Opium and cardiovascular health: A devil or an angel?

Abstract

Opioids have the highest rate of illicit drug consumption after cannabis worldwide. Opium, after tobacco, is still the most commonly abused substance in the Middle East. In addition to the ease of availability, one reason for the high consumption of opium in Asian countries might be a traditional belief among Eastern people and even medical staff that opium may have ameliorating effects on cardiovascular diseases (CVDs) as well as diabetes mellitus, hypertension, and dyslipidemia. Over the last decade, many studies have been performed on humans and animals to evaluate the interplay between opium consumption and stable coronary artery disease, acute coronary syndromes, and atherosclerosis. In this review, we conclude that opium consumption should be considered a risk factor for CVDs. Healthy individuals, as well as cardiac and diabetic patients, should be informed and educated about the hazardous effects of opium consumption on cardiovascular and other chronic diseases.

Keywords: Acute coronary syndrome; Coronary artery disease; Opium; Papaver; Stroke.

Fig. 1

Central illustration: Chemical structure of five main alkaloids of opium (Papaversomniferum L.) and the potential mechanisms of the harmful effects of opium consumption on coronary artery disease, ischemic stroke, and peripheral arterial disease. hs-CRP, high sensitivity C-reactive protein; IL, interleukin; IL-1Ra, interleukin-1 receptor antagonist; IFN-γ, interferon-γ; Lp (a), lipoprotein (a); PAI-1, plasminogen activator inhibitor-1; TGF-β, transforming growth factor-β.