Is the Urinary Morphine Concentration a Useful Marker for the Assessment of the Severity of Coronary Artery Stenosis in Opium Addicts?

Document Type : Original Article

Authors

1 Department of Cardiology, Physiology Research Center, Kerman University of Medical Sciences, Kerman, IR Iran.

2 Midwifery Faculty, Kerman Branch, Islamic Azad University, Kerman, IR Iran.

3 General Cardiologist, Birjand University of Medical Sciences, Birjand, IR Iran.

4 Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, IR.Iran

Abstract

Background: 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.
Methods: This study was conducted on 200 opium addicts admitted to the angiographic ward of a referral hospital at Kerman University of Medical Sciences. From these patients, 134 cases with CAD according to angiographic results were selected 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.
Results: 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).
Conclusions: 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. 

Keywords

References

1. National policy and strategies about prevention
and control of addiction. 2005. Tehran, Iran :
Headquarter against opiate abuse and smuggled.
2. Rahimimovaghar A : Guideline for prevention
and treatment of addiction. Tehran prevention of
vice cultural welfare organization, 1997
3. Ziaaddini H, ziaaddini MR. The household
survey of drug abuse in kerman, Iran. J Applied
sci : 2005 ; 5(2) : 380-2.
4. Nakhaee N, Divsalar K, Meimandi M, Dabiri S.
Estimating the prevalence of opiates use by
unlinked anonymous urine drug testing: a pilot
study in Iran. Substance use & misuse. 2008;
43:513 – 520.
5. Nasrollahzadeh D, Kamangar F, Aghcheli K,
Sotoudeh M, Islami F, Abnet CC, et al. Opium,
tobacco, and alcohol use in relation to
oesophageal squamous cell carcinoma in a highrisk area of Iran. Brit J Cancer. 2008; 98:1857 –
1863.
6. Masjedi MR, Naghan PA, Taslimi S,
Yousefifard M, Ebrahimi SM, Khosravi A, et al.
Opium could be considered an independent risk
factor for lung cancer: a case-control study.
Respiration. 2013;85(2):112-8.
7. Sadjadi A, Derakhshan MH, Yazdanbod A,
Boreiri M, Parsaeian M, Babaei M, et al.
Neglected role of hookah and opium in gastric
carcinogenesis: A cohort study on risk factors
and attributable fractions. International Journal
of Cancer. 2014;134(1):181-8.
8. Naghibzadeh-Tahami A KN, YazdiFeyzabadiV,Varzandeh M, Haghdoost AA.
Opium as a risk factor for upper gastrointestinal
cancers: a population-based case-control study
in Iran. Archives of Iranian medicine.
2014;17(1):2.
9. Akbari M, Naghibzadeh-Tahami A, Khanjani N,
Baneshi MR, Kamali E, Hesampour M, et
al.Opium as a Risk Factor for Bladder Cancer:
A Population-based Case-control Study in Iran.
Archives of Iranian medicine. 2015;18(9):567.
10. Naghibzadeh-Tahami A, Feyzabadi VY,
Khanjani N, Ashrafi-Asgarabad A ,Alizaeh H,
Borhaninejad VR, Moradi-Joo M, Zeinali M,
Zahedi MJ ,Aghaee-Afshar M, Haghdoost AA.
Can opium use contribute to a higher risk of
colorectal cancers? A matched case-control
study in Iran. Iranian journal of public health.
2016 Oct;45(10):1322 .
11. Lankarani KB, Khosravizadegan Z,
Naghibzadeh-Tahami A, Akbari M ,Khodadost
M, Honarvar B, Khodadost B, Goodarzi F,
Jokari K, Sekhavati E ,Tabrizi R. Opium use
and risk of lower gastrointestinal cancers :
Population-based case-control study in South of
Iran. International Journal of Cancer
Management. 2017;10(6).
12. Hadji M, Marzban M, Gholipour M, Rashidian
H, Naghibzadeh-Tahami A ,Haghdoost AA,
Rezaianzadeh A, Rahimi-Movaghar A, Moradi
A, Seyyedsalehi M, Poustchi H. National Study
of Opium and Cancer in Iran (IROPICAN :(
Study Protocol and Results of the Pilot Phase .
13. Asgari S, Nisal sarrafzadegan, Gholam-Ali
naderi. Effect of opium addiction on new and
traditional cardiovascular risk factors. Lipids in
health and disease. 2008 ; 7 : 42.
14. Bjornaas MA, Bekken AS, Ojlert A, Haldorsen
T. A 20-year prospective study of mortality and
cause of death among hospitalized opiod addicts
in oslo. BMC psychiatry 2008 ; 8. 8
15. Marmor M, Penh A, Widmer K, Ievin RI.
coronary artery disease and opioid use. Am j
cardiol 2004 ; 93(10) : 1295-1297
16. Sadeghian S, Darvish S, Davoodi G, Salarifar
M, Mahmoodian M, Fallah N, et al. The
association of opium with coronary artery
disease. European Journal of Cardiovascular
Prevention & Rehabilitation. 2007;14(5):715-7.
17. Sadr Bafghi SM, Rahei M, Bahadorzadeh L,
Namayeh SM. Is opium addiction a risk factor
for acute myocardial infarction?. Acta medica
Iranica 2005 ; 43(3) : 218-22.
18. Mann DL, Zipes DP, Libby P, Bonow RO.
Braunwald's heart disease e-book: a textbook of
cardiovascular medicine 10th ed. Elsevier
Health Sciences; 2014.
19. Davoodi G, Sadeghian S, Akhondzadeh S,
darvish S. A comparison of specifications, shortterm prognosis of acute myocardial infarction in
opium dependent patients and non dependents.
German j psychiatry 2005 ; 8 : 33-37.
20. American psychiatric association. Diagnostic
and statistical manual of mental disorders DSM-IV-TR 4th ed. Washington DC : american
psychiatric publishing ; 2000
21. Mann DL, Zipes DP, Libby P, Bonow RO.
Braunwald's heart disease: a textbook of
cardiovascular medicine: Elsevier Health
Sciences; 2014.
22. Masoumi M, Shahesmaeili A, Mirzazadeh A,
Tavakoli M. opium addiction and severity of
coronary artery disease : a case-control study.
Journal research of medical sciences 2010 ;
15(1) : 27-32
23. Aghaee-Afshar M, Khazaeli P, Behnam B,
Zadehkermani M, Ashraf-Ganjooei N. Presence
of Lead in Opium. Arch Iranian Med.2008;
11(5):553 – 554.
24. Salehi H, Sayadi A, Tashakori M, Yazdandoost
R, Soltanpoor N, Sadeghi H, et al. Comparison
of serum lead level in oral opium addicts with
healthy control group. Arch Iranian Med.2009;
12(6):555 – 558.
25. Amiri M, Amini R. A comparison of blood-lead
level (BLL) in opi-um-dependant addicts with
healthy control group using the graphite
furnace/atomic absorption spectroscopy (GFAAS) followed by chemometric analysis.Iran
Red Crescent Med J. 2012; 14(8):488 – 491.
26. Navas-Acien A, Guallar E, Silbergeld EK,
Rothenberg SJ. Lead exposure and
cardiovascular disease: a systematic review.
Environmental health perspectives. 2007:472-
82.
27. Vaziri N, Gonick H. Cardiovascular effects of
lead exposure. Indian Journal of Medical
Research. 2008;128(4):426.
28. Pyrgakis VN. Smoking and cardiovascular
disease. Hellenic J Cardiol. 2009;50(3):231-4.
29. Chen Z, Boreham J, editors. Smoking and
cardiovascular disease. Seminars in vascular
medicine; 2002.
Iranian Heart Journal
Volume 20, Issue 4
October 2019
Pages 64-70

Files

Share

How to cite

Statistics