What was opium used for

Opioid receptors were identified and characterized in binding assays and their localization examined. However, the complexity of the system including interaction with several neurons and transmitters indicate the goal of nonaddictive opiates to be elusive. Combination therapy, innovative delivery systems and long-acting formulations may improve clinical utility.

Abstract Opium has been known for millennia to relieve pain and its use for surgical analgesia has been recorded for several centuries. Publication types English Abstract Historical Article. Anesth Analg. Opium use and mortality in Golestan cohort study: prospective cohort study of 50 adults in Iran. Is opium addiction a risk factor for acute myocardial infarction? Acta medica Iranica. Comparing short-term mortality in opium users and non-users candidate for coronary artery bypass graft surgery.

Opium addiction increases interleukin 1 receptor antagonist IL-1Ra in the coronary artery disease patients. PLoS One. Comparing plasma level of CRP, factor VII, fibrinogen; platelet counts, systolic and diastolic blood pressure in smokers with opium addicted smokers.

J Qazvin Univ of Med Sci. Effect of opium addiction on new and traditional cardiovascular risk factors: do duration of addiction and route of administration matter? Lipids Health Dis. Najafipour H, Beik A. The impact of opium consumption on blood glucose, serum lipids and blood pressure, and related mechanisms.

Front Physiol. Effects of opium addiction on some serum factors in addicts with non-insulin-dependent diabetes mellitus. Addict Biol. Opium and heroin alter biochemical parameters of human's serum. Am J Drug Alcohol Abuse. Passive opium smoking does not have beneficial effect on plasma lipids and cardiovascular indices in hypercholesterolemic rabbits with ischemic and non-ischemic hearts.

J Ethnopharmacol. Elevated plasma Homocysteine concentration in opium-addicted individuals. Analysis of coagulation tests, proteins C and S, and plasma fibrinogen in addicts and non-addicts with coronary artery disease.

J Kermanshah Univ Med Sci. Comparison of plasma fibrinogen level in opium addict men with non-addict men; Serum level of plasminogen activator inhibitor type-1 in addicted patients with coronary artery disease. The effect of opium addiction on serum adiponectin and leptin levels in male subjects: a case control study from Kerman coronary artery disease risk factors study KERCADRS. Excli J. Lead poisoning among opium users in Iran: an emerging health hazard.

Subst Abuse Treat Prev Policy. Clinical aspects of opium adulterated with lead in Iran: a review. Basic Clin Pharmacol Toxicol. Nakhaee S, Mehrpour O. Opium addiction as new source of lead poisoning: an emerging epidemic in Iran. Lead exposure and cardiovascular disease—a systematic review. Environ Health Perspect.

Effects of opium consumption on coronary artery disease risk factors and oral health: results of Kerman coronary artery disease risk factors study a population-based survey on subjects aged years. Serum markers of inflammation and oxidative stress in chronic opium Taryak smokers. Immunol Lett. In vitro antioxidant properties of morphine.

Pharmacol Res. Gettler JF. Hypocholesterolemia in substance abusers. South Med J. Opioids confer myocardial tolerance to ischemia: interaction of delta opioid agonists and antagonists. J Thorac Cardiovasc Surg. J Mol Cell Cardiol. Opioids and cardioprotection. Pharmacol Ther. Drug-induced prolonged corrected QT interval in patients with methadone and opium overdose. The incidence of different kinds of cardiac arrhythmia after myocardial infarction in smokers and opium abusers hospitalized in imam Ali Hospital, Zahedan, J Pharm Sci Res.

The effect of opium addiction on arrhythmia following acute myocardial infarction. Acta Medica Iranica. The cardiovascular responses to mu opioid agonist and antagonist in conscious normal and obese rats. Feuerstein G, Siren A A role in hypertension?

Evidence for differential opioid mu 1- and mu 2-receptor-mediated regulation of heart rate in the conscious rat. Br J Pharmacol ; 4 — Modulation of the cardiac autonomic transmission of pithed rats by presynaptic opioid OP4 and cannabinoid CB1 receptors. Naunyn Schmiedeberg's Arch Pharmacol Sep; 3 — Opioids and cardiac arrhythmia: a literature review. Med Princ Pract. Response to thrombolytic agents in acute myocardial infarction in opium abusers versus non-abusers.

J Res Pharm Pract. Effect of opium addiction on aspirin resistance in stable angina pectoris. Download references. You can also search for this author in PubMed Google Scholar. SN, NZ, OM made substantial contributions in drafting the manuscript and revising it critically for important intellectual content. All authors have read and approved the final version of the manuscript.

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Subst Abuse Treat Prev Policy 15, 30 Download citation. Received : 15 January Accepted : 08 April Published : 17 April Anyone you share the following link with will be able to read this content:. Sorry, a shareable link is not currently available for this article. Provided by the Springer Nature SharedIt content-sharing initiative. Skip to main content. Search all BMC articles Search. Download PDF. Abstract Background In Iran, as in many other Asian and Middle Eastern countries, some believe that opium has beneficial effects on cardiovascular system.

Objectives In this study, we sought to clarify the effect of opium on cardiovascular problems by incorporating the previous findings and the current information on the issue and to explain the possible mechanisms of this effect. Methods The available human studies published up to October 30, , were searched in different databases.

Results In this study, most of the published articles suggested the adverse effects of opium on the cardiovascular system, including atherosclerosis, myocardial infarction, arrhythmia, low ejection fraction, and cardiovascular mortality; however, some articles reported the beneficial or impartial effects of opium on the cardiovascular system. Conclusion Although the available evidences were incoherent, it was mostly suggested that opium use does not protect against or improve cardiovascular problems.

Background Opium is a crude material retrieved from Papaver somniferum, which is quite effective in the treatment of acute and chronic pain but can also result in opium use disorder [ 1 ].

Inclusion criteria and study selection Case-control, cohort, and cross-sectional studies were retrieved.

Table 1 Opium and Cardiovascular problems Full size table. Flowchart of the literature search and strategy for the selection of the relevant documents.

Full size image. Results Opium and atherosclerosis Some previous studies mention that opium is a risk factor for atherosclerosis, while others advocate its positive effects. Opium as a potential risk factor for atherosclerosis A study of patients showed that using opium was a risk factor for CADs OR Potential mechanisms Inflammation Atherosclerosis depends on the immune response [ 59 ]. Hyperlipidemia Opium consumption may have undesirable effects on lipid metabolism [ 61 , 62 ].

Oxidative stress Oxidative stress plays a critical role in the pathogenesis of atherosclerosis. Increased Homocysteine Increased homocysteine is one of the factors that can result in the advancement of atherosclerosis and the development of CADs. Increased plasma fibrinogen Increased plasma fibrinogen is also considered as an independent risk factor for CADs and can increase the risk of thrombosis.

Increased plasminogen activator Inhibitor-1 PAI-1 PAI-1 inhibits the formation of plasmin through inhibitory effects on plasminogen activator and consequently prevents the clotting cascade in the arteries. Decreased plasma Adiponectin Adiponectin has anti-diabetic and anti-atherogenic effects, and when decreased, it promotes the risk of developing metabolic disorders such as insulin resistance and cardiovascular diseases CVDs in patients with opium use disorder.

Deficiency of testosterone and estrogen In men, low testosterone level can cause CADs and increase the risk of cardiovascular-related mortality. Hyperprolactinemia Opium increases the level of prolactin in the blood. Insulin resistance Similar to type 2 diabetic patients, people with opium use disorder show insulin resistance and an increase in the insulin level of the blood.

Presence of Lead in opium The presence of impurities such as lead in opium can be a factor causing adverse effects on the cardiovascular system. Lifestyle Opium is a CNS suppressant and can decrease physical activity in addicted individuals, which increases the risk of CVDs [ 40 ].

Opium as a potential protective factor One study investigating the effects of long-term use of opioids on the extent of CADs showed that the coronary arteries clogged less severely in opioid dependents [ 19 ]. Potential mechanism Some studies reflect that opioids can reduce inflammation and CADs [ 19 , 40 ]. Opium as an impartial factor Some studies deem the effects of opium on the development of atherosclerosis to be insignificant.

Opium and MI Myocardial infarction occurs due to a block in the blood flow to a part of the myocardium. Opium preparation should not be given to treat diarrhea that is caused by poisoning until the toxin is no longer in the digestive tract. Opium is derived from the seed pod of a poppy plant. It works by increasing smooth muscle tone and decreasing fluid secretions in the intestines. This slows the movement of bowel matter through the intestines.

It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

Opium can pass into breast milk and may affect the nursing baby. Tell your doctor if you are breast-feeding. This medication is usually taken 1 to 4 times daily to treat diarrhea.

Follow all directions on your prescription label. Opium preparation can slow or stop your breathing. Never use opium preparation in larger amounts, or for longer than prescribed.

Opium preparation may be habit-forming when used over a long period of time. Never share opium preparation with another person, especially someone with a history of drug abuse or addiction. Keep the medication in a place where others cannot get to it. Selling or giving away opium preparation is against the law. Each opium preparation contains a different amount of opium. If you switch from using one opium preparation to using another, your dose will not be the same.

Some opium preparations are much stronger than others, and taking too much opium may cause serious harm. Do not stop using opium preparation suddenly after long-term use , or you could have unpleasant withdrawal symptoms.

When the levels of morphine in poppy seeds from each of the different sources was compared Table 7 , it was found that there was much variation within batch but also between sources of poppy seeds. There is much variation in the extracted opiate compounds, which is primarily due to the environmental differences of the seeds Katrine et al.

The country of origin for both of these poppy seed sources is unknown. When the same comparison was carried out for codeine Table 7 it was also found that there was much variation within different portions of the same batch and between sources of poppy seeds as was the case with morphine. Source 2, which was found to have a level of morphine much higher than the other sources, was also found to have a higher level of codeine.

No other similarities can be drawn from the data. It was also found that the same source with the highest levels of morphine and codeine also exhibited the highest levels of thebaine. Noscapine was identified in only two of the eight sources of poppy seeds Table 7. It was found that the seeds from source 7 contained the highest levels of noscapine of the two sources where noscapine was identified.

Papaverine was detected in some of the analyzed seeds but peaks were so small that it was not possible to quantify them. It has been identified that sub-varieties of Papaver somniferum L. However, this taxonomic information was not available from the suppliers of the seeds.

It has been known since Annett, that factors, such as the season in which the plants are grown, weather conditions, and quality and type of fertilizer used can greatly affect the levels of alkaloids biosynthesised by Papaver somniferum L. In turn, the levels of alkaloids found in opium latex will also be affected.

No data currently exist that compares levels of alkaloids in opium latex and alkaloids from the same plant but it is assumed that the levels would correlate.

On this basis, the country of origin, where the plant was grown in the field e. This means that if a batch of poppy seeds is harvested from one field, naturally there will be variation in the levels of alkaloids from each of the plants. It has also been shown that the alkaloids present in the opium latex may contaminate the poppy seeds as part of the growing process and that a batch of poppy seeds is the combination of multiple fields in one country: all of these factors may explain why there is such variation within batch and between sources of poppy seeds.

However, the muffin matrix greatly interfered with the extraction process. During the extraction process, a fatty emulsion was formed which affected further sample preparation techniques Figure 3. These aliquots were filtered twice prior to being transferred into HPLC vials however when the chromatograms were analyzed for these muffin extractions, no alkaloids were identified.

For this reason, it was not possible to include the poppy seed muffins extract results in the comparison between harvested poppy seeds, thermally processed seeds on their own and poppy seeds on the top of bread buns. In addition, seed portions from three randomly selected sources were extracted and analyzed with the results shown in Table 8. Again, as was established with extractions of harvested poppy seeds there was much variation in the alkaloids identified and in the levels of those alkaloids present, Deuterated morphine was added prior to extraction of the alkaloids from the seeds and percentage extractions were incorporated into the calculations.

Figure 3. Sample tubes containing poppy seed muffin and extraction solvent, post agitation, and centrifugation. Table 8. Comparison of levels of alkaloids identified in harvested poppy seeds, seeds from the surface of bread rolls and seeds heated with no matrix. What was identified from this data was that whether the seeds were heated on the surface of the bread roll or were heated with no bread matrix, the levels of alkaloids if detected were considerably lower than in the harvested seeds.

Koleva et al. When comparing the results from the current work to levels published in the literature Table 9 it can be seen that these findings are in-keeping with those published by Sproll et al. The work published by Grove et al. However, this could have been due to the sensitivity of the GC-MS instrument employed, the lack of information regarding the presence of other alkaloids present in poppy seeds at this time as the work reported by Grove et al.

The levels of alkaloids identified in the current work are generally lower than those found by Sproll et al. This research has shown that alkaloid variation exists depends on the specific alkaloids, their source and thermal processing.

It was clear from the data obtained in this current work, and from other studies published in the literature, that there is much variation in the levels of alkaloids identified in poppy seeds. This variation can be attributed to a variety of natural parameters, such as weather and soil conditions, but also in the way that the seeds are harvested Lachenmeier et al.

Processing methods prior to packaging and even the baking process has been shown to greatly affect the level of alkaloids Sproll et al. The findings of this study correlate with the studies published in the literature. When poppy seeds are consumed on a bun or roll, it has been estimated that each roll contains 1—4 g of poppy seeds Lachenmeier et al. Assuming that the average salad contains 3—6 g 1—2 teaspoons of poppy seeds and the average bread bun has between 1.

This value cannot be used when relating to young children, the elderly or individuals of poor health Sproll et al. With respect to the values of morphine obtained in this work for harvested seeds, seeds on top of a bread roll and seeds heated with no matrix Table 10 and taking into account the weights of poppy seeds used in a variety of food products mentioned above, the morphine ingested will not exceed the ARfD determined by the EFSA.

Table Comparison of alkaloids identified on harvested and thermally processed poppy seeds. This update related to the detection of morphine, codeine, oripavine, noscapine, and papaverine in poppy seed samples whereas, the previous report related only to the levels of morphine entering the food chain. Codeine values were given in relation to morphine equivalents, using a conversion factor of 0. Noscapine and papaverine were considered in the most recent publication however, the data that was available to the EFSA did not allow for a hazard characterization but they did conclude that the presence of these compounds would not present a health concern.

In relation to the presence of thebaine and oripavine not included in the work of this paper , it was concluded that there was insufficient data to make any assessment. Based on these updated EFSA findings, the presence of the morphine and codeine in the poppy seeds analyzed in this work, would still would still fall below the recommendations outlined.

There is also little or no information on packaging of poppy seeds regarding what, if any, treatment has taken place prior to packaging. Since the ingestion of poppy seeds has been used as reasons for failure of workplace drug testing and roadside drug testing, more should be done to ensure as much information as is possible is available on the preparation methods of the seeds.

The datasets generated for this study are available on request to the corresponding author. This work was approved by the Northumbria University Ethics committee. The university holds a UK Home Office Drug License for the storage and use of controlled drug standards and for the extraction of alkaloids from poppy seeds.

The laboratory work, analysis of data and writing was carried out predominantly by MC. JD and JA helped in the design and review of data and interpretation and all parties contributed to the writing and review of the article. All authors contributed to the article and approved the submitted version.

This work was funded with the support from the Department of Applied Sciences, Northumbria University.