Opium Poppy Agriculture and Consumption

After cannabis, opiates are the world’s second most widely abused illegal drug. Opium is the latex of unripe pods of Papaver somniferum (Opium poppy). Opium has been used traditionally for lowering blood lipids, and postpone cardiac diseases, as well as used for the treatment of diabetes and cancer. In eastern countries, the high prevalence of opium use could be attributed to high supply and conventional assumptions. Although, opium consumption reduced the levels of lipid profile and fasting blood sugar (FBS) in patients, while it also reduced left ventricle ejection fraction. Opium consumption increased inflammatory lung disease and risk of lung cancer as well as increased free radicals by activating lipid peroxidation.

Opium was used for its medicinal and perhaps for its sensory-altering effects long before records of such use could be made. Opium was and continues to be obtained from the opium poppy (Papaver somniferum), which may have been domesticated thousands of years ago in what is now Turkey (Asia Minor). The cultivation and use of opium moved readily to the ancient civilizations of Greece and Egypt, and Arabian traders eventually carried it to India and China. The opium poppy is depicted in the most ancient written language, Sumerian, in approximately 3100 B.c. in southern Iraq (Mesopotamia). In the Ebers Papyri Egyptian physicians recommended the use of opium for a number of disorders in 1550 B.c. (Davenport-Hines, 2002; Terry and Pellens, 1928). Apparent references to opium were made by, among others of the ancient world, Homer, Hippocrates, Theophrastus-a pupil of Aristotle-Virgil, Pliny, and Galen. Until fairly recently, the primary sources of both legal and illicit opium were Afghanistan and Myanmar, with reduced amounts grown in Turkey and Pakistan as their standards of living and outside pressure increased. In the past decade, countries that previously specialized in cocaine production, such as Columbia and Mexico, were growing large amounts of opium for illegal export to the United States and Europe (Brzezinski, 2002; Karch, 2002).

ObjectiveThe association between opium use and bladder cancer has been investigated in many studies, with varying reporting results reported. This study aims to estimate the total odds ratio for the association between bladder cancer and opium consumption using meta-analysis.MethodsThe study was designed according to PRISMA guidelines. Two independent researchers searched for the relevant studies using PubMed, Web of Science, Scopus, OVID, Embase, and Google Scholar. After systematic screening of the studies identified during the first step, Cochrane risk of bias tool was determined for the selected studies. The case-control and the cohort studies were investigated to assess risk of bladder cancer due to opium use. In addition, the cross-sectional studies were analysed separately to assess frequency of opium consumption. These estimates were combined using the inverse variance method. Fixed or random effect models were applied to combine the point odds ratios. The heterogeneity between the primary results was assessed using the Cochran test and I-square index. The suspected factors for heterogeneity were investigated using meta-regression models. An Egger test was conducted to identify any probable publication bias. Forest plots illustrated the point and pooled estimates. All analyses were performed using Stata version 14 software and RevMan version 5.3.ResultsWe included 17 primary studies (11 case-control, one cohort and five cross-sectional) in the final meta-analysis. The total odds ratios (95% confidence intervals) for developing bladder cancer by opium use alone, and concurrent use of opium and cigarettes were estimated as 3.85 (3.05–4.87) and 5.7 (1.9–16.3) respectively. The odds ratio (95% confidence interval) for opium use with or without cigarette smoking was estimated as 5.3 (3.6–7.7).ConclusionThis meta-analysis showed that opium use similar to cigarette smoking and maybe with similar mechanisms can be a risk factor for bladder cancer. It is therefore expected to be a risk factor for other cancers.

Background: We examined the association between opium consumption and pancreatic cancer incidence in a large-scale prospective cohort of the general population in northeastern Iran.Methods: A total of 50,045 adults were systematically followed up (median of 7.4 years), and incident cases of pancreatic cancer were identified. Self-reported data on opium consumption was collected at baseline. Cumulative use (-year) was defined as number of nokhods (a local unit, approximately 0.2 g) of opium consumed per day multiplied by number of years consuming. Adjusted HRs and 95% confidence intervals (CIs) for the association between opium consumption and pancreatic cancer were calculated using Cox proportional hazards regression models.Results: Overall, 54 confirmed cases of pancreatic cancer were identified. Opium use of more than 81 nokhod-years (high cumulative use), compared with never use, was strongly associated with pancreatic cancer even after adjustments for multiple potential confounding factors [HR = 3.01; 95% CI, 1.25-7.26]. High cumulative consumption of opium was significantly associated with risk of pancreatic cancer after adjusting for cumulative dose of cigarette smoking [HR = 3.56; 95% CI, 1.49-8.50]. In a sensitivity analysis, we excluded participants (including 2 pancreatic cancer cases) who were recruited within the first 5 years of starting opium consumption; high cumulative use of opium was still associated with pancreatic cancer risk [HR = 2.75; 95% CI, 1.14-6.64].Conclusions: Our results showed a positive association between opium consumption and pancreatic cancer.Impact: This is the first prospective large-scale study to show the association of opium consumption with pancreatic cancer as a risk factor. Cancer Epidemiol Biomarkers Prev; 27(3); 268-73. ©2017 AACR.

Objective: Narcotic and alcohol use are recognized as the two important underlying factors in all types of trauma. In this study, the prevalence of opium consumption was investigated in traumatic patients who referred to Shahid Rahnemoon hospital in Yazd in 2018. Methods: In this descriptive cross-sectional study, 252 patients with trauma admitted to Shahid Rahnemoon Hospital from October to December 2018 were studied. In order to collect the data, a checklist was administered including the patients’ demographic information (age and gender), opium consumption, location of trauma, day of occurrence of trauma and cause of trauma. Results: The mean of patients’ age was 31.33±19.46 years ranging from 2 to 90 years and 71.4% of them were males. The most common causes of trauma included accidents with motor vehicles (56%), falls from height (19.8%), and intimate partner violence (6%), respectively. Regarding opium consumption, 87.3% of patients did not use it, while 10.3% consumed opium. Narcotic abuse was significantly different with regard to the patients’ gender (P=0.000) and age (P=0.000). Conclusion: Opium consumption increases the risk of error and accident while driving. People on methadone treatment also show high-risk behaviors and are at greater risk of accidents.

Opium derived from the condensed juice of the poppy, Papaver Somniferum, has been used as an analgesic, euphoric, and soporific for centuries. The use of opium use goes back 6000 years to China. It was initially cultivated in 3400 B.C. in Mesopotamia, and has been used therapeutically and recreationally ever since. In fact, opium was available during the time of Hippocrates, the father of medicine (circa 470-370 B.C.). In 1660 A.D., the English physician, Thomas Sydenham, compounded an opium tincture, which he called Laudanum. This was considered the medicinal “cure all” for most ailments. Numerous scientists have experimented since then by mixing opium with other agents including whiskey, rum, brandy, ether, and chloroform. Laudanum is now virtually extinct in the U.S., though still can be obtained in a number of European countries.

The study has been carried out in three desert districts, namely Barmer, Jaisalmer and Bikaner districts of Rajasthan. The objective was to find out the associated risk factors of different health problems related to smoking and their ill- effects among the opium consumers. A total of 600 subjects were interviewed who consumed opium and at the same time smoked cigarettes/ beedis or chewed tobacco as well. The subjects were identified by Simple Random Sampling (SRS) technique in these rural areas of these districts and the data has been collected using pre-tested schedule. Those who smoked tobacco and consumed opium were separated and analysed to find the associated risk factors. The median age of smokers was 42.3 ± 9.04 years and of opium consumers was 38.5± 6.78 years. The odds ratio calculated was 1.08 and the relative risk (RR) of respiratory problems among the opium consumers was 1.68 and that of smokers was 2.44, which is higher and is statistically significant (P<0.05). This showed that smokers have significant risk of health problems and are being shadowed by opium use. Almost all the individuals who consumed opium were smokers/chewers in some or the other form and always have psychological problems by their mind drifting towards opium. The risks including chronic cough, stomach pain, chest pain etc. were common among opium consumers who are smokers. The duration of consumption was highly correlated with diseases, r = 0.80, in subjects who were consuming for the last 15 years. These subjects also chewed tobacco and smoked about 20 beedis on an average/day. The association of smoking tobacco and opium addiction has significant correlation on health with chronic diseases (P<0.05) and they are being dominated by the opium effect. The longer duration of consumption of opium and smoking becomes a major risk factor which can be attributable for cause of cancers of different type and may lead to mortality.

One-hundred and twenty-nine opiate addicts on a monthly maintenance regimen were studied. Subjects with a positive family history of opium use had an earlier age of onset than the subjects without a family history of opium use. Self-reported psychosocial problems resulting from opium use were documented in only seven subjects. Individuals who began opium use after 1979, when it became illegal to use the drug, had a significantly later age of onset than subjects who began before 1979, suggesting that negative legal sanctions can delay initiation of opium consumption.

BackgroundCoronary artery disease (CAD) is a universal public health challenge, more prominently so in the low- and middle-income countries. In this study, we aimed to determine prevalence and trends of CAD risk factors in patients with documented CAD and to determine their effects on the age of CAD diagnosis.Materials and methodsWe conducted a registry-based, serial cross-sectional study using the coronary angiography data bank of the Tehran Heart Center. Adult patients who had obstructive (> 50% stenosis) CAD were included in the study. The prevalence and 11-year trends of conventional CAD risk factors were analyzed by sex and age, and their adjusted effects on the age of CAD diagnosis were calculated.ResultsFrom January 2005 to December 2015, data for 90,094 patients were included in this analysis. A total of 61,684 (68.5%) were men and 28,410 (31.5%) were women. Men were younger at diagnosis than women, with a mean age of 60.1 in men and 63.2 in women (p < 0.001), and had fewer risk factors at the time of diagnosis. Mean age at diagnosis had an overall increasing trend during the study period. Increasing trend was seen in body-mass index, hypertension prevalence, diabetes mellitus. All lipid profile components (total cholesterol, low-density lipoprotein cholesterol, triglycerides, and high-density lipoprotein cholesterol) decreased over time. Of particular interest, opium consumption was associated with 2.2 year earlier age of CAD diagnosis.ConclusionThe major results of this study (lower age of CAD diagnosis in men, lower age of diagnosis associated with most risk factors, and lower prevalence of serum lipids over time) were expected. A prominent finding of this study is confirming opium use was associated with a much younger age of CAD onset, even after adjusting for all other risk factors. In addition to recommendations for control of the traditional risk factors, spreading information about the potential adverse effect of opium use, which has only recently been associated with higher risk of CAD, may be necessary.

Background: Occupational settings expose workers to various substances linked to cancer risk, influenced by exposure intensity and duration. Considering the diverse work conditions across Iranian cities and the unexplored link between occupation and bladder cancer (BC) in Guilan Province, identifying high-risk occupations and industries is imperative for implementing preventive measures in the region. Objectives: To investigate the effect of people's occupations on bladder cancer in Guilan Province. Methods: The study encompassed 266 diagnosed BC patients in Guilan Province who received treatment at local healthcare centers, along with 191 control individuals aged 18 and over. Data for the cases were meticulously recorded in medical records at the Guilan Cancer Registry. The same checklists, including demographic characteristics, comorbidities, addiction status, water consumption habits, environmental exposures, current and previous occupation, previous history of cancer, and family history of cancer, were recorded for the controls. Odds ratios and their 95% confidence intervals were estimated using adjusted logistic regression (LR). Results: The study found that the odds ratio of bladder cancer (BC) was 2.80 (95% CI: 1.26 - 6.21) for the age group 60 - 70 years and 18.2 (95% CI: 7.31 - 45.6) for individuals above 70 years. Rural dwelling increased the risk by 5.06-fold, while well water consumption and regular opium use amplified it by 6.12-fold and 2.58-fold, respectively. Exposure to tar and carbon derivatives led to a 3.53-fold increase in risk, and exposure to combustion/greenhouse gases showed a 10.72-fold increase. Chemical-related occupations, tar, carbon derivatives, smoking, and opium consumption were significant risk factors. Conclusions: Occupations involving chemical substances such as greenhouse gases, tar, and carbon derivatives are associated with a higher risk of bladder cancer (BC). Furthermore, smoking, opium use, and well water consumption significantly elevate the risk of this cancer.

The place of opium in the history of the Chinese diaspora in Latin America and the Caribbean has received scant attention. This article is a preliminary attempt to look into this history, based on fragmentary evidence available. From 1847 to l874, as many as 225,000 Chinese indentured or contract laborers (coolies), almost all men, were sent to Cuba, still a Spanish colony, and newly independent Peru. Both the human trade itself, as well as work and life on the plantations, closely resembled slavery; indeed, the coolies in Cuba worked alongside African slaves. Opium was part of the coolie trade from its inception, distributed in the holding pens in South China ports, on the long, arduous voyages across the Pacific or Atlantic, as well as on the plantations. Cuban and Peruvian planters permitted, even encouraged, the sale, barter and consumption of opium by their coolies, in effect creating a mechanism of social control by alternately distributing and withholding this very addictive substance to desperate men. But this cynical use of opium might also have backfired on them, as sustained and massive ingestion lowered productivity, caused premature death (often by suicide), and resulted in high absenteeism.

Several epidemiological studies have reported that regular use of opium can be associated with an increased risk of developing cancers, including oesophageal, laryngeal, bladder, lung, and gastric cancer. In this systematic review, we aimed at investigating whether experimental studies support this finding and, if yes, how opium consumption can cause cancer. Most of the articles that have studied opium or its derivatives have found it as a carcinogen. However, due to the complex composition, different forms, and various ways of opium use, further comprehensive experimental studies are required. Using modern genomic and epigenomic methods seems to help determine the molecular mechanisms underlying opium carcinogenicity.

Randomized controlled trial of postoperative belladonna and opium rectal suppositories in vaginal surgery

Globally, bladder cancer has been identified as one of the most frequent occupational cancers, but our understanding of occupational bladder cancer risk in Iran is less advanced. This study aimed to assess the risk of bladder cancer in relation to occupation in Iran. We used the IROPICAN case-control study data including 717 incident cases and 3477 controls. We assessed the risk of bladder cancer in relation to ever working in major groups of the International Standard Classification of Occupations (ISCO-68) while controlling for cigarette smoking, opium consumption. Logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CI). In men, decreased ORs for bladder cancer were observed in administrative and managerial workers (OR 0.4; CI: 0.2, 0.9), and clerks (OR 0.6; CI: 0.4, 0.9). Elevated ORs were observed in metal processors (OR 5.4; CI: 1.3, 23.4), and workers in occupations with likely exposure to aromatic amines (OR 2.2; CI: 1.2, 4.0). There was no evidence of interactions between working in aromatic amines-exposed occupations and tobacco smoking or opium use. Elevated risk of bladder cancer in men in metal processors and workers likely exposed to aromatic amines aligns with associations observed outside Iran. Other previously confirmed associations between high-risk occupations and bladder cancer were not observed, possibly due to small numbers or lack of details on exposure. Future epidemiological studies in Iran would benefit from the development of exposure assessment tools such as job exposure matrices, generally applicable for retrospective exposure assessment in epidemiological studies.

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.