Is the Urinary Morphine Concentration a Useful Marker for the Assessment of the Severity of Coronary Artery Stenosis in Opium Addicts?

Background: Some studies have shown that opium is a potential risk factor for coronary artery disease (CAD). The method of opium use in most of these studies has been evaluated verbally. In the present study, we assessed the urinary morphine concentration to confirm opium addiction. This study aimed to evaluate the association between the urinary morphine concentration and the severity of coronary artery stenosis in opium addicts. Methods: This study was conducted on 200 opium addicts admitted to the angiographic ward of a referral hospital at Kerman University of Medical Sciences. From these patients, 134 cases with CAD according to angiographic results were selected for our study. The patients were divided into 2 groups of mild CAD with < 50% stenosis and severe CAD with > 50% stenosis. Opium addiction and its severity were diagnosed based on the DSM IV criteria and confirmed by the measurement of the urinary morphine concentration. Results: Severe coronary artery stenosis was detected in 77.6% of the opium addicts. A urinary morphine concentration exceeding the median index was associated with higher odds of severe CAD, but this association was not statistically significant (OR = 2.2, 95% CI: 0.62 to 7.9; P = 0.21). Conclusions: The opium addicts in the current study were at a higher risk for severe CAD, but there was no significant relationship between the urinary morphine concentration and the severity of CAD. This paraclinical test was not an accurate marker for the assessment of the severity of CAD. The role of other alkaloids in opium should be evaluated.