Evaluation of the Frequency of Stimulant and Opioid Abuse in the Poisoned Cases Referred To Hospitals in Ardabil, Iran

Document Type : Original Article

Authors

1 Department of Internal Medicine, Faculty of Medicine, Ardabil University of Medical Science, Ardabil, Iran.

2 Faculty of Medicine, Ardabil University of Medical Science, Ardabil, Iran.

3 Department of Community Medicine, Faculty of Medicine, Ardabil University of Medical Science, Ardabil, Iran.

4 Department of Obstetrics and Gynecology, Faculty of Medicine, Ardabil University of Medical Science, Ardabil, Iran.

5 Arizona Poison & Drug Information Center, the University of Arizona, college of pharmacy, Tucson, Arizona, USA.

Abstract

Introduction:
Poisoning with acute opioids and stimulant is the most common causes of emergency visits, and its early detection and treatment is of utmost importance. The present study aimed to evaluate the frequency of opioid and stimulant use in poisoned cases.
Materials and Methods:
This cross-sectional descriptive study was conducted on 255 cases with acute opioids and stimulant poisoning.
Results:
Out of all patients, 7(2.7%) patients died due to severe complications. Moreover, 72.2% of patients were male, and the majority of cases (86.87%) were urban residents. The leading cause of poisoning was suicide (65.1%), and 34.9% of patients had accidental poisoning. The mean age of patients was 36.26 years. Tramadol, methadone, and opium with 29.4%, 23.9%, and 23.5% were the most used opioids for poisoning, respectively.
Conclusion:
As evidenced by the obtained results, tramadol poisoning is the most common poisoning in patients referring to hospital emergence. Nevertheless, tramadol use and availability need to be prevented and controlled; moreover, the awareness of health system providers should be raised about the care of these patients.

Keywords


  1. Mert E, Gamsiz N. Demographical and aetiological and clinical characteristics of poisonings in Mersin. Turkey. Hum Exp Toxicol. 2006; 25:217.
  2. Eddleston M. Patterns and problems of deliberate selfpoisoning in the developing world. QJM. 2000; 93:715–31.
  3. Farzaneh E, Amani F, Sadeghiyeh S, Rezaeei I, Mirzarahimi M, Mostafazadeh B, et al. Acute Poisining in Adults Admitted in Ardabil Imam Khomeini Hospital. J Ardabil Univ Med Sci. 2013; 12(5 Suppl.1): 95-102. (Full text in Persian).
  4. Fauci AS, Braunwald E, Kasper DL. Hauser S Editors. Harrison’s of Internal Medicine, 18th edition, New York, McGraw-Hill, 2012; pp: 785-790.
  5. Farzaneh E. Epidemiology Of Acute opiate overdose in Ardabil, Tehran, Razi International congress center,4th Annual Congress on Emergency Medicine, 2010.
  6. Farzaneh E, Mehrpour O, Alfred S, Hassanian moghaddam H. Self-poisoning suicide among student in Tehran. Psychiactria Danubina, 2010; 22(1):34-38.
  7. Hassanian Moghaddam M, Pajoumand A. A one-Year Epidemiological Study of Acute Poisoning among 176Adults and Adolescents Admitted to Loghman Hospital, Tehran between 2005 and 2006. Pajoohandehjurnal. 2007;12(3): 169-176.
  8. Mahmoudi G A, Nourmohammadi H, Azizpourfard Y, Farhadi A. A survey of causes of the opium tendency and addiction in patients whith the diagnosis of opium poisoning in Khorramabad educational hospitals. Yafte. 2015; 17(1): 55-62.
  9. Darke SH, Ross J, Hall W. Overdose among heroin users in Sydney, Australia: prevalence and correlates of non-fatal overdose. Addiction March 1996;91(3): 405-411.
  10. Ahmadi H,Hoseini J, Rezaei M. Epidemiology of poisoning due to Tramadol in Imam Khomeini hospital of Kermanshah. Behbood 2010;15:
    73-77.
  11. Moghadamnia AA, Abdollahi M. An epidemiological study of poisoning in northern Islamic Republic of Iran. East Mediterr Health J 2002; 8(1): 88-94.
  12. Ghazi-Khansari M, Oreizi S. A prospective study of fatal outcomes of poisoning in Tehran. Vet Hum Toxicol 2006; 37(5): 449-52.
  13. Singh O, Javeri Y, Juneja D, Gupta M, Singh G, Dang R. Profile and outcome of patients with acute toxicity admitted in intensive care unit: Experiences from a major corporate hospital in urban India. Indian J Anaesth 2011; 55(4): 370-4.
  14. Turhan E, Inandi T, Aslan M, Zeren C. Epidemiology of attempted suicide in Hatay, Turkey. Neurosciences (Riyadh) 2011; 16(4): 347-52.
  15. Efart A, Xinhua L, Edward N, Deborah S. Suicide attempt, in substance abusers: Effects of major depression in relation to substance use disorders American Journal of Psychiatry, 2012; 29; 231-240.
  16. Regier DA, Boyed JH, Burke JD, Rae DS, et al. One month prevalence of mental disorders in the United States based on five epidemiologic catchments area sites. Arch Gen psychiatry. 2001; 46(13): 77-89.
  17. Krbakhsh M, Salehianzandi N. Acute opiate overdose inTehran: The forgotten role of opium. Addictive Behaviors 2007;32: 1835- 1842.
  18. Rahimi A, E. Mohammad Razzaghi. A qualitative study on opioid overdose in injection drug users in Tehran. Tehran Univ Med J. 2006; 64(4): 43-53.
  19. Ozkose Z, Ayoglu F. Etiological and demographical characteristics of acute adult poisoning in Ankara. Turkey. Hum Exp Toxicol 2002; 18:614-18.
  20. Zare fazlohahi Z, Maleki M, Shaikhi N. Epidemiology of Adult poisoning In Talegani Hospital of Urmia 1383-1386. Nurs Midwifery J. 2010; 8 (2).
  21. Malekshahi M. Investigating the factors affecting the tendency to industrial narcotics among the clients of Ilam city addiction centers. MSc thesis in Shoushtar Azad University, 2013.
  22. Dunn, K. E., Barrett, F. S., Yepez-Laubach, C., Meyer, A. C., Hruska, B. J., Petrush, K,etal. Opioid overdose experience, risk behaviors, and knowledge in drug users from a rural versus an urban setting. Journal of Substance Abuse Treatment. December 2016; (71): 1-7.
  23. Sadock BJ, Sadock VA.Synopsis of psychiatry, 10th edition, Philadelphia, Williams & Wilkins, 2007; pp:198-203.
  24. Hamdieh M, Matlabi N, Asheri H. Study of prevalence of stimulant drugs, alcohol and amphetamine use in adolescents and young people aged 15-35 years old in Tehran. Journal of Faculty Medicine of Shahid Beheheshti niversity of Medical Sciences 2008; 32(4): 315-9.
  25. Farzaneh E, Amani F, Etemad FA. Clinico-Epidemiological Study on Patients with Opium Poisoning Treated at Ardabil Hospitals, Iran, 2014-2015. Asia Pac J Med Toxicol 2016;5:111-4.
  26. Man LH, Best D, Gossop M, Stillwell G, Strang J. Relationship between prescribing and risk of opiate overdose among drug users in and out of maintenance treatment. Eur Addict Res 2004; 10:35-40.
  27. Strang J, Powis B, Best D, Vingoe L, Griffiths P,et al. Preventing opiate overdose fatalities with take-home naloxone: prelaunch study of possible impact and acceptability Addiction 1999; 94: 199-204.
  28. Sergeev B, Karpets A, Sarang A,Tikonov M. Prevalence and circumstances of opiate overdose among injection drug users in the Russian Federation. Urban Health 2003;212-9.
  29. Cook S, Moeschler O, Michaud K, Yersin B. Acute opiate overdose: characteristics of 190 consective cases. Addiction 1998; 93:1559-65.
  30. Gulohglu C, Kara IH. Acute poisoning cases admitted to a university hospital emergency department in Diyarbakir, Turkey. HET 2005; 24(2): 49-54
  31. Srivastava A, Shah Peshin S, Kaleekal T, Kumar Gupta S. An epidemiological study of poisoning cases reported to the national poisons center, All India Institute of Medical Sciences, New Delhi.HET 2005; 24(6):279-285.