Abstract
The long-term use of opioids leads alternations in both innate-adaptive immune systems and other diagnostic hematologic cells. The purpose of this study is to evaluate the alterations of these parameters in patients with heroin/opioid addictions. Adults, meeting the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria of the American Psychiatric Association regarding opioid use disorder (Heroin Group or HG, n = 51) and healthy controls (Control Group or CG, n = 50), were included in the study. All hematological parameters, inflammation indexes (neutrophil-lymphocyte ratio and platelet-lymphocyte ratio), and iron panel were compared with the controls. Mean corpuscular volume, red blood cell distribution width, mean corpuscular hemoglobin content, unsaturated iron-binding capacity, and total iron-binding capacity were significantly higher in HG compared to CG, while red blood cell count, hemoglobin, hematocrit, and serum iron levels were significantly lower. Additionally, platelet and platelet distribution width were significantly high while mean platelet volume was low in HG. Regarding the parameters related to immunity, white blood cell, neutrophil count, and neutrophil percentage were significantly high while lymphocyte percentage and basophils count were significantly low. Besides, inflammatory indexes were significantly higher in HG compared to CG. Intravenous administration of heroin resulted in lower levels of hemoglobin, hematocrit, and mean corpuscular volume than inhalation and intranasal administration. Our data demonstrated that chronic use of opioids is related to all of the hematologic series. The chronic use of opioid alters the immunologic balance in favor of innate immunity cells and changes the hematometric/morphometric characteristics of erythrocytes. What is more, the route of heroin administration should be taken into consideration as well. This study may lead to a better understanding of the hematological effects of heroin/opioid use in patients with relevant addictions.
Highlights
Heroin is a powerful opioid analgesic and it is metabolized from the active form of morphine and a less active form of mono-acetyl morphine in 15-20 minutes
Heroin group consisted of 49 men and 2 women, and the control group consisted of 48 men and 2 women
It can be seen that mean corpuscular volume (MCV) (p
Summary
Heroin is a powerful opioid analgesic and it is metabolized from the active form of morphine and a less active form of mono-acetyl morphine in 15-20 minutes. In addition to the known effect of the heroin on neuronal cell groups, in the studies conducted, it has been shown that, by activating tyrosine kinases in nonneuronal cell groups [2], it triggers inflammatory processes in the brain and facilitates the release of histamine that can directly affect the dopamine system [3,4,5]. It has been shown that heroin changes the amounts of major and trace element [7]. Among these elements, iron is known to have significance on tissue oxygenation as well as an effect on cognitive functions. The systemic side effects of heroin are of interest to many studies on neuroimmunology and hematology
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