title: Thallium exists in opioid poisoned patients.
abstract: BACKGROUND
  Thallium (Tl) is a toxic heavy metal that exists in nature. Tl poisoning (thallotoxicosis) may occur in opioid addicts. This study was designed to evaluate the frequency and level of urinary Tl in opioid abusers. In addition, clinical findings were evaluated.
  
  
  METHODS
  A total of 150 subjects were examined. Cases with a history of at least 3 years of abuse were admitted in the Imam Reza Hospital as the case group; 50 non-opioid abusers from the target population were included as the control group. Twenty-four hour urinary qualitative and quantitative Tl analyses were performed on both groups.
  
  
  RESULTS
  Out of the 150 subjects, 128 (85 %) were negative for qualitative urinary Tl, followed by 5 % (trace), 7 % (1+), 2 % (2+), and 1 % (3+). Mean (standard error (SE), Min-Max) quantitative urinary Tl level was 14 μg/L (3.5 μg/L, 0-346 μg/L). Mean urinary Tl level in the case group was 21 μg/L (5 μg/L, 0-346 μg/L) and that in the controls was 1 μg/L (0.14 μg/L, 0-26 μg/L), which were significantly different (P = 0.001). The most frequent clinical findings were ataxia (86 %), sweating (81 %), and constipation (54 %). In all cases (n = 150), the mean (SE) value for cases with positive qualitative urinary Tl was 26.8 μg/L (0.9 μg/L) and that in the negative cases was 2.3 μg/L (0.2 μg/L), which were significantly different (P = 0.002).
  
  
  CONCLUSIONS
  This study showed that long-term opioid abuse may lead to Tl exposure. In opioid abusers with the clinical manifestation of thallotoxicosis, urinary Tl should be determined.
authors.affiliation: Department of Addiction studies, School of Medical Kashan University of Medical Sciences, Kashan, Iran.
authors.forename: Amir
authors.initials: A
authors.lastname: Ghaderi
authors.affiliation: Departments of Pharmacodynamics and Toxicology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Naser
authors.initials: N
authors.lastname: Vahdati-Mashhadian
authors.affiliation: Department of Clinical Toxicology, Kerman University of Medical Sciences, Kerman, Iran.
authors.forename: Zohreh
authors.initials: Z
authors.lastname: Oghabian
authors.affiliation: Departments of Pharmacodynamics and Toxicology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Valiallah
authors.initials: V
authors.lastname: Moradi
authors.affiliation: Addiction Research Centre, Mashhad University of Medical Sciences, Imam Reza Hospital, Ibn-e-Sina Street, Mashhad, 91735-348, Iran. AfshariR@mums.ac.ir.|British Columbia Center for Disease Control, Vancouver, Canada. AfshariR@mums.ac.ir.
authors.forename: Reza
authors.initials: R
authors.lastname: Afshari
authors.affiliation: Atherosclerosis and Coronary Artery Research Center, Birjand University of Medical Science, Birjand, Iran.
authors.forename: Omid
authors.initials: O
authors.lastname: Mehrpour
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D004340:Drug Contamination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009293:Opioid-Related Disorders / Q000453:epidemiology / Q000652:urine*; D013793:Thallium / Q000506:poisoning* / Q000652:urine*; D055815:Young Adult
chemical_list: D013793:Thallium