their psychological distress. Therefore, it can be concluded that narrative therapy group interventions improve mental health of women with addicted husbands

Opium addiction alters immune responses to stresses such as an injury due to changing the secretion of cytokines. The present study assessed the effect of opium addiction on the cytokines [tumor necrosis factor α (TNFα), interferon-γ (IFN-γ), interleukin-4 (IL-4), and IL-10] before and after laparotomy.
Male rats were randomly divided into control and opium addicted (n = 20). Then, cytokines were measured before surgery, immediately after surgery (within 30-60 minutes) and 24 hours after surgery.
Findings: IFN-γ was raised in an addicted group in three phases of the study as compared to that of the control group. IL-4 in opium addicted group decreased in two phases after surgery compared to the control group. IL-4 was lower after surgery in comparison to before surgery in the opium addicted group. The difference in IL-10 and TNFα levels was not statistically significant in the all groups measured in three phases of the investigation.
The results revealed that opium addiction can increase plasma level of IFN-γ in rats and decrease plasma level of IL-4 after surgical stress. It seems that opium addicted rats are a more susceptible to increased inflammation.

Although the triggering role of both opium use and elevated plasma homocysteine level for progressing atherosclerosis and, therefore, appearing coronary heart disease has been clearly determined, no study are available with respect to the relation between these to risk profiles. In the present study and for the first time, we hypothesized that the opium addiction can be potentially correlated with elevated homocysteine concentration. 217 persons (103 opium-addicted and 114 non-addicted) were randomly selected from the Kerman Coronary Artery Disease Risk Study (KERCADRS), Iran, as a population-based, epidemiological prospective study. In all participants, an enzyme immunoassay kit was used to measure homocysteine in serum samples. The serum level of homocysteine was significantly higher in the opium-addicted ones compared to non-addicted individuals (11.49 ± 7.45 vs. 8.02 ± 3.87 μmol/l) (P < 0.001). In this regard, 21.3% of the opium users and only 3.2% of the non-users had homocysteine concentration > 15 μmol/l (P < 0.001). On the other hand, individuals addicted to opiates exhibited significantly elevated odds of having homocysteine level higher than 15 [odds ratio (OR) = 8.244, 95% confidence interval (CI) = 3.117-21.806]. Multivariable linear regression model showed that the opium addiction could strongly predict elevated homocysteine level in the study individuals [beta = 3.524, standard error (SE) = 0.852] (P < 0.001). Opium consumption can be strongly accompanied with the elevation of plasma homocysteine concentration, and thus opium addiction can exhibit elevated odds of having hyperhomocysteinemia.

Opium addiction can change immune response to Types of stress such as injury or trauma due to alterations in the in secretion status of cytokines in the body. In this study, effects of opium addiction on wound healing and post-operative adhesion bands were assessed after laparotomy. Male rats (n=20) were randomly divided into opium addicted (documented with Naloxone test) and control group. Three weeks after surgery, site of abdominal incision was excised elliptically and sent for wound healing grading assessment by pathologist and an intra-abdominal adhesion band assessment was done. The concentrations of three cytokines (TNF, IFN and IL10) were also measured before, immediately after surgery and 24 hour after surgery. Post-operative intra-abdominal adhesion was decreased in opium addicted group in comparison to control group (p value = 0.014). No statistically significant difference was found in the wound healing phase in two groups (P value = 0.057). Our findings showed that serum level of TNF, IFN and IL10 in two groups measured in all phases of examination (before surgery, within 30-60 min after surgery and 24h after surgery), were not statistically different/significant (p>0.05). Since opium addiction can decrease post-operative intra-abdominal adhesions in rats, they may be susceptible to increased inflammation and these effects may be due to decreased post-operative pain.

Opium abuse as a relatively common behavior among Iranian population may have an association with the other coronary artery disease (CAD) risk factors. Here, we reported the prevalence of opium abuse and its co-exposures with oral health and other CAD risk factors. We recruited 5900 inhabitant aged 15-75 years using a randomized cluster household survey. All were interviewed for level of physical activity (PA), depression, anxiety and opium use and assessed for hypertension, diabetes, hyperlipidemia, and oral health status. Regarding to opium abuse, participants were grouped into: “Non-,” “occasional,” and “dependent” users.Using logistic regression model for every CAD risk factor, we assessed whether the co-exposure of opium and CAD risk factor is significant. Overall, 10.6% reported ever opium use including 5.6% dependent and 5% occasional users. The prevalence of opium abuse was increased from 2.1% in 15-25 years to 24.5% in 55-64 years group. Opium abuse, in occasional and dependent forms, was associated with depression (adjusted odds ratio [AOR] 1.81 and 2.49) and low PS (AOR 1.43 and 1.71 respectively). Dependents were less obese than nonusers (P < 0.01). Opium abuse had no significant association with hypertension, diabetes, oral health status and lipid profile. Opium abuse was associated with depression and low PA. No ameliorative effect was observed on hypertension, diabetes, and plasma lipid profile. Therefore, positive association of opium with depression and LPA and the incorrectness of belief on its ameliorative effect on three other important risk factors of CAD should be clearly highlighted in public health messages to the community.

Many of lay person believe that opium lowers blood glucose. However some studies show the opposite results. In this study, we tried to evaluate the effect of opium on blood glucose and insulin resistance. This comparative study including 53 addicts in case groups who used opium just in the form of smoking and 55 non-addicts in a control group, took part in the study, after proving not to be opium users. After taking blood samples, their fasting blood glucose (FBG), fasting blood insulin and lipid profiles were evaluated. Furthermore, insulin resistance index was analyzed via the homeostatic model assessment of insulin resistance (HOMA-IR) formula with the cut-off points of 7.2 and 7.1. Age and gender were not significantly different between the groups. There was no significant difference regarding the prevalence of insulin resistance between the two groups, according to the cut-off points of 7.1 and 7.2 (P = 0.196 and P = 0.248, respectively). Mean insulin resistance index was not significantly different between the two groups (P = 0.325). In the case group, fasting blood insulin was considerably lower (P = 0.025) and fasting blood sugar (FBS) was significantly higher (P = 0.016) than the control group. According to the level of insulin and FBS in addicts, it does not seem that opium has a significant effect on reducing the blood glucose and insulin resistance.