Cardio-metabolic Risk with Opioid dependence

Volume 4 Issue 12 Dec 2014

Consultation- Liaison Psychiatry Focus: Biochemistry

Opioid is commonly abused substance in India. As compared to tobacco, opioid is available in various forms and abused in many ways, its use is greatly influence by various socio-cultural factors. It is difficult to assess the extent and the type of opioid most abused. Opioid abuse penetrates through various socio-economic strata and regions in India. Opioid abuse is found in high prevalence in certain states like Punjab, Rajasthan, Odisha, Tamil Nadu, Uttarakhand and Maharashtra. Opioid abuse is subjected to great cultural diversity of India. Cultural acceptance of its use in certain communities during various social activities like marriage, spiritual processes, and condolence obscure the margins of use, abuse and dependence. People are unaware of harmful consequences contrary to it they belief that opioid ameliorates grief and prevent heart disease.

Studies suggest that Opioid abusers have high morbidity and mortality due to elevated risk of hypertension and diabetes mellitus. Chronic opioid use subjected to raised cardio-metabolic risk parameters like insulin resistance, pro-coagulant state in blood, inflammation, reduced antioxidant capacity and thus indicating a proatherogenic state. Ischemic heart disease is the major cause of premature death in opioid abusers.
It is worth to mention that a large fraction of these patients still beyond the reach of medical care and just one percent of these gets psychiatric attention. This is because of lack of awareness, stigma, legal issues and poor coordination in medical facilities.

In view of complex bio-psychosocial factors and need for early intervention it is pertinent to highlight the role of psychiatric intervention early in the process. A collaborative model mental health professionals working with primary health care physicians required for holistic care for these patients. There is need of early detection and intervention through various psychological and pharmacological measures to prevent lifetime health morbidity & mortality.

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