Lung disease with chronic obstruction in opium smokers in Singapore: Clinical, electrocardiographic, radiological, functional, and pathological features

Costa, Jonathan L.; Tock, E. P. C.; Boey, H. K.

doi:10.1136/thx.26.5.555

Cited by 15 publications

(13 citation statements)

References 42 publications

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“…Whereas these studies were case series, and not formally controlled for smoking cigarettes, they still provide important insights. For example, comparing studies of opium users (nearly all of whom also smoked cigarettes) with those who only smoked cigarette (and not opium), Da Costa et al found that the prevalence of parenchymal and pleural fibrosis was much higher in those who used opium 4. In addition, there were distinctive radiographic features—described as ill-defined nodular shadows with or without reticular patterns—in opium users that were not seen in pure cigarette smokers 4.…”

Section: Discussionmentioning

confidence: 99%

“…For example, comparing studies of opium users (nearly all of whom also smoked cigarettes) with those who only smoked cigarette (and not opium), Da Costa et al found that the prevalence of parenchymal and pleural fibrosis was much higher in those who used opium 4. In addition, there were distinctive radiographic features—described as ill-defined nodular shadows with or without reticular patterns—in opium users that were not seen in pure cigarette smokers 4. More recent study from the UK has also shown the association between heroin inhalation and early onset emphysema 34.…”

Section: Discussionmentioning

confidence: 99%

“…Other researchers have also reported a higher frequency of cough, radiological abnormalities and fibrosis in opium users 4–6. For example, studying 48 opium users with a FEV 1 of <60%, Da Costa et al reported high rates of bronchitis and bronchiolitis, destructive emphysema and peribronchiolar fibrosis 4. However, these clinical studies were limited by small sample sizes, lack of control groups and possible confounding by cigarette smoking and other factors.…”

Section: Introductionmentioning

confidence: 99%

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Mortality from respiratory diseases associated with opium use: a population-based cohort study

Rahmati

Shakeri

Khademi

et al. 2016

Thorax

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Background Recent studies have suggested that opium use may increase mortality from cancer and cardiovascular diseases. However, no comprehensive study of opium use and mortality from respiratory diseases has been published. We aimed to study the association between opium use and mortality from respiratory disease using prospectively collected data. Methods We used data from the Golestan Cohort Study (GCS), a prospective cohort study in northeastern Iran, with detailed, validated data on opium use and several other exposures. A total of 50,045 adults were enrolled from 2004 to 2008, and followed annually until June 2015, with a follow-up success rate of 99%. We used Cox proportional hazard regression models to evaluate the association between opium use and outcomes of interest. Results During the follow-up period 331 deaths from respiratory disease were reported (85 due to respiratory malignancies and 246 due to nonmalignant etiologies). Opium use was associated with an increased risk of death from any respiratory disease (adjusted hazard ratio (HR) 95% CI; 3.13 (2.42-4.04)). The association was dose-dependent with a HR of 3.84 (2.61-5.67) for the highest quintile of cumulative opium use vs. never use (Ptrend<0.001). The hazard ratios (95% CI) for the associations between opium use and malignant and nonmalignant causes of respiratory mortality were 1.96 (1.18-3.25) and 3.71 (2.76-4.96), respectively. Conclusion Long-term opium use is associated with increased mortality from both malignant and nonmalignant respiratory diseases.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Mortality from respiratory diseases associated with opium use: a population-based cohort study

Rahmati

Shakeri

Khademi

et al. 2016

Thorax

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“…(1, 48, 49) Other cross-sectional or case-control studies and a large cohort study(15) have shown that opium use can increase the risk of lung cancer,(50) bladder cancer,(6–8, 51) cardiovascular diseases,(9–14) and respiratory diseases. (52–54)…”

Section: Discussionmentioning

confidence: 99%

Opium Use and Risk of Mortality from Digestive Diseases: A Prospective Cohort Study

Malekzadeh

Khademi

Pourshams

et al. 2013

American Journal of Gastroenterology

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Background Opium use, particularly in low doses, is a common practice among adults in northeastern Iran. We aimed to investigate the association between opium use and subsequent mortality from disorders of the digestive tract. Methods We used data from the Golestan Cohort Study (GCS), a prospective cohort study in northeastern Iran, with detailed, validated data on opium use and several other exposures. A total of 50,045 adults were enrolled during a four-year period (2004–2008) and followed annually until December 2012, with a follow-up success rate of 99%. We used Cox proportional hazard regression models to evaluate the association between opium use and outcomes of interest. Results 8,487 (17%) participants reported opium use, with a mean duration of 12.7 years. During the follow-up period 474 deaths from digestive diseases were reported (387 due to gastrointestinal cancers and 87 due to nonmalignant etiologies). Opium use was associated with an increased risk of death from any digestive disease (adjusted hazard ratio (HR) = 1.55, 95% CI 1.24 – 1.93). The association was dose-dependent, with a HR of 2.21 (1.57–3.31) for the highest quintile of cumulative opium use vs. no use (Ptrend = 0.037). The hazard ratios (95% CI) for the associations between opium use and malignant and nonmalignant causes of digestive mortality were 1.38 (1.07 – 1.76) and 2.60 (1.57 – 4.31), respectively. Increased risks were seen both for smoking opium and for ingestion of opium. Conclusion Long-term opium use, even in low doses, is associated with increased risk of death from both malignant and nonmalignant digestive diseases.

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“…However, PEF was measured in habituated opium smokers (Da Costa, Toch and Boey, 1971) and was impaired. These authors attributed the chronic obstructive lung disease of these patients to dust deposition from particulate matter in the smoke.…”

Section: Discussionmentioning

confidence: 99%

Respiratory Function in Heroin and Methadone Addicts

Aylett

1978

British Journal of Addiction to Alcohol & Other Drugs

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SummaryPEF and minute volume have been studied in 68 male and 23 female addicts maintained on methadone, heroin, or both drugs and on 12 ex‐addicts. The findings have been compared with other authors for normal and tobacco cigarette smokers of the same age group. PEF was impaired in both users and ex‐users. In users PEF was no less impaired with methadone than with heroin, and with or without tobacco smoking. Minute volume was in the normal range, implying adaptation of the respiratory centre to chronic drug misuse as a part of tolerance. It seems likely that heroin/methadone depresses the cough reflex with risk of developing chronic bronchitis in dependent young people. Methadone was no better in this respect than heroin.

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Lung disease with chronic obstruction in opium smokers in Singapore: Clinical, electrocardiographic, radiological, functional, and pathological features

Cited by 15 publications

References 42 publications

Mortality from respiratory diseases associated with opium use: a population-based cohort study

Mortality from respiratory diseases associated with opium use: a population-based cohort study

Opium Use and Risk of Mortality from Digestive Diseases: A Prospective Cohort Study

Respiratory Function in Heroin and Methadone Addicts

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