Opium use and mortality in Golestan Cohort Study: prospective cohort study of 50 000 adults in Iran
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Open Access
- 17 April 2012
- Vol. 344 (apr17 2), e2502
- https://doi.org/10.1136/bmj.e2502
Abstract
Objectives To investigate the association between opium use and subsequent risk of death. Design Prospective cohort study. Setting The Golestan Cohort Study in north-eastern Iran collected detailed validated data on opium use and other exposures at baseline. Participants were enrolled between January 2004 and June 2008 and were followed to May 2011, with a follow-up success rate of over 99%. Participants 50 045 participants aged 40-75 at baseline. Main outcomes Mortality, all cause and major subcategories. Results 17% (n=8487) of the participants reported opium use, with a mean duration of 12.7 years. During the follow-up period 2145 deaths were reported. The adjusted hazard ratio for all cause mortality associated with ever use of opium was 1.86 (95% confidence interval 1.68 to 2.06). Opium consumption was significantly associated with increased risks of deaths from several causes including circulatory diseases (hazard ratio 1.81) and cancer (1.61). The strongest associations were seen with deaths from asthma, tuberculosis, and chronic obstructive pulmonary disease (11.0, 6.22, and 5.44, respectively). After exclusion of people who self prescribed opium after the onset of major chronic illnesses, the associations remained strong with a dose-response relation. Conclusion Opium users have an increased risk of death from multiple causes compared with non-users. Increased risks were also seen in people who used low amounts of opium for a long period and those who had no major illness before use.This publication has 40 references indexed in Scilit:
- Activation of peripheral δ2 opioid receptors increases cardiac tolerance to ischemia/reperfusion injury: Involvement of protein kinase C, NO-synthase, KATP channels and the autonomic nervous systemLife Sciences, 2009
- Socio-economic status and oesophageal cancer: results from a population-based case–control study in a high-risk areaInternational Journal of Epidemiology, 2009
- Cohort Profile: The Golestan Cohort Study--a prospective study of oesophageal cancer in northern IranInternational Journal of Epidemiology, 2009
- Opium, tobacco, and alcohol use in relation to oesophageal squamous cell carcinoma in a high-risk area of IranBritish Journal of Cancer, 2008
- Association of intravenous morphine use and outcomes in acute coronary syndromes: Results from the CRUSADE Quality Improvement InitiativeAmerican Heart Journal, 2005
- Opium revisited: a brief review of its nature, composition, non‐medical use and relative risks1Addiction, 1997
- Opium and oesophageal cancer: effect of morphine and opium on the metabolism of N-nitrosodimethylamine and N-nitrosodiethylamine in the ratCarcinogenesis: Integrative Cancer Research, 1997
- Immunotoxicological screening of morphine and methadone in an extended 28 day study in ratsInternational Journal of Immunopharmacology, 1995
- Characterization and identification of 6 mutagens in opium pyrolysates implicated in oesophagel cancer in IranMutation research. Reviews in mutation research, 1985
- INGESTED MUTAGENS FROM OPIUM AND TOBACCO PYROLYSIS PRODUCTS AND CANCER OF THE ŒSOPHAGUSThe Lancet, 1978