Research published in the British Medical Journal has found that long term opium users are more than twice as likely to die from cancer, respiratory conditions, tuberculosis, and circulatory disease.
The study — referred to as The Golestan Cohort Study (GCS) — raises questions about the long-term use of prescription opioids, which are derived from opium, in the treatment of chronic pain.
“In high income countries doctors rarely, if ever, encounter someone who uses opium. However millions of patients with chronic pain are prescribed opioids such as morphine and codeine that may carry risks that are incompletely understood,” said Assistant Professor Irfan Dhalla from St. Michael’s Hospital in Toronto. “For the management of chronic non-cancer pain, a better prescription may be caution,” Dhalla wrote in an accompanying editorial.
This GCS study was conducted in Golestan Province in northern Iran, where recreational opium use is relatively common. Over 50,000 adults who use opium were followed for an average of five years. Researchers excluded participants who began taking opium for a pre-existing chronic illness.
Although researchers adjusted for health risks like cigarette smoking and poverty, they found that opium users were 86 percent more likely to die from asthma, cancer, chronic pulmonary disease and other major health problems. Individuals who consumed opium over an extended period of time, even in low does, were twice as likely to die due to major causes.
Increased risk of death was associated with both opium ingestion and opium smoking. The findings were also similar for smokers and non-smokers, women and men, and people who live in rural and urban communities.
“Long term recreational opioid use, even at relatively modest levels, causes important increases in death from multiple different causes,” said study co-author Paul Brennan, head of the Section of Genetics at the International Agency for Research on Cancer in Lyon,France.
While the study centered on opium for recreational use, the findings also have implications for opium-derived painkillers used for medicinal purposes. The study is the first of its kind to measure the risk of death in opium users compared to non-users. Worldwide, approximately 20 million people use opium or one of the drug’s derivatives.