The Relationship between Opioid Addiction and Diameter of the Common Bile Duct

Document Type: Original Article

Authors

1 Addiction Research Centre, Department of Clinical Toxicology, Faculty of Medicine, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Department of Community Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

3 Medical toxicology Research Centre, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.

4 Cardiac Anesthesia Research Centre, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.

5 Department of Internal Medicine, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.

6 Assistant professor of Internal Medicine, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

7 Department of Community Medicine and Public Health, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

Introduction: According to statistics, opioid addiction is quite common in Iran. Pathologic dilatation of the Common Bile Duct (CBD) may be caused by mechanical obstruction or opioid consumption; the latter is especially common among chronic opium abusers. The aim of this study was to assess the relationship between CBD diameter and addiction-related factors in opium users.

Materials and Methods: This cross-sectional study was conducted in Imam Reza Hospital, Mashhad, Iran. A checklist, consisting of 18 items on demographic characteristics, type, administration route, and duration of opioid consumption, and type of biliary disease as indicated by Endoscopic Retrograde Cholangiopancreatography (ERCP), was prepared and completed via interview. The results of ERCP and abdominal ultrasonography of 40 addicted patients were gathered. Data were analyzed, using SPSS version 11.5. P-value less than 0.05 was considered statistically significant.

Results: In total, 31 (62%) out of 50 patients were male, and the mean age of the subjects was 66±12.0 years. According to the findings, 46 (92%) cases were addicted to opium and four (8%) cases to laudanum (a solution prepared from opium). Among the addicted cases, 30 (75%) used opium through inhalation, while 10 (25%) cases used it orally. There was a significant relationship between the type of opioid and CBD diameter (P=0.03). However, no significant relationship was found between CBD diameter and the route of administration or opioid dose (P=0.6 and 0.06, respectively).

Conclusion: Opium used by addicts has various degrees of impurity. It can be concluded that higher opium purity induces more CBD dilatation, although further investigations are highly recommended.

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