The Perspective of Traditional Persian Medicine on Botanicals Effective in Quitting Opium Addiction: A Review

Traditional Persian medicine (TPM) is a set of theoretical and practical sciences that are used in the diagnosis, prevention, and treatment of physical, mental, or social disorders. This holistic medical system can provide solutions for some diseases, including drug addiction, that modern medicine, only offers symptomatic treatment. Since the addiction prevalence in the 16th century, Persian medicine scholars have introduced various ways to quit it. In this study, we investigated if Persian medicine has treatment options to quit opium addiction. We studied the main textbooks of TPM that specifically talked about addiction. Our study was conducted according to a systematic prioritization in traditional medicine. Additionally, scientific databases such as PubMed, ScienceDirect, Scopus, and Google Scholar searched for plant active ingredients in current pharmacology. By this method, forty-nine drugs were found, and nine drugs with herbal origin obtained the highest score in addiction treatment. Since the main purpose of the study is finding new drugs theoretically effective in quitting opium addiction; we sought to find evidence of that effectiveness in modern pharmacology and we found them in most prioritized drugs. Prioritizing traditional drugs can lead to find new drugs which also have evidence of effectiveness in modern studies. Therefore, they could be introduced as novel natural remedies for disease. The list of drugs obtained in this study can be the basis for conducting in vitro and in vivo studies for design and development of new drugs in the treatment of opium addiction. In fact, traditional medicine could have a special place in quitting opium addiction, and this capacity should be further exploited.

Clusters of the Risk Markers and the Pattern of Premature Coronary Heart Disease: An Application of the Latent Class Analysis

Background: Coronary heart disease (CHD) is the major cause of mortality in the world with a significant impact on the younger population. The aim of this study was to identify prematurity among patients with coronary artery bypass graft surgery (CABG) based on the clustering of CHD risk factors.Methods: Patients were recruited from an existing cohort of candidates for CABG surgery named Tehran Heart Center Coronary Outcome Measurement (THC-COM). A latent class analysis (LCA) model was formed using 11 potential risk factors as binary variables: cigarette smoking, obesity, diabetes, family history of CHD, alcohol use, opium addiction, hypertension, history of stroke, history of myocardial infarction (MI), peripheral vascular disease (PVD), and hyperlipidemia (HLP). We analyzed our data to figure out how the patients are going to be clustered based on their risk factors.Results: For 566 patients who were studied, the mean age (SD) and BMI of patients were 59.1 (8.9) and 27.3 (4.1), respectively. The LCA model fit with two latent classes was statistically significant (G2 = 824.87, df = 21, p < 0.0001). The mean (SD) age of patients for Class I and Class II was 55.66 (8.55) and 60.87 (8.66), respectively. Class I (premature) was characterized by a high probability of smoking, alcohol consumption, opium addiction, and a history of MI (P < 0.05), and class II by a high probability of obesity, diabetes, and hypertension.Conclusion: Latent class analysis calculated two groups of severe CHD with distinct risk markers. The younger group, which is characterized by smoking, addiction, and the history of MI, can be regarded as representative of premature CHD.

Opium may affect coronary artery disease by inducing inflammation but not through the expression of CD9, CD36, and CD68

The molecular mechanisms of opium with regard to coronary artery disease (CAD) have not yet been determined. The aim of the present study was to evaluate the effect of opium on the expression of scavenger receptors including CD36, CD68, and CD9 tetraspanin in monocytes and the plasma levels of tumor necrosis factor alpha (TNF-α), interferon gamma (IFN-γ), malondialdehyde (MDA), and nitric oxide metabolites (NOx) in patients with CAD with and without opium addiction. This case–control study was conducted in three groups: (1) opium-addicted patients with CAD (CAD+OA, n=30); (2) patients with CAD with no opium addiction (CAD, n=30); and (3) individuals without CAD and opium addiction as the control group (Ctrl, n=17). Protein and messenger RNA (mRNA) levels of CD9, CD36, and CD68 were evaluated by flow cytometry and reverse transcription-quantitative PCR methods, respectively. Consumption of atorvastatin, aspirin, and glyceryl trinitrate was found to be higher in the CAD groups compared with the control group. The plasma level of TNF-α was significantly higher in the CAD+OA group than in the CAD and Ctrl groups (p=0.001 and p=0.005, respectively). MDA levels significantly increased in the CAD and CAD+OA groups in comparison with the Ctrl group (p=0.010 and p=0.002, respectively). No significant differences were found in CD9, CD36, CD68, IFN-γ, and NOx between the three groups. The findings demonstrated that opium did not have a significant effect on the expression of CD36, CD68, and CD9 at the gene and protein levels, but it might be involved in the development of CAD by inducing inflammation through other mechanisms.

Characteristics of gastric precancerous conditions and Helicobacter pylori infection among dyspeptic patients in north-eastern Iran: is endoscopic biopsy and histopathological assessment necessary?

Background Early detection and appropriate treatment of precancerous, mucosal changes could significantly decrease the prevalence of life-threatening gastric cancer. Biopsy of the normal-appearing mucosa to detect Helicobacter pylori and these conditions is not routinely obtained. This study assesses the prevalence and characteristics of H. pylori infection and precancerous conditions in a group of patients suffering from chronic dyspepsia who were subjected to gastric endoscopy and biopsy mapping. Methods This cross-sectional study included dyspeptic patients, not previously treated for H. pylori, undergoing esophagogastroduodenoscopy (EGD) with their gastric endoscopic biopsies obtained for examination for evidence of H. pylori infection and precancerous conditions. Demographic and clinical data on the gender, smoking, opium addiction, alcohol consumption, medication with aspirin, corticosteroids and non-steroidal anti-inflammatory drugs (NSAIDs) and family history of cancer were collected by interviewing the patients and evaluating their health records. The cohort examined consisted of 585 patients with a mean (SD) age of 48.0 (14.46) years, 397 (67.9%) of whom were women. Results H. pylori infection was identified in 469 patients (80.2%) with the highest prevalence (84.2%) in those aged 40–60 years. Opium addiction correlated with a higher a H. pylori infection rate, while alcohol consumption was associated with a lower rate by Odds Ratio 1.98 (95% CI 1.11–3.52) and 0.49 (95% CI 0.26–0.92), respectively. The prevalence of intestinal metaplasia, gastric atrophy and gastric dysplasia was 15.2, 12.6 and 7.9%, respectively. Increased age, positive H. pylori infection, endoscopic abnormal findings and opium addiction showed a statistically significant association with all precancerous conditions, while NSAID consumption was negatively associated with precancerous conditions. For 121 patients (20.7% of all), the EGD examination revealed normal gastric mucosa, however, for more than half (68/121, 56.2%) of these patients, the histological evaluation showed H. pylori infection, and also signs of atrophic mucosa, intestinal metaplasia and dysplasia in 1.7, 4.1 and 1.7%, respectively. Conclusion EGD with gastric biopsy mapping should be performed even in the presence of normal-appearing mucosa, especially in dyspeptic patients older than 40 years with opium addiction in north-eastern Iran. Owing to the high prevalence of precancerous conditions and H. pylori infection among patients with dyspepsia in parts of Iran, large-scale national screening in this country should be beneficial.

BODY IMMUNOLOGICAL REACTIVITY IN OPIOMANIA

Due to the general trend of changes in reactivity in many exogenous and endogenous diseases, more and more attention is currently being paid to changes in immunological reactivity in drug addiction. The expediency of assessing the state of immune mechanisms in opioid addiction is determined by the need to predict their course and outcome. The aim of the study was to study the immunological reactivity of the body in patients with opium addiction in a stage of abstinence. For this purpose, clinical and immunological studies were conducted in 80 patients who use opioid drugs. The duration of the disease ranged from 0.5-19 years. Of these, the disease duration is up to 3 years – 28 patients (group I), and over 3 years – 52 patients (group II). The number of subjects in the control group was n = 50. Authors carried out the assessment of the mental, narcological, somatic, and neurological status. In addition, they have studied the general clinical, biochemical and immunological parameters As a result of this study, it was found, that patients of group I had more pronounced T-lymphocytopenia. A persistent increase in the value of serum IgM was revealed both in the dynamics of abstinence and depending on the duration of the disease, which may indicate a strain on the humoral link of immunity in opium addiction. In addition, as the duration of chronic narcotization increases, there is a tendency to increase the relative number of B-lymphocytes. Thus, at the patients with opium addiction in a state of abstinence develop T-lymphocytopenia. Moreover, with an increase in the duration of the disease, an increase in the level of IgM by 2-2.6 times. The revealed changes in the immunological reactivity of the organism suggest the need to include immunocorrective therapy in the complex of therapeutic measures for opium addiction.

Opium and Addiction in a Cross-Cultural Context: De Quincey's ‘Confessions’ (1821) and the Chinese Novel, Romantic Illusions of the Fool of Yangzhou (Fengyue meng) (c. 1848)

This essay examines De Quincey's representation of opium ‘addiction’ in the cross-cultural context of Britain and China in the light of recent revisionist medical discussions of addiction and dependence, and revisionist historical writing about opium use in nineteenth-century China. De Quincey's representation of the opium user is compared to that of China's first ‘city novel’, Courtesans and Opium: Romantic Illusions of the Fool of Yangzhou believed to have been written in 1848 (trans 2009). In this complex fiction, opium smoking is presented as a largely pleasurable and common pastime which has the potential for danger if abused by the unwary. It is not connected with dreams and nightmares, or figured as a stimulus of, or analogy for, the creative imagination. It offers a fascinating view of the leisure world of nineteenth-century China, where recreational opium smoking is common and not problematic when undertaken moderately.

The Manchurian Plague and COVID-19: China, the United States, and the “Sick Man,” Then and Now

In this article, I explore the historical resonances between China’s 1911 pneumonic plague and our current situation with COVID-19. At the turn of the 20th century, China was labeled “the Sick Man of the Far East”: a once-powerful country that had become burdened by opium addiction, infectious disease, and an ineffective government. In 1911, this weakened China faced an outbreak of pneumonic plague in Manchuria that killed more than 60 000 people. After the 1911 plague, a revolutionized China radically restructured its approach to public health to eliminate the stigma of being “the Sick Man.” Ironically, given the US mishandling of the COVID pandemic, observers in today’s China are now calling the United States “the Sick Man of the West”: a country burdened by opioid addiction, infectious disease, and an ineffective government. The historical significance of the phrase “Sick Man”—and its potential to now be associated with the United States—highlights the continued links between epidemic control and international status in a changing world. This historical comparison also reveals that plagues bring not only tragedy but also the opportunity for change.