Skip to main content
Top
Published in: Archives of Osteoporosis 1/2022

01-12-2022 | Opioids | Original Article

The association of opioid consumption and osteoporosis in old men: Bushehr Elderly Health (BEH) program

Authors: Mahnaz Sanjari, Hossein Yarmohammadi, Noushin Fahimfar, Safoora Gharibzadeh, Kazem Khalagi, Gita Shafiee, Ramin Heshmat, Iraj Nabipour, Azam Amini, Amirhossein Darabi, Arash Ghazbani, Bagher Larijani, Afshin Ostovar

Published in: Archives of Osteoporosis | Issue 1/2022

Login to get access

Abstract

Summary

In a population of 1156 men aged ≥ 60 years, opioid drug use was reported by 4.1% (n = 47) of participants. Among opioids, opium was the most prevalent consuming drug (83%). Adjusting for potential confounders, opioid consumption showed a positive association with osteoporosis.

Purpose

Limited evidence suggest a relationship between opioid consumption and osteoporosis. This study aims to investigate the possible association of osteoporosis and drug use among older adult men of Bushehr, Iran.

Methods

In this study, 1156 men aged ≥ 60 years of Bushehr Elderly Health (BEH) were included. Bone density and trabecular bone score (TBS) were measured using dual-energy X-ray absorptiometry. Total osteoporosis was noted based on osteoporosis at either site of the lumbar spine, femoral neck, and total hip densitometry. Drug use was defined as a self-reported current use of opioid drugs, either regular (daily) use or irregular consumption. Multivariable modified Poisson regression analysis was used for investigating the association of opioids and osteoporosis, reporting the adjusted prevalence ratio (APR) with 95% confidence interval (CI). The association between drug use and TBS was evaluated using a linear regression model.

Results

Opioid drug use was reported by 4.1% (n = 47) of participants. Among drug users, opium was the most prevalent consuming drug (83%). In all, 38.3% of drug users and 22.4% of non-users had osteoporosis (p-value = 0.011). Multivariable analysis showed that adjusting by age, education, smoking, alcohol consumption, body mass index, diabetes, and physical activity, a positive and significant association was detected between opioid drug use and the likelihood of osteoporosis (APR: 1.46, 95%CI: 1.02–2.10). Considering the potential confounders, the results also showed a negative association between drug consumption and TBS (β: − 0.027, 95%CI: − 0.053, − 0.001).

Conclusion

Opioid drug use has a positive association with osteoporosis in elderly men, independent of other conventional risk factors. Elderly drug users might be at a higher risk for osteoporotic fractures, given the effect of substance use on cognition. So, osteoporosis among drug users would be of importance, especially in countries where opium consumption is prevalent.
Literature
1.
go back to reference Wilby KJ, Wilbur K (2017) Cross-national analysis of estimated narcotic utilization for twelve Arabic speaking countries in the Middle East. Saudi Pharm J 25(1):83–87CrossRef Wilby KJ, Wilbur K (2017) Cross-national analysis of estimated narcotic utilization for twelve Arabic speaking countries in the Middle East. Saudi Pharm J 25(1):83–87CrossRef
2.
go back to reference Baheshmat S et al (2022) Spouse and child abuse associated with illicit drug use in Iran: a systematic review and meta-analysis. Trauma Violence Abuse 23(5):1494–1509 Baheshmat S et al (2022) Spouse and child abuse associated with illicit drug use in Iran: a systematic review and meta-analysis. Trauma Violence Abuse 23(5):1494–1509
3.
go back to reference Shahbazi F et al (2018) Analysis of mortality rate of illicit substance abuse and its trend in five years in Iran, 2014–2018. Addict Health 10(4):260PubMedPubMedCentral Shahbazi F et al (2018) Analysis of mortality rate of illicit substance abuse and its trend in five years in Iran, 2014–2018. Addict Health 10(4):260PubMedPubMedCentral
4.
go back to reference Ghoreishi SMS et al (2017) Epidemiological study of mortality rate from alcohol and illicit drug abuse in Iran. J Res Health Sci 17(4):395PubMedCentral Ghoreishi SMS et al (2017) Epidemiological study of mortality rate from alcohol and illicit drug abuse in Iran. J Res Health Sci 17(4):395PubMedCentral
5.
go back to reference Nikfarjam A et al (2016) National population size estimation of illicit drug users through the network scale-up method in 2013 in Iran. Int J Drug Policy 31:147–152CrossRefPubMed Nikfarjam A et al (2016) National population size estimation of illicit drug users through the network scale-up method in 2013 in Iran. Int J Drug Policy 31:147–152CrossRefPubMed
6.
go back to reference Attari MA et al (2012) Cannabis and opium abuse patterns and their associated complications in a sample of young Iranians. J Child Adolesc Subst Abuse 21(3):238–246CrossRef Attari MA et al (2012) Cannabis and opium abuse patterns and their associated complications in a sample of young Iranians. J Child Adolesc Subst Abuse 21(3):238–246CrossRef
7.
go back to reference Nakhaee S et al (2020) Opium use and cardiovascular diseases: a systematic review and meta-analysis. Crit Rev Toxicol 50(3):201–212 Nakhaee S et al (2020) Opium use and cardiovascular diseases: a systematic review and meta-analysis. Crit Rev Toxicol 50(3):201–212
8.
9.
go back to reference Gotthardt F et al (2017) Bone mineral density and its determinants in men with opioid dependence. J Bone Miner Metab 35(1):99–107CrossRefPubMed Gotthardt F et al (2017) Bone mineral density and its determinants in men with opioid dependence. J Bone Miner Metab 35(1):99–107CrossRefPubMed
11.
go back to reference Zamani M et al (2018) Prevalence of osteoporosis with the World Health Organization diagnostic criteria in the Eastern Mediterranean Region: a systematic review and meta-analysis. Arch Osteoporos 13(1):129CrossRefPubMed Zamani M et al (2018) Prevalence of osteoporosis with the World Health Organization diagnostic criteria in the Eastern Mediterranean Region: a systematic review and meta-analysis. Arch Osteoporos 13(1):129CrossRefPubMed
12.
go back to reference Rizou S et al (2018) Clinical manifestations of osteoarthritis in osteoporotic and osteopenic postmenopausal women. J Musculoskelet Neuronal Interact 18(2):208PubMedPubMedCentral Rizou S et al (2018) Clinical manifestations of osteoarthritis in osteoporotic and osteopenic postmenopausal women. J Musculoskelet Neuronal Interact 18(2):208PubMedPubMedCentral
13.
go back to reference Fahimfar N et al (2020) Prevalence of osteosarcopenia and its association with cardiovascular risk factors in Iranian older people: Bushehr Elderly Health (BEH) program. Calcif Tissue Int 106(4):364–370CrossRefPubMed Fahimfar N et al (2020) Prevalence of osteosarcopenia and its association with cardiovascular risk factors in Iranian older people: Bushehr Elderly Health (BEH) program. Calcif Tissue Int 106(4):364–370CrossRefPubMed
15.
go back to reference Kim J et al (2016) Economic burden of osteoporotic fracture of the elderly in South Korea: a national survey. Value Health Reg Issues 9:36–41CrossRefPubMed Kim J et al (2016) Economic burden of osteoporotic fracture of the elderly in South Korea: a national survey. Value Health Reg Issues 9:36–41CrossRefPubMed
16.
go back to reference Piscitelli P et al (2019) Incidence and costs of hip fractures in elderly Italian population: first regional-based assessment. Arch Osteoporos 14(1):81CrossRefPubMed Piscitelli P et al (2019) Incidence and costs of hip fractures in elderly Italian population: first regional-based assessment. Arch Osteoporos 14(1):81CrossRefPubMed
19.
go back to reference Mirzaie M, Darabi S (2017) Population aging in Iran and rising health care costs. Iranian J Ageing 12(2):156–169 Mirzaie M, Darabi S (2017) Population aging in Iran and rising health care costs. Iranian J Ageing 12(2):156–169
20.
go back to reference Shafiee G et al (2017) Bushehr Elderly Health (BEH) programme: study protocol and design of musculoskeletal system and cognitive function (stage II). BMJ Open 7(8):e013606CrossRefPubMedPubMedCentral Shafiee G et al (2017) Bushehr Elderly Health (BEH) programme: study protocol and design of musculoskeletal system and cognitive function (stage II). BMJ Open 7(8):e013606CrossRefPubMedPubMedCentral
21.
go back to reference Kanis JA et al (2013) Standardising the descriptive epidemiology of osteoporosis: recommendations from the Epidemiology and Quality of Life Working Group of IOF. Osteoporos Int 24(11):2763–2764CrossRefPubMedPubMedCentral Kanis JA et al (2013) Standardising the descriptive epidemiology of osteoporosis: recommendations from the Epidemiology and Quality of Life Working Group of IOF. Osteoporos Int 24(11):2763–2764CrossRefPubMedPubMedCentral
22.
go back to reference Silva BC et al (2014) Trabecular bone score: a noninvasive analytical method based upon the DXA image. J Bone Miner Res 29(3):518–530CrossRefPubMed Silva BC et al (2014) Trabecular bone score: a noninvasive analytical method based upon the DXA image. J Bone Miner Res 29(3):518–530CrossRefPubMed
23.
go back to reference Bartl R, Bartl C (2019) The osteoporosis manual: prevention, diagnosis and management. Springer Bartl R, Bartl C (2019) The osteoporosis manual: prevention, diagnosis and management. Springer
24.
go back to reference Klishadi R, Khosravi A, Famouri F, Sadeghi M, Shirani S (2001) Assessment of physical activity of adolescents in Isfahan. J Shahrekord Univ Med Sci 3(2) Klishadi R, Khosravi A, Famouri F, Sadeghi M, Shirani S (2001) Assessment of physical activity of adolescents in Isfahan. J Shahrekord Univ Med Sci 3(2)
25.
go back to reference Mahan LK, Raymond JL (2016) Krause's food & the nutrition care process-e-book. Elsevier Health Sciences Mahan LK, Raymond JL (2016) Krause's food & the nutrition care process-e-book. Elsevier Health Sciences
26.
go back to reference Aadahl M, Jørgensen T (2003) Validation of a new self-report instrument for measuring physical activity. Med Sci Sports Exerc 35(7):1196–1202CrossRefPubMed Aadahl M, Jørgensen T (2003) Validation of a new self-report instrument for measuring physical activity. Med Sci Sports Exerc 35(7):1196–1202CrossRefPubMed
27.
go back to reference Maharlouei N et al (2017) The incidence of hip fracture in Shiraz, Iran: a promising rate comparing to previous studies. Osteoporos Int 28(6):1989–1993CrossRefPubMed Maharlouei N et al (2017) The incidence of hip fracture in Shiraz, Iran: a promising rate comparing to previous studies. Osteoporos Int 28(6):1989–1993CrossRefPubMed
28.
go back to reference Heydari Z et al (2017) An investigation of the risk factors of osteoporosis and the correlation between opium consumption and osteoporosis in adults. Addict Health 9(4):214PubMedPubMedCentral Heydari Z et al (2017) An investigation of the risk factors of osteoporosis and the correlation between opium consumption and osteoporosis in adults. Addict Health 9(4):214PubMedPubMedCentral
29.
go back to reference Grey A et al (2011) Decreased bone density in men on methadone maintenance therapy. Addiction 106(2):349–354CrossRefPubMed Grey A et al (2011) Decreased bone density in men on methadone maintenance therapy. Addiction 106(2):349–354CrossRefPubMed
30.
go back to reference Hooman Khademi M et al (2016) Opioid therapy and its side effects: a review. Arch Iran Med 19(12):870PubMed Hooman Khademi M et al (2016) Opioid therapy and its side effects: a review. Arch Iran Med 19(12):870PubMed
31.
go back to reference Harada S-I, Rodan GA (2003) Control of osteoblast function and regulation of bone mass. Nature 423(6937):349–355CrossRefPubMed Harada S-I, Rodan GA (2003) Control of osteoblast function and regulation of bone mass. Nature 423(6937):349–355CrossRefPubMed
32.
go back to reference Coluzzi F et al (2015) The unsolved case of “bone-impairing analgesics”: the endocrine effects of opioids on bone metabolism. Ther Clin Risk Manag 11:515CrossRefPubMedPubMedCentral Coluzzi F et al (2015) The unsolved case of “bone-impairing analgesics”: the endocrine effects of opioids on bone metabolism. Ther Clin Risk Manag 11:515CrossRefPubMedPubMedCentral
33.
go back to reference Kim EY et al (2009) Frequency of osteoporosis in 46 men with methamphetamine abuse hospitalized in a National Hospital. Forensic Sci Int 188(1–3):75–80CrossRefPubMed Kim EY et al (2009) Frequency of osteoporosis in 46 men with methamphetamine abuse hospitalized in a National Hospital. Forensic Sci Int 188(1–3):75–80CrossRefPubMed
34.
go back to reference Pedrazzoni M et al (1993) Effects of chronic heroin abuse on bone and mineral metabolism. Eur J Endocrinol 129(1):42–45CrossRef Pedrazzoni M et al (1993) Effects of chronic heroin abuse on bone and mineral metabolism. Eur J Endocrinol 129(1):42–45CrossRef
35.
go back to reference Ramli FF, Hashim SAS, Effendy NM (2021) Factors associated with low bone density in opioid substitution therapy patients: a systematic review. Int J Med Sci 18(2):575CrossRefPubMedPubMedCentral Ramli FF, Hashim SAS, Effendy NM (2021) Factors associated with low bone density in opioid substitution therapy patients: a systematic review. Int J Med Sci 18(2):575CrossRefPubMedPubMedCentral
36.
go back to reference Li G et al (2017) An overview of osteoporosis and frailty in the elderly. BMC Musculoskelet Disord 18(1):1–5CrossRef Li G et al (2017) An overview of osteoporosis and frailty in the elderly. BMC Musculoskelet Disord 18(1):1–5CrossRef
37.
go back to reference Kim YA et al (2019) Effects of physical activity on bone mineral density in older adults: Korea National Health and Nutrition Examination Survey, 2008–2011. Arch Osteoporos 14(1):1–10CrossRef Kim YA et al (2019) Effects of physical activity on bone mineral density in older adults: Korea National Health and Nutrition Examination Survey, 2008–2011. Arch Osteoporos 14(1):1–10CrossRef
38.
go back to reference Jain RK, Vokes T (2019) Physical activity as measured by accelerometer in NHANES 2005–2006 is associated with better bone density and trabecular bone score in older adults. Arch Osteoporos 14(1):1–7CrossRef Jain RK, Vokes T (2019) Physical activity as measured by accelerometer in NHANES 2005–2006 is associated with better bone density and trabecular bone score in older adults. Arch Osteoporos 14(1):1–7CrossRef
39.
go back to reference Bayani MA et al (2016) The relationship between type 2 diabetes mellitus and osteoporosis in elderly people: a cross-sectional study. Int Biol Biomed J 2(1):39–46 Bayani MA et al (2016) The relationship between type 2 diabetes mellitus and osteoporosis in elderly people: a cross-sectional study. Int Biol Biomed J 2(1):39–46
40.
go back to reference DeShields S, Cunningham T (2018) Comparison of osteoporosis in US adults with type 1 and type 2 diabetes mellitus. J Endocrinol Invest 41(9):1051–1060CrossRefPubMed DeShields S, Cunningham T (2018) Comparison of osteoporosis in US adults with type 1 and type 2 diabetes mellitus. J Endocrinol Invest 41(9):1051–1060CrossRefPubMed
41.
go back to reference Ghadimi R, Hosseini SR, Asefi S, Bijani A, Heidari B, Babaei M (2018) Influence of smoking on bone mineral density in elderly men. Int J Preventive Med 9 Ghadimi R, Hosseini SR, Asefi S, Bijani A, Heidari B, Babaei M (2018) Influence of smoking on bone mineral density in elderly men. Int J Preventive Med 9
42.
go back to reference Cheraghi Z et al (2019) The effect of alcohol on osteoporosis: a systematic review and meta-analysis. Drug Alcohol Depend 197:197–202CrossRefPubMed Cheraghi Z et al (2019) The effect of alcohol on osteoporosis: a systematic review and meta-analysis. Drug Alcohol Depend 197:197–202CrossRefPubMed
43.
go back to reference Søgaard AJ et al (2018) The association between alcohol consumption and risk of hip fracture differs by age and gender in Cohort of Norway: a NOREPOS study. Osteoporos Int 29(11):2457–2467CrossRefPubMed Søgaard AJ et al (2018) The association between alcohol consumption and risk of hip fracture differs by age and gender in Cohort of Norway: a NOREPOS study. Osteoporos Int 29(11):2457–2467CrossRefPubMed
44.
go back to reference Tian L, Yang R, Wei L, Liu J, Yang Y, Shao F, Guo T (2017) Prevalence of osteoporosis and related lifestyle and metabolic factors of postmenopausal women and elderly men: A cross-sectional study in Gansu province, Northwestern of China. Medicine 96(43) Tian L, Yang R, Wei L, Liu J, Yang Y, Shao F, Guo T (2017) Prevalence of osteoporosis and related lifestyle and metabolic factors of postmenopausal women and elderly men: A cross-sectional study in Gansu province, Northwestern of China. Medicine 96(43)
45.
go back to reference Mughal N, Inderjeeth AJ, Inderjeeth CA (2019) Osteoporosis in patients with dementia is associated with high morbidity and mortality: ‘findings from a single orthogeriatric unit.’ Aust J Gen Pract 48(1/2):53CrossRefPubMed Mughal N, Inderjeeth AJ, Inderjeeth CA (2019) Osteoporosis in patients with dementia is associated with high morbidity and mortality: ‘findings from a single orthogeriatric unit.’ Aust J Gen Pract 48(1/2):53CrossRefPubMed
46.
go back to reference Park K-S et al (2017) Education and exercise program improves osteoporosis knowledge and changes calcium and vitamin D dietary intake in community dwelling elderly. BMC Public Health 17(1):966CrossRefPubMedPubMedCentral Park K-S et al (2017) Education and exercise program improves osteoporosis knowledge and changes calcium and vitamin D dietary intake in community dwelling elderly. BMC Public Health 17(1):966CrossRefPubMedPubMedCentral
Metadata
Title
The association of opioid consumption and osteoporosis in old men: Bushehr Elderly Health (BEH) program
Authors
Mahnaz Sanjari
Hossein Yarmohammadi
Noushin Fahimfar
Safoora Gharibzadeh
Kazem Khalagi
Gita Shafiee
Ramin Heshmat
Iraj Nabipour
Azam Amini
Amirhossein Darabi
Arash Ghazbani
Bagher Larijani
Afshin Ostovar
Publication date
01-12-2022
Publisher
Springer London
Published in
Archives of Osteoporosis / Issue 1/2022
Print ISSN: 1862-3522
Electronic ISSN: 1862-3514
DOI
https://doi.org/10.1007/s11657-022-01181-y

Other articles of this Issue 1/2022

Archives of Osteoporosis 1/2022 Go to the issue