key: cord-0969591-m3joula5
authors: Khosravi, Mohsen
title: Increasing opium use in Iran in response to unsubstantiated rumors that it protects against COVID‐19
date: 2021-10-21
journal: Addiction
DOI: 10.1111/add.15706
sha: fcc0367bd3c174ee1d53d28b3dd24def4682b4a1
doc_id: 969591
cord_uid: m3joula5

nan

Increasing opium use in Iran in response to unsubstantiated rumors that it protects against COVID-19

We write to address misconceptions identified by some commentators on the alleged protective effects of opium consumption and the SARS-CoV-2 virus [1] . This mistaken news caused a flood of opium use in the Iranian society, as field reports from the main squares for the sale of opium, including Shush Square in Tehran, indicated a five to six times increase in the number of customers [2] . Also, some preliminary scientific findings on the protective effects of opium use against SARS-CoV-2 infection led to pseudoscientific speculations on the veracity of this popular belief [3] . For instance, it has been proposed that short-term opium use competes with binding of SARS-CoV-2 to the angiotensin converting enzyme 2 (ACE-2) receptors and suppresses serum levels of interleukins involved in COVID-19-associated hyperinflammatory syndrome [4] , but most evidence did not support the claims that opium consumption reduced the risk of contracting COVID-19 or of the severity of infection acquired. Indeed, most studies have reported opium use as a triggering or aggravating factor of COVID-19 [5, 6] . So, what is the reason for an increased mortality rate from COVID-19 among individuals The morphine-induced immune modulation can also be affected by the chronicity of using this class of agents. In this regard, a systematic review of in-vitro studies has revealed that morphine at high doses and over several months could increase the risk of bacterial infections by inhibiting the cellular immune system [10] . Another related study suggested that long-term opium use may be associated with suppression of B and T lymphocyte proliferation, induction of necrosis and apoptosis in immune cells and thymic and splenic atrophy [11] . Recent evidence has also shown that opium, as an immunosuppressive agent, can reduce leukocyte activity by inhibiting the migration of bone marrow-derived cells in the long term [12] . Regardless of the action mechanism of morphine, the scientific consensus has been on its detrimental effects on the immune system and the reasons for the increased risk of mortality among opium-addicted patients with COVID-19 [7] . Because individuals may be rapidly affected by each other's emotional reactions, policymakers and professionals in Iran and world-wide should be aware of the rumors and the potential risk of 'emotional contagion' among the general population. Indeed, raising public awareness about the adverse effects of opium on the clinical course of COVID-19 can be effective in reducing its mortality rate.

None.

Opium addiction and COVID-19: Truth or false beliefs

COVID-19 pandemic and addiction: Current problems in Iran

Consideration of immunomodulatory actions of morphine in COVID-19-short report

Angiotensin converting enzyme-2 as therapeutic target in COVID-19

COVID-19 risk and outcomes in patients with substance use disorders: Analyses from electronic health records in the United States

The effect of opium on severity of COVID-19 infection: An original study from Iran

The reasons for higher mortality rate in opium addicted patients with COVID-19: a narrative review

Opiumassociated QT interval prolongation: a cross-sectional comparative study

A double-edged sword of using opioids and COVID-19: a toxicological view

The association between prescribed opioid receipt and community-acquired pneumonia in adults: a systematic review and meta-analysis

The plasma levels of the cytokines in opiumaddicts and the effects of opium on the cytokines secretion by their lymphocytes

The effects of opium addiction through different administration routes on inflammatory and coagulation factors