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

Abstract

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.

Hospital-Treated Pneumonia Associated with Opioid Use Among Community Dwellers with Alzheimer’s Disease

“…Opioid use has been associated with a higher risk of pneumonia among older community-dwelling people [13], people with rheumatoid arthritis [15], COPD [14], Medicaid beneficiaries [16] and, more recently, among veterans with and without HIV [17]. Similarly, a higher risk of pneumonia-related mortality has been previously described among opium users [32]. Among opioid users with COPD the risk estimates for pneumonia have been similar, although somewhat lower than in our study [14].…”

Individual and Combined Effects of Environmental Risk Factors for Esophageal Cancer Based on Results From the Golestan Cohort Study

“…19,20 In our previous casecontrol study of ESCC in Golestan, both ingesting and smoking opium were associated with increased risk of ESCC, 9 and previous analyses in the GCS have shown consistently harmful associations between both smoking and ingesting opium and risk of pancreatic cancer, 36 digestive disease mortality, 37 and respiratory disease mortality. 38 However, the null result may be related to the small number of patients who ingested opium (total of 31 cases), and more prospective analyses of opium ingestion and ESCC risk are needed before a conclusion about this exposure can be made.…”

Opium and grade of urothelial bladder cancer

“…Iran accounts for the second most severe addiction to opium in the world (13). Unfortunately, there is a traditional positive attitude to opium use (14). This attitude as well as some other factors such as poverty, unemployment, urbanization, homelessness, and divorce, cause a high rate of opium usage in Iran (13).…”