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BACKGROUND: The prevalence and burden of substance and opium use have increased worldwide over the past decades. In light of rapid population changes in Tehran, we aimed to evaluate the prevalence of opium and other substance use among adult residents in Tehran, Iran. METHOD: From March 2016 to March 2019, we utilized data from 8 296 participants in the Tehran Cohort Study recruitment phase (TeCS). We calculated the age-sex-weighted prevalence of substance use and the geographic distribution of substance use in Tehran. We also used logistic regression analysis to determine possible determinants of opium use. RESULT: We analyzed data from 8 259 eligible participants with complete substance use data and the average age of participants was 53.7 ± 12.75 years. The prevalence of substance use was 5.6% (95% confidence interval [CI]: 4.6- 7.1%). Substance use was more common in males than females (Prevalence: 10.5% [95% CI: 8.6- 12.6%] vs. 0.5% [95% CI: 0.2- 1.2%], respectively). The age-sex weighted prevalence of substance use was 5.4% (95% CI: 4.6-7.1%). Moreover, opium was the most frequently used substance by 95.8% of substance users. Additionally, we found that male gender (Odds ratio [OR]: 12.1, P

A series of 21 novel compounds based on noscapine were synthesized and investigated as potential anticancer therapeutics. These new compounds were prepared from the N-demethylation of noscapine followed by the three-component A3-coupling of N-nornoscapine as a secondary amine, an aldehyde and a terminal alkyne catalyzed by copper iodide (CuI). Two classes of derivatives were synthesized by applying phenylacetylene and propargyl alcohol as the alkyne moiety. Chemical structures of the products were confirmed by 1HNMR, 13CNMR, and HR-MS. In vitro cytotoxicity of the synthesized derivatives was studied on MCF-7 breast cancer cell line treated with different doses of compounds for 48 h. Compounds 6l, 6n and 6h (IC50 = 18.94, 19.29 and 32.11 µM, respectively) displayed the highest potency compared to that of noscapine (IC50 = 36.38 µM). [ABSTRACT FROM AUTHOR]

Background: Poppy seed tea (PST) is a legally obtainable source of opiates made from the seeds of the opium poppy. Our large telehealth opioid use disorder (OUD) provider group has treated several patients with PST misuse. Methods: We retrospectively identified patients with primary PST use disorder treated with buprenorphine in a telehealth-only practice with first visits between January 2021 and December 2022. Patients were identified by having the word "poppy" in their enrollment note, and then charts were reviewed to determine which patients had primary PST misuse. Demographics, buprenorphine doses, and retention in treatment were recorded. Results: We identified 18 patients treated for PST use disorder. Fifteen (83.3%) identified as male, mean age was 40.4 (standard deviation 8.8) years, and patients resided in 10 different U.S. states. Median starting buprenorphine dose was 2 mg (interquartile range (IQR) 2–2.5 mg). Median stabilizing dose of buprenorphine was 16 mg daily (IQR 15–20.5 mg). As of June 2023, 5 patients (27.8%) were still in active treatment. Two patients (11.1%) had completed a planned, elective taper. Ten patients (55.6%) had unplanned discontinuation from treatment, and 3 patients (16.7%) discontinued for other reasons. Conclusions: To our knowledge, this is the largest case series describing PST misuse in the U.S., and the first to demonstrate its treatment in the telehealth setting. PST use disorder is treatable with buprenorphine with doses similar to treatment of other opioid use disorders. Clinicians who treat patients with OUD should be aware of PST use disorder and its treatment. [ABSTRACT FROM AUTHOR]

Background: Late-onset multiple sclerosis (LOMS), defined as the development of MS after the age of 50, has shown a substantial surge in incidence rates and is associated with more rapid progression of disability. Besides, studies have linked tobacco smoking to a higher chance of MS progression. However, the role of smoking on the risk of developing LOMS remains unclear. This study aims to evaluate the possible association between lifetime exposure to cigarette and waterpipe smoking, drug abuse, and alcohol consumption and the risk of LOMS. Methods: This population-based case-control study involved LOMS cases and healthy sex and age-matched controls from the general population in Tehran, Iran. The primary data for confirmed LOMS cases were obtained from the nationwide MS registry of Iran (NMSRI), while supplementary data were collected through telephone and on-site interviews. Predesigned questionnaire for multinational case-control studies of MS environmental risk factors was used to evaluate the LOMS risk factors. The study employed Likelihood ratio chi-square test to compare qualitative variables between the two groups and utilized two independent sample t-test to compare quantitative data. Adjusted odds ratio (AOR) for age along with 95% confidence intervals (CI) were calculated using matched logistic regression analysis in SPSS 23. Results: Totally, 83 LOMS cases and 207 controls were included in the analysis. The female to male ratio in the cases was 1.5: 1. The mean ± SD age of 83 cases and 207 controls was 61.14 ± 5.38) and 61.51 ± 7.67 years, respectively. The mean ± SD expanded disability status scale (EDSS) score was 3.68 ± 2.1. Although the results of waterpipe exposure had no significant effect on LOMS development (P-value: 0.066), ever cigarette-smoked participants had a significantly higher risk of developing LOMS than those who never smoked (AOR: 2.57, 95% CI: 1.44–4.60). Furthermore, people with a history of smoking for more than 20 years had 3.45 times the odds of developing MS than non-smokers. Drug and alcohol abuse were both associated with LOMS in our study; of which opioids (AOR: 5.67, 95% CI: 2.05–15.7), wine (AOR: 3.30, 95% CI: 1.41–7.71), and beer (AOR: 3.12, 95% CI: 1.45–6.69) were found to pose the greatest risk of LOMS, respectively. Conclusion: For the first time, we identified smoking, drug, and alcohol use as potential risk factors for LOMS development. According to the global increase in cigarette smoking and alcohol use, these findings highlight the importance of conducting interventional approaches for prevention. [ABSTRACT FROM AUTHOR]

The article focuses on the intricate relationship between opium addiction, religion, and commodity culture in Charles Dickens' "The Mystery of Edwin Drood," illustrating how these themes reflect a commodified society. Topics include the portrayal of John Jasper's futile quest for relief through opium, the blurring of real and representational worlds in a highly spectacular culture, and Dickens's critique of psychological escapism as a commentary on addiction and social reality.

Objective: Chronic diarrhea affects approximately 5% of the population. Opioids inhibit gastrointestinal motility, and opium tincture has shown anti-propulsive effects in healthy, but no controlled studies of its clinical efficacy exist. We aimed to investigate the anti-propulsive and central nervous system (CNS) effects of opium tincture in patients with chronic diarrhea. Materials and methods: The study was a randomized, double-blinded, placebo-controlled, cross-over trial in subjects with chronic diarrhea refractory to standard treatment. Participants received opium tincture or placebo during two intervention periods, each lasting seven days. Bowel movements were recorded daily, and gastrointestinal transit time was investigated with the wireless motility capsule system. Gastrointestinal symptoms, health-related quality of life, and CNS effects (pupil size, reaction time, memory, and general cognition) were also investigated, along with signs of addiction. Results: Eleven subjects (mean age: 45 ± 17 years, 46% males) with a median of 4.7 daily bowel movements were included. The number of daily bowel movements was reduced during opium tincture treatment to 2.3 (p = 0.045), but not placebo (3.0, p = 0.09). Opium tincture prolonged the colonic transit time compared to placebo (17 h vs. 12 h, p < 0.001). In both treatment arms, there were no changes in self-reported gastrointestinal symptoms, health-related quality of life, or CNS effects, and no indication of addiction was present. Conclusion: Opium tincture induced anti-propulsive effects in patients with chronic diarrhea refractory to standard treatment. This indicates that opium tincture is a relevant treatment strategy for selected patients with chronic diarrhea. Moreover, no evidence of opioid-induced sedation or addiction was found. Trial Registration Number: NCT05690321 (registered 2023-01-10) [ABSTRACT FROM AUTHOR]

Background: Comorbid major depressive disorder (MDD) and opium use disorder (OUD) are known to increase the risk of suicide. The purpose of this study was to compare the efficacy and safety of adjunctive therapy with either ketamine or buprenorphine in patients with comorbid MDD and OUD. Methods: This was a randomized double-blind controlled trial in adults admitted to a hospital in Iran. Sixty-six participants were enrolled and received either ketamine or buprenorphine, along with current antidepressant therapy. The primary outcome was change in depressive symptoms assessed using the Beck Depression Inventory (BDI) after 2 hours, 24 hours, and 7 days following initiation of treatment. Secondary outcomes included changes in suicidal ideation, evaluated by the Beck Scale for Suicidal Ideation (BSSI). Results: Both groups experienced a significant decrease in the severity of depression following the interventions (p <.05). However, there was no significant difference in the between-group comparison (p >.05). Both groups also exhibited a significant reduction in suicidal ideation compared to before the study, with the decrease in severity being over 85% in both groups (p <.05). Conclusion: Both ketamine and buprenorphine appear to be equally effective in reducing symptoms of depression and suicidal ideation among individuals with MDD and OUD. [ABSTRACT FROM AUTHOR]

Abstract Background Late-onset multiple sclerosis (LOMS), defined as the development of MS after the age of 50, has shown a substantial surge in incidence rates and is associated with more rapid progression of disability. Besides, studies have linked tobacco smoking to a higher chance of MS progression. However, the role of smoking on the risk of developing LOMS remains unclear. This study aims to evaluate the possible association between lifetime exposure to cigarette and waterpipe smoking, drug abuse, and alcohol consumption and the risk of LOMS. Methods This population-based case-control study involved LOMS cases and healthy sex and age-matched controls from the general population in Tehran, Iran. The primary data for confirmed LOMS cases were obtained from the nationwide MS registry of Iran (NMSRI), while supplementary data were collected through telephone and on-site interviews. Predesigned questionnaire for multinational case-control studies of MS environmental risk factors was used to evaluate the LOMS risk factors. The study employed Likelihood ratio chi-square test to compare qualitative variables between the two groups and utilized two independent sample t-test to compare quantitative data. Adjusted odds ratio (AOR) for age along with 95% confidence intervals (CI) were calculated using matched logistic regression analysis in SPSS 23. Results Totally, 83 LOMS cases and 207 controls were included in the analysis. The female to male ratio in the cases was 1.5: 1. The mean ± SD age of 83 cases and 207 controls was 61.14 ± 5.38) and 61.51 ± 7.67 years, respectively. The mean ± SD expanded disability status scale (EDSS) score was 3.68 ± 2.1. Although the results of waterpipe exposure had no significant effect on LOMS development (P-value: 0.066), ever cigarette-smoked participants had a significantly higher risk of developing LOMS than those who never smoked (AOR: 2.57, 95% CI: 1.44–4.60). Furthermore, people with a history of smoking for more than 20 years had 3.45 times the odds of developing MS than non-smokers. Drug and alcohol abuse were both associated with LOMS in our study; of which opioids (AOR: 5.67, 95% CI: 2.05–15.7), wine (AOR: 3.30, 95% CI: 1.41–7.71), and beer (AOR: 3.12, 95% CI: 1.45–6.69) were found to pose the greatest risk of LOMS, respectively. Conclusion For the first time, we identified smoking, drug, and alcohol use as potential risk factors for LOMS development. According to the global increase in cigarette smoking and alcohol use, these findings highlight the importance of conducting interventional approaches for prevention.

Background: Opioids inhibit motility and secretion of the gut and have been used for antidiarrheal treatment for centuries. However, the underlying mechanisms of opium tincture are not evident. Aim: To investigate the effects of opium tincture on gastrointestinal motility, intestinal volumes, and water content of different gut segments assessed by magnetic resonance imaging (MRI). Methods: Twenty healthy volunteers were included in a randomized, placebo‐controlled, crossover study of 9 days of treatment with 30 drops of opium tincture per day. MRI was performed on day 1 (before treatment) and day 9 (during treatment). Measurements included assessments of gastric volume, gastric emptying, gastric motility, small bowel volume, small bowel water content, small bowel motility, colon volume, colon water content, and whole gut transit. Key Results: Opium tincture delayed gastric emptying by a mean difference of 5.6 min [95% CI: 1.8–9.4], p = 0.004, and increased postprandial gastric meal volume (17–21%, p = 0.02). Small bowel endpoints did not change. Opium tincture delayed whole gut transit time (p = 0.027) and increased ascending colon volume by 59 mL [95% CI: 15–103], p = 0.004, and transverse colon volume by 48 mL [95% CI: 4–92], p = 0.027. T1‐relaxation time of the descending colon chyme was decreased during opium treatment, indicating dryer feces (difference: −173 ms [95% CI: −336 ‐11], p = 0.03). Conclusion and Inferences: Opium tincture induced changes in the stomach and colon in healthy volunteers. An improved understanding of how opioids affect gut functions may lead to a better understanding and optimized management of diarrhea. [ABSTRACT FROM AUTHOR]

This article explores the sociocultural history of opium consumption and its popularisation through the beauty of female attendants in Manchukuo, which was a crucial part of the Japanese Empire and an important 'contact zone' of diverse cultures. It offers a glimpse into the opium–prostitution nexus by exploring the legal, commercial, social, and cultural dimensions of the gendered and sexualised practice of opium consumption, which reinforced a highly entangled triangulation of imperial consultants from Japan and Korea, Chinese opium shop-owners, and consumers of multiple nationalities. As such, the article highlights how this subculture developed at a time of increasingly pervasive surveillance of sex workers as well as deeply asymmetrical power relations between imperial subjects and the Chinese locals, and along class and gender lines. In examining how female attendants promoted opium within illegal establishments, I argue that the gendered and sexualised consumption of opium reshaped the culture and economy of the substance's use and that this culture, its regulation, and imperialism damaged Manchukuo society. By doing so, the article reveals the subculture of gendered and sexualised opium consumption in Manchukuo and the Japanese Empire more broadly. [ABSTRACT FROM AUTHOR]

Background and Objective: Opium use is one of the most common problems that impose significant social, psychological, and economic burdens on societies. Understanding the factors involved in the treatment of opium use is essential. This study aimed to evaluate inhibitory response and impulsivity in opium users. Methods: This descriptive-analytical study was conducted on 170 opium users (139 men and 31 women) who visited the Methadone Maintenance Treatment Center in Gorgan, Iran during 2022, selected through convenience sampling. The Stop Signal Task (SST) was used to assess participants' inhibitory response, and the Barratt Impulsiveness Scale (BIS) was used to measure impulsivity levels. Results: The average overall impulsivity score was 67.8±11.85. The average correct responses were 45.09±5.67, incorrect responses were 4.51±3.95, and delays were 0.96±2.32. The mean response time to each stimulus was 1290±512.83 milliseconds. There was a statistically significant correlation between impulsivity dimensions and age, correct responses and education level, and response time for inhibitory control with age and education level (P

Double duct sign on imaging is defined as dilated common bile duct and pancreatic duct till ampulla and is usually associated with an ampullary obstruction likely periampullary malignancy. Sphincter of Oddi dysfunction is an uncommon cause of double duct sign. In the present case, we are discussing a rare cause of Sphincter of Oddi dysfunction with double duct sign.

Pain is a phenomenon whose recognition reflects historically different views of the human being. The various medical practices in the treatment of pain from antiquity and the Middle Ages to the late Enlightenment are an impressive testimony to the time of their emergence. When we look at the history of pain treatment, we have to go back at least as far as the Stone Age. This is where the palaeontological evidence of therapeutic experiments in the form of boreholes in the human skull can be found. It is very likely that this was a form of treatment for headaches, as a similar method can still be found today among African natives. The basis of this therapy was the assumption that the „evil spirit of pain“ could escape through this opening and the patient would be cured of the pain. The main aim of treating illness and pain was to expel these spirits from the body. The magical-religious understanding of pain was also present in other ancient cultures, e.g. Egyptian culture, for example the pain after an injury in battle was caused by the gods and spirits of the dead. In ancient Egypt, they believed that evil spirits entered the body through the nostrils or ears. This was directly followed by healing methods, for example in descriptions of treatments using vomiting, sneezing or urination to make the spirits leave the body. So although pain was usually seen as divine punishment, it was treated early on. Pain therapeutic endeavours through the use of opium can be traced back to the Assyrians, Sumerians and ancient Egyptians. In the following centuries of the Middle Ages, many of the findings from antiquity disappeared. Pain was largely seen as God‘s punishment for sins or as a test from God. Accordingly, healing and relief were sought primarily from God and the saints. Only the possibility of developing knowledge about the anatomical and physiological functions of the body and in particular the identification of the brain as the seat of all perception (including the perception of pain) freed pain therapy from magical historical elements. This is where the rational phase of medicine begins, focussing on expanding the development of the therapeutic possibilities of pain. [ABSTRACT FROM AUTHOR]

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This study presents a new strategy to discriminate between opium samples obtained from different geographical regions. Nuclear magnetic resonance (NMR) profiling and chemometrics were applied to geographical classification of opium originating from Myanmar and Afghanistan, which are two major opium producing countries in the world. A total of 50 Myanmar and 46 Afghanistan authentic opium samples were analyzed by 1H‐NMR, and the chemical profiles were characterized. Different sample preparation procedures, data processing methods, and chemometrics were compared to obtain the best classification effect. It was found that drying and the addition of buffer solutions were unnecessary for classification purposes; thus, the gum opium samples were extracted directly with CD3OD, which shortened sample preparation time. A full discrimination between the two geographical origins was achieved by 1H‐NMR profiling and orthogonal partial least squares discriminant analysis. All 30 opium samples were classified correctly by the developed orthogonal partial least squares discriminant analysis model. Compared with traditional chromatography and mass spectrometry profiling methods, the 1H‐NMR profiling method was faster (with instrument analysis time of less than 3 min) and reproducible. This study provides new insights into the applying of NMR profiling and chemometrics to rapid drug profiling analysis. [ABSTRACT FROM AUTHOR]

Background and Objective: Opium use is one of the most common problems that impose significant social, psychological, and economic burdens on societies. Understanding the factors involved in the treatment of opium use is essential. This study aimed to evaluate inhibitory response and impulsivity in opium users. Methods: This descriptive-analytical study was conducted on 170 opium users (139 men and 31 women) who visited the Methadone Maintenance Treatment Center in Gorgan, Iran during 2022, selected through convenience sampling. The Stop Signal Task (SST) was used to assess participants' inhibitory response, and the Barratt Impulsiveness Scale (BIS) was used to measure impulsivity levels. Results: The average overall impulsivity score was 67.8±11.85. The average correct responses were 45.09±5.67, incorrect responses were 4.51±3.95, and delays were 0.96±2.32. The mean response time to each stimulus was 1290±512.83 milliseconds. There was a statistically significant correlation between impulsivity dimensions and age, correct responses and education level, and response time for inhibitory control with age and education level (P<0.05). There was no statistically significant correlation between the various dimensions of inhibitory response and impulsivity (cognitive impulsivity, nonplanning impulsivity, and motor impulsivity) and overall impulsivity. Conclusion: Opium users are generally impulsive. Additionally, younger individuals and those with lower education levels are more impulsive compared to others. [ABSTRACT FROM AUTHOR]

This paper explores the intersections between two phenomena that have shaped eastern Kachin State in Myanmar's northern borderlands with China since the late 1980s: the transformation of once-remote spaces into resource frontiers shaped by overlapping and cumulative forms of export-oriented resource extraction, and the upsurge of opium cultivation and drug use. Through the analytic of extractivism, we examine how the modalities surrounding logging and plantations in the Myanmar-China borderlands offer critical insights into how drugs have become entrenched in the region's political economy and the everyday lives of people 'living with' the destruction, violence and insecurity wrought by extractive development. [ABSTRACT FROM AUTHOR]

Stand-alone price analysis of illicit opium and coca does not explain why smallholders turn to illicit crops for coping and survival. Under conditions of precarity, illicit crop markets can stimulate productivity. They generate returns that can tame crises and relieve pressures. To smallholders facing marginalisation, violence, and climate change – growing opium and coca, despite their illegality, can reduce or spread risks and provide more predictability. Thus, rather than fix on the 'invisible hand' of price theory, the focus should be on the 'visible hand' of political entrepreneurship, interdependent relationships, and the metrics of precarity. To do this, this paper retrospectively compares illicit crop prices before and after certain historical moments in Bolivia, Myanmar, Colombia, and Afghanistan. [ABSTRACT FROM AUTHOR]

Drawing on long-term fieldwork in Badakhshan, a borderland province in the northeast of Afghanistan, the paper explores the role that opium poppy cultivation has played in a marginal high-altitude economy. Framed by the analytic of 'narco-frontiers' and the puzzle of the persistence of small farmers in uneven agrarian transitions, the paper investigates the diversity of market and non-market institutions that operate across the means of production of opium. Rather than seeing opium poppy production as the vanguard of an agrarian transition, it is suggested that it is more of a rearguard action to ensure survival. [ABSTRACT FROM AUTHOR]

Background: We investigated acute poisonings resulting from medications affecting the nervous system and illicit substances at Loghman Hakim Hospital in Tehran. Methods: We retrospectively reviewed patient records at Iran's largest tertiary toxicology referral center between January 2010 and December 2015. We analyzed the prevalence, trend, age and gender distribution of acute poisoning caused by nervous system agents. Results: The present study included 16,657 (57.27%) males and 12,426 (42.73%) females, resulting in 29,083 patients. The median age of men and women was 29 and 26 years, respectively (p < 0.0001). There were 12,071 (72.47%) men and 10,326 (83.10%) women under the age of 40 (p < 0.001). Most cases were intentional (69.38% in men and 79.00% in women, p < 0.001) and 44.10% had a history of poisoning. The proportions of men and women varied significantly between different age groups and nervous system agents. For women, the most common agent was alprazolam, whereas for men, methadone. The overall trend of acute poisoning with drug used in addictive disorders, opioids and alcohol was increasing but decreasing with benzodiazepines and antidepressants. Acute poisoning by nervous system agents led to more deaths in men (1.95% vs. 0.56%; p < 0.001). Conclusions: Methadone intoxication was common especially among young men and most of these intoxications were intentional. Women and men aged 20–29 most frequently suffer poisoning from alprazolam and clonazepam, respectively. Women over 60 and men over 30 used opium. Illicit drugs caused more than half of the deaths, and opium dominated. This study may create awareness and develop educational and preventive gender and age-specific local programs. [ABSTRACT FROM AUTHOR]

This article examines the representation of Asian indentured migrants as 'consumers' in colonial British Guiana and Trinidad. Focusing on the specific case of opium, it explores how attitudes towards the drug fed into broader debates about socio-economic responsibilities of these labouring communities. After first establishing the considerable revenues which colonial authorities derived from the taxation of opium, the article illustrates the growing calls for migrants to 'pay back' to the colonies which had shouldered the cost of their introduction. It also explores how stereotypical representations of Chinese and Indian consumption informed debates about the economic viability of continuing to import various forms of migrant labour. The article argues that migrant consumption mattered, and that understanding why it mattered necessitates a broader understanding of how indentured migration shaped the economic and social histories of various British colonies following emancipation. [ABSTRACT FROM AUTHOR]

This study investigated the association between lung cancer and waterpipe smoking, which is an emerging global public health concern. Multicentre case-control study. This study included 627 cases and 3477 controls from the Iranian Study of Opium and Cancer (IROPICAN) study, which was conducted between 2017 and 2020. One frequency-matched control for each lung cancer patient was selected by age, gender and residential place; however, this study used controls of four cancer types in the analyses. The multivariable logistic regression model estimated the odds ratio (OR) and 95% confidence intervals (CIs). Additional analyses were performed among 181 lung cancer cases and 2141 controls who were not cigarette smokers or opium or nass/pipe users. The odds of lung cancer were higher among waterpipe smokers than never-smokers (OR = 1.3, 95% CI: 1.0–1.7). Results showed a higher OR of lung cancer for those who smoked the waterpipe daily (OR = 2.1, 95% CI: 1.4–3.0), smoked more than two heads per day (OR = 2.7, 95% CI: 1.8–4.0), had smoked for >20 years (OR = 1.9, 95% CI: 1.3–2.7), smoked more than 20 head-years (OR = 2.8, 95% CI: 1.9–4.1) and initiated smoking before the age of 30 years (OR = 1.7, 95% CI: 1.1–2.5). The association was only statistically significant for squamous cell carcinomas (OR = 1.8, 95% CI 1.2–2.7). Furthermore, this study observed a higher OR of lung cancer among exclusive waterpipe smokers (OR = 2.3, 95% CI: 1.6, 3.5). Waterpipe smoking was associated with an increased risk of lung cancer. The association was stronger with higher frequency, duration and intensity of exposure to waterpipe smoking. The association increases in exclusive waterpipe smokers, which is likely due to controlling for residual confounding by cigarette smoking and opium consumption, and higher exposure levels in this subpopulation. [ABSTRACT FROM AUTHOR]

Double duct sign on imaging is defined as dilated common bile duct and pancreatic duct till ampulla and is usually associated with an ampullary obstruction likely periampullary malignancy. Sphincter of Oddi dysfunction is an uncommon cause of double duct sign. In the present case, we are discussing a rare cause of Sphincter of Oddi dysfunction with double duct sign. [ABSTRACT FROM AUTHOR]

The evolving landscape of opioid prescription practices necessitates a comprehensive understanding of emerging patterns, particularly among new opioid users discharged from emergency departments. This study delves into the intricate realm of opioid utilization by elucidating the prevalence of their prescriptions. A retrospective analysis of electronic health records was conducted, including a cohort of 71 patients who received opioid prescriptions upon discharge from emergency departments from 1 January 2022 to 30 June 2022. Demographic characteristics and prescription details were systematically examined. This study illuminates tramadol's prominence, with 84% of prescriptions and a Defined Daily Dose (DDD) morphine equivalent of 60 mg, as the primary choice as a new opioid, a finding that draws attention due to the closely aligned dosages with morphine equivalents. This discovery prompts a critical reassessment of tramadol's therapeutic role, considering its multifaceted nature encompassing serotonergic effects and heightened fall risks. This study advocates for a nuanced and vigilant approach to tramadol prescription, cognizant of its potential risks and therapeutic implications, and highlights the imperative of optimizing data quality and traceability within electronic health records to enhance patient care and facilitate future research endeavors. [ABSTRACT FROM AUTHOR]

We investigate the effect of international opium price shocks on the per capita dispensation of prescription opioids in the USA. Using quarterly county‐level data for 2002q4–2016q4, three main results emerge. First, reductions in opium prices significantly increase the quantity of opioids prescribed, and more so in counties with a larger pre‐existing market for pain relief, as captured by the incidence of mining sites. Second, the increase involves only natural and semi‐synthetic, but not fully‐synthetic, opioids, suggesting that the effect is moderated by the amount of raw material contained in the products. The impact is larger prior to 2010, when overdose deaths were more related to the use of legally prescribed opioids. Third, advertising expenses, stock prices and the profits of opioid producers increase following negative opium price shocks, suggesting an important role of supply‐side economic incentives. [ABSTRACT FROM AUTHOR]

Background: Illicit drug use has become a global epidemic, yet it is unclear if drug smoking increases the risk of tobacco-related cancers.Objectives: We aimed to evaluate hypothesized associations between smoking three drugs - opium, phencyclidine (PCP) and crack cocaine and lung and upper aerodigestive tract (UADT) cancers.Methods: A population-based case-control study with 611 lung cancer cases (50% male), 601 UADT cancers cases (76% male), and 1,040 controls (60% male) was conducted in Los Angeles County (1999-2004). Epidemiologic data including drug smoking histories were collected in face-to-face interviews. Associations were estimated with logistic regressions.Results: Adjusting for potential confounders, ever vs. never crack smoking was positively associated with UADT cancers (aOR = 1.56, 95% CI: 1.05, 2.33), and a dose-response relationship was observed for lifetime smoking frequency (p for trend = .024). Heavy (> median) vs. never crack smoking was associated with UADT cancers (aOR = 1.81, 95% CI: 1.07, 3.08) and lung cancer (aOR = 1.58, 95% CI: 0.88, 2.83). A positive association was also observed between heavy PCP smoking and UADT cancers (aOR = 2.29, 95% CI: 0.91, 5.79). Little or no associations were found between opium smoking and lung cancer or UADT cancers.Conclusion: The positive associations between illicit drug use and lung and/or UADT cancers suggest that smoking these drugs may increase the risk of tobacco-related cancers. Despite the low frequency of drug smoking and possible residual confounding, our findings may provide additional insights on the development of lung and UADT cancers.

Background & aim: Drug abuse has become one of the important problems in society. Craving is the core of drug abuse. The aim of the present study was to investigate the combined effect of education based on acceptance and commitment and green tea tablets on cravings in opium addicts. Methods: The present study conducted in 2020 applied a semi-experimental pre-test-post-test design with a control group. The statistical population of the present study was opium addicts in addiction treatment clinics of Tabriz, Iran. The research sample consisted of 40 participants selected by available sampling methode and simple randomly assigned to 4 groups. The group receiving green tea tablets, combined therapy group based on acceptance and commitment training with the Hayes protocol for 8 sessions of one and a half hours and grean tea tablets, Education group based on acceptance and commitment, the control group did not receive any intervention. The participants were evaluated through Salehi Fedredi, Barefan and Ziaei temptation questionnaire before the intervention, and the final session. Data were analyzed using multivariate and unilabiate analysis of covariance with Benferoni test. Results: The results indicated that green tea tablets and education based on acceptance and commitment had an effect on craving in opium addicts (p

Drug production and trafficking, and the related development of criminal groups, are among the most serious problems of the modern world. Issues related to the drug business appear when the institutions and the economic and social systems of the state disintegrate. An example of this is Afghanistan, which has recently become the world’s largest producer of opiates. The growing production of opiates has had negative consequences for Afghan society, causing various social problems, and for the international community, strengthening organized criminal groups involved in drug trafficking around the world. The aim of this study is to look for the most important factors causing the rapid increase in opiate cultivation in Afghanistan, and to assess how the Taliban’s return to power will affect the drug business. The study was carried out through an analysis of available scientific literature, including statistical studies, as well as various compilation documents.

Tobacco use is a major health concern worldwide, especially in low/middle-income countries. We aimed to assess the prevalence of cigarette smoking, waterpipe, and pipe use in Tehran, Iran. We used data from 8272 participants of the Tehran Cohort Study recruitment phase. Tobacco use was defined as a positive answer to using cigarettes, waterpipes, or pipes. Participants who did not report tobacco use during the interview but had a previous smoking history were categorized as former users. Age- and sex-weighted prevalence rates were calculated based on the national census data, and characteristics of current and former tobacco users were analyzed. Age- and sex-weighted prevalence of current tobacco users, cigarette smokers, waterpipe, and pipe users in Tehran was 19.8%, 14.9%, 6.1%, and 0.5%, respectively. Current tobacco use was higher in younger individuals (35-45 years: 23.4% vs. ≥ 75 years: 10.4%, P  12 years: 19.3% vs. illiterate: 9.7%, P

Opioids have the best price of illicit drug intake after hashish worldwide. Opium, after tobacco, continues to be the maximum generally abused substance with inside the Middle East. In addition to the convenience of availability, one cause for the excessive intake of opium in Asian international locations is probably a conventional notion amongst Eastern human beings or even scientific team of workers that opium may also have ameliorating consequences on cardiovascular diseases (CVDs) in addition to diabetes mellitus, hypertension, and dyslipidemia. Over the final decade, many studies were achieved on human beings and animals to assess the interaction among opium intake and solid coronary artery disease, acute coronary syndromes, and atherosclerosis. In this review, we finish that opium intake must be taken into consideration a chance thing for CVDs. Healthy individuals, as nicely as cardiac and diabetic patients, must be knowledgeable and knowledgeable approximately the dangerous consequences of opium intake on cardiovascular and different persistent diseases. [ABSTRACT FROM AUTHOR]

Copyright of Desacatos is the property of Centro de Investigaciones y Estudios Superiores en Antropologia Social and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Drug use is one of the biggest problems in many countries of the world. Addiction has many negative consequences for the users. One of the most important effects of drugs on the brain and causing ischemic stroke is that due to the heterogeneous and different results of these studies, the current study aims to investigate the relationship between opium and marijuana addiction and ischemic stroke through a systematic review and meta-analysis. In this study, electronic database namely PubMed, Scopus, Web of Science, Embase, ScienceDirect, and Google Scholar search engine were systematically utilised, until February 2023. In order to evaluate the quality of the studies, the Newcastle–Ottawa Scale (NOS) was used Data analysis was conducted using Random Effects model. The heterogeneity of the studies was evaluated by the I2 index. In the review of 7 studies with a sample size of 3,312,141 individuals, the odds ratio obtained for the association between marijuana use and ischemic stroke was 1.36 (95% CI: 0.96–1.92). The odds ratio obtained for the association between opium use and ischemic stroke was 2.16 (95% CI: 1.15–4.06). According to the results obtained from current paper's meta-analysis, there is a relationship between marijuana and opium addiction and ischemic stroke. Therefore, informing the society about the effects of drugs on the brain and causing ischemic strokes, especially in adolescents and youth, and providing care and counselling measures can be effective in reducing drug use and its effects on causing ischemic strokes. [ABSTRACT FROM AUTHOR]

Aim: The current systematic review and meta-analysis aimed to assess the association between Gastrointestinal (GI) cancers and opium use. Background: GI malignancies are a global public health issue and are associated with many risk factors including genetic and lifestyle factors. Methods: PubMed, Web of Science, Embase and Scopus and the Google Scholar search engine in addition to Persian databases including Magiran and SID were searched using relevant keywords. The associations of opium use, long duration of opium use, high daily amount opium use and high cumulative opium use and GI cancer and various subtypes of GI cancers were estimated and pooled in format of odds ratios (OR) and their corresponding 95% confidence intervals (CI) with a random effects model. Results: 22 articles that were published between 1983 and 2022 entered the analyses. There were significant relationships between opium use based on crude effect sizes (OR: 2.53, 1.95-3.29) and adjusted effect sizes (OR: 2.64, 1.99-3.51), high daily opium use (or: 3.41, 1.92-6.06), long duration of opium use (OR: 3.03, 1.90-4.84) and high cumulative opium use (OR: 3.88, 2.35-6.41), all compared to never opium use, and GI cancer. The results were not sensitive to sensitivity analyses and no influential publication biases were found in these analyses. Conclusion: Our meta-analysis showed that opium use could be associated with increased risk of overall and some particular GI cancers including oropharyngeal, gastric, pancreatic and colorectal cancers. Opium use as a potentially modifiable factor, therefore, should be more emphasized. [ABSTRACT FROM AUTHOR]

Objective The escalating challenges of drug and alcohol abuse underscore the critical need to prioritize Addiction-Affected Family members (AAFs), who face diverse health consequences and complex challenges. This study focuses on Addiction-Affected Mothers (AAMs) and their coping strategies during their child's substance abuse, aiming to explore their experiences during both the addiction and recovery periods. Materials & Methods Using interpretative phenomenological analysis (IPA), nine AAMs, whose children had completed recovery, participated in semi-structured interviews. Purposive sampling ensured firsthand insights, with data analysis following IPA principles, including coding, categorization, and interpretation. Trustworthiness was maintained through member checking, peer debriefing, and ethical considerations. Results The data analysis and the codes extracted from the interviews revealed four main themes and 14 subthemes. The four main themes extracted from the data included 1. Social Isolation, 2. The Swamp Trails, 3. The Continuum of Injuries, and 4. The Pursuit of Freedom. The first three main themes contained 11 sub-themes reflecting the mothers' experiences caused by their child's addiction, and the fourth theme, containing 3 sub-themes, comprised of countermeasures and effective mechanisms employed to overcome addiction-caused problems. Conclusion The study provides evidence-based insights for enhanced services and policies targeting Addiction-Affected Mothers, who often initiate responses within families. Specialized interventions are crucial to address their unique needs and those of their families, minimizing the direct and indirect effects of addiction. Encouraging AAMs' participation in support sessions is vital for ongoing coping. Effective resources and strategies can facilitate long-term recovery for both individuals with substance abuse and their families, contributing to a deeper understanding of familial dynamics affected by addiction. [ABSTRACT FROM AUTHOR]

Opioids are commonly used for management of pain. The term opioids include compounds that are extracted from the poppy seed as well as semi synthetic and synthetic compounds. Their regular non-medical use, Prolonged use, misuse and the use without medical supervision can lead to opioid dependence and other health related problems. Opiate dependence is the disorder of regulation of opioid use arising from repeated or continuous use of opioids. In worldwide, about 275 million people or {5.5 percentage of global population aged 15 to 64 yrs.} Used drugs At least once in 2019. Among them about 62 million people used opioids. Opioid use can lead to death due to effects of opioids on the part of the brain which regulates breathing. The number of opioid overdoses has increased in recent years in several countries in part due to the increased use of opioids in the management of chronic pain. Males, People of older age and people with low social economic status are at higher risk of opioid overdose than women. In this article we highlighted about various types of opioids, how it causes effects and symptoms for acute poisoning and chronic poisoning and suggested some of the safety measures and treatment guidelines regarding the opioid overdose condition. [ABSTRACT FROM AUTHOR]

Copyright of Larq Journal for Philosophy, Linguistics & Social Sciences is the property of Republic of Iraq Ministry of Higher Education & Scientific Research (MOHESR) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction This paper aimed to evaluate the effect of opium on bladder cancer grade and stage. We analyzed the impact of opium on the stage and grade of bladder cancer. Methods In this retrospective study, we analyzed 446 patients with pathologically confirmed bladder cancer treated from February 2012 to January 2019. Demographic data including sex, age, body mass index, opium consumption, and smoking, were collected. Exclusion criteria were patients receiving chemotherapy, inaccessible pathologic reports, and previous abdominopelvic radiotherapy. Chi-squared test was used in case of categorical variables. The significance level was set at 0.05. The analyses were performed using the statistical software Stata ver. 13. Results Our results indicate show that higher muscle-invasive stages occurred in opium users group compared to the non-opium users (P-value<0.001 vs. P-value: 0.104). The BMIs≥25 indicated a greater high grades percentage in the opium users compared with non-users (P-values=0.137 and 0.316 for the ages <65 and ≥65 years and 0.602 and 0.013 for the BMIs <25 and ≥25). Accordingly, in people with BMIs≥25, odds of high grades were 2.8-fold, compared with non-users. Patients with BMIs of 25 or more had 2.8 times the chance of getting high grades compared to those who did not. Regarding muscle stages, while all subgroups showed significance, the largest effect size of 4.2 was obtained for the <65 age group. Conclusions Our data revealed the higher muscle-invasive stages in the opium users comparing compared to non-opium users. Also, in patients with BMIs≥25, odds of high grades were 2.8 folds, compared with non-opium users. [ABSTRACT FROM AUTHOR]

Opium abuse and exposure to heavy metals elevate the risk of coronary artery disease (CAD). Therefore, we aimed to determine the association between opium abuse and blood lead levels (BLLs) and the CAD complexity. We evaluated patients with acute coronary symptoms who underwent coronary angiography, and those with >50% stenosis in at least one of the coronary arteries were included. Furthermore, Synergy between PCI with Taxus and Cardiac Surgery I (SYNTAX I) score and BLLs were measured. Based on the opium abuse, 95 patients were subdivided into opium (45) and control (50) groups. Differences in demographics and CAD risk factors were insignificant between the two groups. The median BLLs were remarkably higher in the opium group than in controls (36 (35.7) and 20.5 μg/dL (11.45), respectively, p = 0.003). We also revealed no significant differences in SYNTAX score between the two groups (15.0 (9.0) and 17.5 (14.0), respectively, p = 0.28). Additionally, we found no significant correlation between BLLs and the SYNTAX scores (p = 0.277 and r = -0.113). Opium abuse was associated with high BLLs. Neither opium abuse nor high BLLs were correlated with the complexity of CAD. Further studies are warranted to establish better the relationship between opium abuse, BLLs, and CAD. [ABSTRACT FROM AUTHOR]

This article rethinks the relationship between opium and empire in twentieth-century Asia. A rich scholarship focuses on the success of anti-opium activists, whose moral crusades gave birth to today's global drug control regimes. By contrast, I center attention on the lesser-known pro-opium forces, demonstrating how "bad" actors, recognized now as apologists for a dangerous drug, were once essential stakeholders in imperial rule. This article traces the interconnected lives of actors that favored continuing the drug's legal commerce across Southeast Asia: the merchants, bankers, agents of shipping firms, insurance agencies and warehousing companies as well as employees of colonial industries and governments that sustained opium supply chains from India to British Malaya and French Indochina into the 1930s. Hardly a coherent coalition of profit-seeking actors, these pro-opium forces represented situational allies with linked fates despite diverse opinions, fragmented interests, and ambivalent positions toward their own opium-entangled practices. Understanding their dispersed nature gives scholars reason to revisit the imperial origins of global drug control, while underscoring Southeast Asia's importance for understanding global histories of drugs and international relations. [ABSTRACT FROM AUTHOR]

There are few theories and little empirical evidence about the bilateral impact of substance use and coronavirus disease 2019 (COVID-19), so a logical and accurate picture of this area is required. We investigated the effects of opium use on severity of disease on hospitalized COVID-19 patients in east of Iran. Demographic and clinical characteristics, vital signs, laboratory tests, mortality rate, type and duration of opium consumption in hospitalized patients who recovered from COVID-19 in the follow-up after 3 months were evaluated. In this study, 60 (20%) participants were the opium user and 251 (80%) were the non-user patients. Based on clinical symptoms, hypertension and systolic blood pressure in opium user were significantly higher than non-user patients (p < 0.05). In the laboratory tests, only the level of urea was higher in the opium positive group (37 [26.5–48.5] vs. 32 [23–43], respectively) and the percent of lymphocytes were lower in the opium positive (17 [8.2–25.8] vs. 18.7 [13.85–26.35], respectively). The initial therapies of both opium positive and negative infected patients showed not any significant changes (p > 0.05). Among the studied groups, one deceased case with COVID-19 was related to a drug user patient. Although, uses of opium reduced the levels of some risk factors, vital signs at admission and initial therapies during hospitalization in COVID-19 patients but it increased lung and heart diseases. Also, the severity of COVID-19 including hospitalization and mortality were associated with opium consumption. [ABSTRACT FROM AUTHOR]

Abstract The association between personal habits and metabolic syndrome (MetS) remains controversial. This study aimed to assess the prevalence of MetS among youths and its association with cigarette, tobacco, opium, and alcohol consumption in the Rafsanjan Youth Cohort Study (RYCS). The current cross-sectional study was based on data from RYCS, as part of the Rafsanjan Cohort Study (RCS). RCS is a branch of the prospective epidemiological research studies in Iran (PERSIAN). In the present study, 2843 youths aged 15–35 were included. MetS was diagnosed using the international diabetes federation (International IDF), National Cholesterol Education Panel- Adult Treatment Panel III (NCEP-ATPIII), and Iranian criteria (IDF Iranian). Binary logistic regression models were performed to estimate odds ratios (ORs) and confidence intervals (CIs). The prevalence of MetS was 7.67%, 7.14%, and 10.13% based on NCEP-ATPIII, IDF Iranian, and International IDF criteria respectively. The odds of MetS according to international IDF and Iranian IDF in the alcohol-drinking group in the last 12 months (OR: 1.51, 95%CI 1.02–2.21, OR: 1.66, 95%CI 1.11–2.48 respectively) were greater compared with the non-drinking group. The odds of having high TG in the alcohol-drinking group in the last 12 months was 1.53 times higher than the control group (OR = 1.53, 95% CI: 1.20–1.94). Furthermore, the odds of having high waist circumference (WC) according to IDF International was significantly higher in the tobacco-smoking group in the last 12 months and in the tobacco-smoking group in the last 12 months daily (OR: 1.23, 95%CI 1.01–1.49 and OR: 1.41, 95%CI 1.01–1.98 respectively) compared to the control groups. The prevalence of MetS was 7.67%, 7.14%, and 10.13% based on NCEP-ATPIII, IDF Iranian, and International IDF criteria respectively. The odds of MetS and high TG were greater in the alcohol-drinking group in the last 12 months compared with the non-drinking group. The odds of high WC in the last 12 months, were greater in the tobacco-smoking group compared with the non-smoking group. However, more longitudinal studies are needed to verify the associations observed in the current study.

Abstract Background The prevalence and burden of substance and opium use have increased worldwide over the past decades. In light of rapid population changes in Tehran, we aimed to evaluate the prevalence of opium and other substance use among adult residents in Tehran, Iran. Method From March 2016 to March 2019, we utilized data from 8 296 participants in the Tehran Cohort Study recruitment phase (TeCS). We calculated the age-sex-weighted prevalence of substance use and the geographic distribution of substance use in Tehran. We also used logistic regression analysis to determine possible determinants of opium use. Result We analyzed data from 8 259 eligible participants with complete substance use data and the average age of participants was 53.7 ± 12.75 years. The prevalence of substance use was 5.6% (95% confidence interval [CI]: 4.6- 7.1%). Substance use was more common in males than females (Prevalence: 10.5% [95% CI: 8.6- 12.6%] vs. 0.5% [95% CI: 0.2- 1.2%], respectively). The age-sex weighted prevalence of substance use was 5.4% (95% CI: 4.6-7.1%). Moreover, opium was the most frequently used substance by 95.8% of substance users. Additionally, we found that male gender (Odds ratio [OR]: 12.1, P

Abstract Background/Aims Upper gastrointestinal bleeding (UGIB) is a frequent medical issue. The primary risk factors for bleeding peptic ulcers are Helicobacter pylori infection and non-steroidal anti-inflammatory drugs. The association between acute gastric/duodenal ulcer and opium use has been previously proposed; however, there is no available data on endoscopic findings of patients with acute UGIB who use opium. Materials and methods In the present descriptive cross-sectional study, endoscopic data of 50 consecutive patients with oral opium use and 50 consecutive patients without any opium use who were admitted for UGIB were recorded. The size (5–10 mm, 11–20 mm, or more than 20 mm), number (single, double, or multiple), and location of the ulcers (esophagus, gastric corpus including the fundus and body, antrum, angulus, or duodenum) were examined by endoscopy in both groups. Results Three or more ulcers were observed in 46% and 16% of patients with oral opium use and without opium use, respectively (P-value = 0.001). The rate of giant ulcers (> 20 mm) was significantly higher in patients who used oral opium (40% vs. 12%; P-value = 0.007). Esophageal ulcers were also more common in oral opium users (30%) than non-users (8%) with UGIB (P-value = 0.01). Nevertheless, the location of the ulcers between the two groups generally was not statistically different. Conclusions This study has demonstrated that multiple, large peptic ulcers in GIB are potential complications of oral opium use. This could aid the needed modifications in the treatment protocol for these patients.

The author comments on a study by C. Copeland and colleagues on evidence of xylaxine in the United Kingdom illicit drug market beyond heroine supplies. Topics discussed include lessons from other heroin supply disruptions including a prior Taliban opium ban in 2000 to 2001, examples that may represent evidence of a broader shift toward synthetic drugs replacing agricultural products in Europe, and observation on the widespread barriers to accessing social and health services in North America.

Abstract Background Number of opiate users worldwide has doubled over the past decade, but not all of them are diagnosed with opioid use disorder. We aimed to identify the prevalence and risk factors for OUD after ten years of follow-up. Methods Among 8,500 chronic opiate users at Golestan Cohort Study baseline (2004–2008), we recalled a random sample of 451 subjects in 2017. We used three questionnaires: a questionnaire about current opiate use including type and route of use, the drug use disorder section of the Composite International Diagnostic Interview lifetime version, and the validated Kessler10 questionnaire. We defined opioid use disorder and its severity based on the DSM-5 criteria and used a cutoff of 12 on Kessler10 questionnaire to define psychological distress. Results Mean age was 61.2 ± 6.6 years (84.7% males) and 58% were diagnosed with opioid use disorder. Starting opiate use at an early age and living in underprivileged conditions were risk factors of opioid use disorder. Individuals with opioid use disorder were twice likely to have psychological distress (OR = 2.25; 95%CI: 1.44–3.52) than the users without it. In multivariate regression, former and current opiate dose and oral use of opiates were independently associated with opioid use disorder. Each ten gram per week increase in opiate dose during the study period almost tripled the odds of opioid use disorder (OR = 3.18; 95%CI: 1.79–5.63). Conclusions Chronic opiate use led to clinical opioid use disorder in more than half of the users, and this disorder was associated with psychological distress, increasing its physical and mental burden in high-risk groups.