Effect of Different Psychoactive Substances on Serum Biochemical Parameters

Abstract

Background:Psychoactive substances affect mainly central nervous system and brain function causing changes in behavior.Objectives:The purpose of this study was to determine the effects of different psychoactive substances on serum biochemical parameters.Patients and Methods:The study included 324 drug dependents, and 69 controls. The patient group was determined according to DSM-IV (The diagnostic and statistical manual of mental disorders, fourth edition) criteria. All patients and control subjects were tested for routine biochemical parameters and urine toxicology parameters for psychoactive substance use. Cases and controls with accompanying diseases like diabetes, cancer, metabolic disorders etc. are excluded from the study. Moreover, an association between urine toxicology results and changes in biochemical parameters was evaluated for statistical significance.Results:There was a statistically significant difference in the Gamma-Glutamyl Transferase (GGT), uric acid, creatinine, urea, albumin, Aspartate Aminotransferase (AST) medians between the dependent and control groups (P < 0.05). We found a statistically significant difference in sodium and albumin levels between the opium-dependent and control groups (P < 0.05). In the benzodiazepin dependent group, we found a significant difference in GGT, urea, glucose, sodium, T protein, and AST levels (P < 0.05). Moreover, a statistically significant difference was observed in triglyceride and GGT levels between the ethyl glucuronide and control groups (P < 0.05).Conclusions:In psychoactive substance dependents, serum routine biochemistry parameters can be used to predict the need for intensive monitoring and treatment programs.

Acute Toxic Effects of the New Psychoactive Substance “Voodoo” among Patients presented to the Poison Control Center of Ain Shams University Hospitals (PCC-ASUH), Egypt, during 2017

“…Hyponatremia observed in our study may be explained by antidiuretic hormone release triggered by serotonergic pathway activation from sympathomimetic poisoning [ 29 ]. In contrast to our study, Sanli et al [ 28 ] reported a significant increase in serum sodium among studied patients. Hypokalemia observed in some of our patients may also be caused by beta receptor activation associated with sympathomimetic toxicity [ 30 ].…”

“…Hyperglycemia found in the current study may be explained by respiratory depression and ensuing cerebral vasodilatation leading to enhanced glucose entry into the brain [ 27 ]. Conversely, hypoglycemia observed in a small number of our patients is consistent with Sanli et al [ 28 ], who reported that some psychoactive substances may decrease blood glucose levels by suppressing gluconeogenesis, especially among patients with poor nutrition. Hyponatremia observed in our study may be explained by antidiuretic hormone release triggered by serotonergic pathway activation from sympathomimetic poisoning [ 29 ].…”

“…The increase in serum urea may be explained by dehydration secondary to vomiting, which was observed in some cases and can result in increased urea reabsorption by the kidney [ 32 ]. Additionally, Sanli et al [ 28 ] speculated that nutritional factors such as low protein intake among people who use psychoactive substances may contribute to elevated serum urea. In addition, renal injury may also contribute to these abnormalities as sympathomimetic poisoning causes generalized vasoconstriction resulting in renal ischemia [ 33 ].…”

The Impact of Opium Consumption on Blood Glucose, Serum Lipids and Blood Pressure, and Related Mechanisms

“…Most clinical reports imply that opium has no remarkable impact on blood glucose (Table 1 ) whether in non-diabetic (Asgary et al, 2008 ; Roohafza et al, 2013 ; Javadi et al, 2014 ; Masoomi et al, 2015 ; Sanli et al, 2015 ) or in diabetic individuals (Karam et al, 2004 ; Hosseini et al, 2011 ; Rezvanfar et al, 2011 ; Najafi and Sheikhvatan, 2012a ; Bayani et al, 2014 ; Rahimi et al, 2014 ). In some of these studies, glycated hemoglobin (HbA1c), as an indicator of poor control of blood glucose, was significantly higher in addicted groups (Karam et al, 2004 ; Asgary et al, 2008 ).…”

“…There is a disparity regarding the impact of opium on lipid indices in humans (Table 2 ). Several studies on healthy subjects and on individuals who suffered from diabetes mellitus, acute myocardial infarction (AMI) and coronary artery disease (CAD) have indicated no significant relations between opium addiction and triglyceride (TG), total cholesterol (TC), low density lipoprotein (LDL), and high density lipoprotein (HDL) levels (Azod et al, 2008 ; Shirani et al, 2010 ; Najafi and Sheikhvatan, 2012a ; Roohafza et al, 2013 ; Afarinesh et al, 2014 ; Bayani et al, 2014 ; Javadi et al, 2014 ; Masoomi et al, 2015 ; Sanli et al, 2015 ).…”