Acute opiate overdose in Tehran: The forgotten role of opium

Introduction: The global epidemic of opiate use continues to spread and is an increasing burden especially in developing countries. Acute opiate overdose (AOO) is one of the most dramatic complications of drug abuse. The purpose of this study is to examine the epidemiology of acute opiate overdose in a poisoning center in Tehran. Methods: In this cross-sectional survey, patients who attended the emergency room of Loghman-Hakim hospital the only poisoning center in Tehran - and diagnosed with acute opiate overdose over a six month period were included. Results: Overdose was more common among men (91.2%). The mean and standard deviation of age was 36.9 +/- 15. The most frequent opiate agent was opium (56.5%) followed by heroin. Opium was most commonly used by regular users, as a single agent and through ingestion. Benzodiazepines, antidepressants and alcohol were the most common agents consumed accompanied with opiates. The mortality rate was 8.8% which was not significantly different between cases of heroin and opium overdose. Conclusion: Opium was the major cause of overdose in our study. This result suggests that opium is not a harmless form of addiction although it is regarded as a thing of the past in many countries. (C) 2006 Elsevier Ltd. All rights reserved.