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The iceberg of opium addiction. An epidemiological survey of opium addiction in a rural community.

As part of a medico-social survey in a rural population in the northern part of Iran, data concerning opium users was collected from randomly chosen households. The addiction rate was found to be 69/1000. The rate of registered addicts in the same population is 11/1000. The population in terms of registered addicts seems to be very small, but this is only the tip of the iceberg and does not reflect the true picture within the society. In view of the traditional use of opium in the country, the problem of addiction may become serious unless adequate and effective measures are taken.

Adult

Opium administration to infants in Peshawar region of Pakistan.

Use of opium for sedating infants in the North-West Frontier Province of Pakistan causes a grave public health problem. Among the infants hospitalized for opium overdosage, 22 were studied in detail, and their major clinical picture is presented in this paper. The effect of opium use on the nutritional status of these infants, or the relation of infant opium use to addiction in adult life, have not been assessed. It is, however, pointed out that opium overdosage of infants contributed to infant mortality. Despite emergency treatment, the lethality rate of opium overdosed infants was 40 per cent. It is emphasized that a preventive programme should be undertaken to educate parents who are ignorant of the dangers of opium administration to infants.

Child, Preschool

Opium use in two communities of Pakistan ---a preliminary comparison of rural and urban patterns.

Interviews were conducted to clarify drug use patterns and characteristics of opium users in two communities. Because of the small number of subjects selected from only two communities, the results are not representative of the country as a whole. Nevertheless, in the city of Rawalpindi 90 users were studied and found to have a mean daily opium consumption of 0.9 grams at a cost of Rs. 1.00 ($US 0.10). Opium was taken by mouth once or twice daily. They were solitary users who first used opium as adults, most often for self-treatment of health disorders. The majority were employed males with no history of criminality. In the rural opium-producing village, 28 users were interviewed. They smoked opium three or four times a day in a social setting and reported a mean daily consumption of 11 grams. They were more likely to use the drug for its social and pleasure effects and to have addicts as close friends. The high dose was associated with adverse effects on work performance and with more severe withdrawal symptoms. The findings suggest different intervention strategies for the two populations.

Adult

Opium: a potential urinary bladder carcinogen in man.

Evidence is presented that opium addition is a risk factor for cancer of the bladder. A case-control study of 99 bladder cancer patients admitted to Nemazee Hospital in Shiraz, Iran was evaluated. Cancer patients and controls, matched by age and sex, were analyzed as to their opium and/or cigarette smoking habits. A high correlation between opium addiction and bladder cancer has been observed. This evidence significantly exceeded the one observed in relation to cigarette smoking only. The sex ratio for this cancer site, from hospitalized cases in Southern Iran, is estimated to be about nine male cases per one female case. This high male to female ratio was attributed to the greater addiction of males to opium. It was concluded that opium and, more likely, its pyrolysis derived fractions may represent potential bladder carcinogens in man.

Adult

Influence of opium availability on addiction rates in Laos.

Crude rates of opium addiction were determined in 1972-1974 in ten communities of Laos, representing eight different ethnic groups and three provinces. In six rural communities, data were obtained by a house-to-house survey, and in four urban communities by opium den registration. Communities raising opium poppy as a cash crop had highest crude rates of addiction (7.0-9.8 addicts per 100 people). Thos involved in opium commerce had intermediate rates (4.1-5.5). Where neither opium production nor commerce was present, the communities had the lowest rates of addiction (1.8-2.3).

Agriculture

Hill tribe opium addicts: a retrospective study of 1,382 patients.

This paper presents the results of a retrospective study of 1,382 patients admitted to the Narcotics Treatment Centre for Hill Tribes in Thailand, which was operated by the WHO/UN/Thai Programme for Drug Abuse Control. The study revealed widespread opium addiction among the hill tribes. Of these, the Karen were the largest group. Mean age on admission for treatment was 35 years. The male:female ratio was 7:1. Sixty-six per cent were heads of households. About one-third came from households with more than one addict. The mean duration of daily opium use before admission was 7.9 years. Over 90% of them were addicted to opium; there were eight heroin users. The mean amount of opium used daily was 3.9 g for males and 3.2 g for females. About three-quarters of them used salicylate analgesics with opium. Illness, in particular abdominal pain, was the most frequent cause of their addiction.

Adolescent

Patterns and prevalence of opium use in rural Punjab (India).

A household survey of opium use was carried out in three district of Punjab. Of the 1,400 randomly selected households, 1,276 were covered by the study. All members above the age of 15 years were individually interviewed. The survey included 2,064 men and 1,536 women. The percentage prevalence rate of opium use was 5.76, much higher among men than women. Because of the small number of women involved in opium use (0.5 per cent), the data on socio-demographic variables were analysed only for men. The male opium users were classified as past, experimental, regular and seasonal users, with 3.4, 0.8, 3.6 and 1.8 percentage prevalence rates respectively. The relationships between opium use and variables such as age, occupation, religion, education, marital status and per capita income are discussed as well as their implication on drug abuse control policy.

Adolescent

Assay of major and minor constituents of opium samples and studies of their origin.

Samples of opium from different countries as well as from various regions of India were studied for their morphine and codeine content by gas-liquid chromatography (GLC) as their silyl ethers in a single step. Non-phenolic alkaloids (thebaine, papaverine and narcotine) were extracted with dichloromethane for GLC after conversion of the meconic acid, morphine and codeine in opium into insoluble salts with lime water. The data on alkaloidal constituents have been utilised in a determination of the origin of seized opium samples in this preliminary study.

Alkaloids

GLC determination of opium alkaloids in papaveretum.

A GLC method for the determination of the opium alkaloids in papaveretum, based on the formation of the acetyl derivatives of morphine and codeine, is described. The analytical results are compared with those obtained by the official method. The proposed method is fast and accurate and is particularly suited to the analysis of the raw material.

Chromatography, Gas

Ingested mutagens from opium and tobacco pyrolysis products and cancer of the oesophagus.

Substances which are commonly sucked or chewed in two areas where the incidence of oesophageal cancer is high, the Transkei and north-east Iran, were tested in bacterial mutagenicity assays. Pyrolysed substances, opium dross in north-east Iran and tobacco pipe residues in the Transkei, displayed mutagenic activity in Salmonella typhimurium strains TA98 and TA100 in the presence of rat liver microsomes.

Administration, Oral

Frequency of psychiatric symptoms among 150 opium addicts in Shiraz, Iran.

The psychiatric evaluation of 150 opium addicts in Shiraz, Iran, revealed that (1) the addicts had more psychiatric symptoms than the matched control group, and (2) the most frequent symptom among the addicts was depression. Our findings differ from most Western studies, where anxiety and evidence of antisocial behavior were reported as the most common findings.

Adolescent

Environmental effects on morphine content in opium poppy (Papaver somniferum L.).

Ten cultivars of opium poppy were tested for morphine content during the past five years at the Indian Agricultural Research Institute (IARI), New Delhi. Techniques employed to determine the adaptive potential (Finlay and Wilkinson, 1963; Eberhart and Russel, 1966), relative stability and environmental interaction showed the significant varietal differences when the cultivars' mean square was tested over pooled deviations as the error term. Significant V- X -E (linear) component suggests the existence of genetically conditional differences in the stability of cultivars. Highest morphine content was observed in cultivar H and least in R. Four cultivars exceeded the grand mean. Within the five-year study period three were observed to have given the highest morphine content.

Drug Stability