Effect of Heroin on Liver and Kidney Functions

Abstract

Background and Aim: Drug use disorders are serious health issues with a significant burden for individuals affected and their families. There are also significant costs to society including lost productivity, security challenges and crime. Heroin has the highest dependence, tolerance and withdrawal score. The aim of this study is to assess the effect of heroin on liver and renal functions. Materials and Methods: This comparative case - control study was carried out on 60 males aged from 15 to 45 years old at the Department of Neuropsychiatry and the Center of Psychiatry, Neurology and Neurosurgery, Tanta University, Egypt from March 2019 through April 2020. Patients group: 30 patients with heroin use disorders diagnosed according to DSM-5 criteria with history of smoking. Control group: thirty smoker persons were taken as a control group matching with patients group. All participants were subjected to: History taking, physical examination and investigations including liver and renal function tests, urine drug screening and psychometry by the addiction severity index scale. Results: Heroin addicts had significant elevation in liver enzyme (Aspartate and Alanine transaminase) and alkaline phosphatase (p<0.001). There was no significant difference between heroin group and control regarding Albumin/Globulin ratio, Prothrombin Time, International Normalized Ratio and bilirubin level. Heroin addicts had significant elevation in blood urea, serum creatinine and Albumin/Creatinine ratio (P <0.001). There was significant decrease in Estimated Glomerular Filtration Rate in heroin group in comparison to control group (p<0.001). Positive correlation with statistical significance between (dose of heroin in grams, duration of use of heroin and severity index of addiction) and (liver functions and renal functions) in patient group. Conclusion: In heroin addicts, there was significant elevation in liver enzymes, ALP, Albumin/creatinine ratio, Urea and Creatinine and significant decrease in eGFR. The higher the dose of heroin use, the more the impairment of liver and renal functions. The longer the duration of heroin use,the more the deterioration of liver and renal functions. The more the severity index of addiction, the more the impairment of liver and renal functions.