Evaluation of Clinical Symptoms and Serum Lead Level in Patients with History of Oral Opium Use being Admitted to Hazrat Rasoul Akram, Firoozgar, Firoozabadi and Haft Tir Hospitals, Tehran

Abstract

Introduction: Drug abuse and its complications is a socio-health problem in Middle Eastern countries such as Iran. Smugglers may add lead to drug during drug production, which is in order to increase its weight for greater benefit. Considering the frequency of the patients with various complaints among Iranians, this study was designed and conducted to evaluate the clinical symptoms and serum levels of lead in patients being admitted to Hazrat Rasoul Akram, Firoozgar, Firouzabadi and Haft Tir hospitals with any complaints. Materials and Methods: In this case-control study, serum levels of lead were measured in 128 samples in case and control groups. The case group consisted of 64 patients using oral opium who being admitted to Rasoul Akram and Firoozgar, Haft Tir and Firouzabadi hospitals with different complaints in May 2017. The control group consisted of 64 patients with no history of addiction that were homogenized with the case group in terms of age and sex. They were evaluated for serum levels of lead and other variables. Data were analyzed by SPSS software. Results: The mean serum lead level was 76.34±17.82 in the group using opium and was 7.68±3.72 in the control group that the difference was statistically significant (P <0.001). The most common complaints of patients were abdominal pain and symptoms of bowel obstruction. The mean rate of oral opium consumption was 1.73±0.23 in subjects under 50 years old and with a mean of 2.89±0.27 in subjects over 50 years old. Serum lead level was significantly (P = 0.032) increased compared to the amount consumed. Duration of oral opium consumption was 5 months to 30 years with a mean of 15.24 years, which was not significantly correlated to serum lead level (P = 0.213). Also, the hemoglobin range was significantly correlated to different levels of lead in patients consuming oral opium (P = 0.027). Conclusion: The findings of the present study showed a high mean serum lead level in oral opium addicts in the study population. The results also confirm numerous reports suggesting the definitive diagnosis of lead poisoning as a justifying factor in addicted patients with nonspecific symptoms, which may indicate the need for serum lead level screening in opiate addicts to prevent more serious complications.