Opium use and mortality in Golestan Cohort Study: prospective cohort study of 50 000 adults in Iran

• DOI: 10.1136/bmj.e2502
• Publication Date: 2012-04-17T22:49:22Z
• Authors: H. Khademi; R. Malekzadeh; A. Pourshams; E. Jafari; R. Salahi; S. Semnani; B. Abaie; F. Islami; S. Nasseri-Moghaddam; A. Etemadi; G. Byrnes; C. C. Abnet; S. M. Dawsey; N. E. Day; P. D. Pharoah; P. Boffetta; P. Brennan; F. Kamangar
• Keywords: Adult; Male; کهورت; 610; Iran; Opium; 03 medical and health sciences; 0302 clinical medicine; Cause of Death; Surveys and Questionnaires; Humans; Prospective Studies; Drug Female Follow-Up Studies Health Surveys Humans Iran/epidemiology Male Opioid-Related Disorders/*mortality Opium/*adverse effects Proportional Hazards Models Prospective Studies Questionnaires; Proportional Hazards Models; Adult *Cause of Death Dose-Response Relationship; Dose-Response Relationship, Drug; Research; Opium; use; mortality; Golestan; Cohort; Study; prospective; cohort; study; Iran; Opioid-Related Disorders; 16. Peace & justice; Health Surveys; 3. Good health; مقالات نمایه شده محققین دانشگاه در سایت ,Web of Science ,Scopus; [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie; Female; موارد کلی; Follow-Up Studies

To investigate the association between opium use and subsequent risk of death.Prospective cohort study.The Golestan Cohort Study in north-eastern Iran collected detailed validated data on opium use and other exposures at baseline. Participants were enrolled between January 2004 and June 2008 and were followed to May 2011, with a follow-up success rate of over 99%.50,045 participants aged 40-75 at baseline.Mortality, all cause and major subcategories.17% (n = 8487) of the participants reported opium use, with a mean duration of 12.7 years. During the follow-up period 2145 deaths were reported. The adjusted hazard ratio for all cause mortality associated with ever use of opium was 1.86 (95% confidence interval 1.68 to 2.06). Opium consumption was significantly associated with increased risks of deaths from several causes including circulatory diseases (hazard ratio 1.81) and cancer (1.61). The strongest associations were seen with deaths from asthma, tuberculosis, and chronic obstructive pulmonary disease (11.0, 6.22, and 5.44, respectively). After exclusion of people who self prescribed opium after the onset of major chronic illnesses, the associations remained strong with a dose-response relation.Opium users have an increased risk of death from multiple causes compared with non-users. Increased risks were also seen in people who used low amounts of opium for a long period and those who had no major illness before use.