PLASMA CORTISOL LEVELS IN HEROIN ADDICTS

Abstract

Abstract: Opioids can affect neuroendocrine functions, with the consequence that various endocrine abnormalities, included the increased level of cortisol that can result from depression, may be acceptable in patients who use opioids. The pathophysiological mechanism that has been postulated does explain these findings, including the direct action of heroin along the hypothalamic-pituitary-adrenal axis. The AIM of this study is to examinations the correlation between duration of heroin addicts, plasma cortisol levels and depression in heroin addicts. Materials and Methods: The cross section present study included groups of n= 50 heroin addicts evaluation to the clinic for outpatients (ambulance) in medical institution- Psychiatric Hospital Skopje. All the patients followed criteria for opioid dependence. Criteria for elimination was: chronic liver or renal diseases, HIV diseases or active infection. The cortisol plasma levels were assayed using the chemiluminescent immunometric assay (CLIA) normal range of cortisol level was 55,0 – 690nmol/l. For in vitro diagnostic use with the Immulite 2000 Systems Analyzers –for the quantitative measurement of cortisol in serum, as an aid in the clinical assessment of adrenal status. To determinate exactly results of plasma cortisol levels we use QS of the Biorad. Depression was assays with Beck Depression Inventory (BDI) considerate with 21 items. The results were an analyzed statistically using; descriptive methods, ttest for independent simplex and the Pearson coefficient of linear correlation. The statistical test were considered significant at the level p ≤ 0,05. Results: The group consisted of n=50 heroin addicts evaluation to the clinic for outpatients (ambulance) in medical institution- Psychiatric Hospital Skopje. A higher percentage 54 % of heroin addicts have normal plasma cortisol level and 46 % have a higher plasma cortisol level. In our study we got positive correlation between duration of heroin addiction and plasma cortisol level but without statistically significant p > 0,05. A high number of heroin addicts 62% had higher score of BDI≥10 only 38% had score of BDI<10 (table 6). Between cortisol plasma level and score BDI (depression) we got statistically significant correlation p < 0,0001. Conclusion: In some heroin addicts we got higher plasma cortisol level and higher percent of score BDI≥10. Correlation between plasma cortisol level and score of BDI was significantly. So one of the endocrine abnormalities in opiate users is a higher cortisol plasma level who can correlate with depression. Maybe treatment heroin addicts will be normalization levels of ACTH and cortisol.