Evaluation of Serum Cortisol Levels and Response to Cosyntropin Test in Methadone-Treated Opium Addicts

Background and Objective: Opium has been used for thousands of years for medical and analgesic purposes and also its misuse has increased in recent years. Methadone, a synthetic opioid has been used as an analgesic and to help patients quit opium addiction. However, some evidence suggest long-term use of opioids can affect hypothalamic-pituitary-adrenal axis. To assess this hypothesis, we aimed to evaluate the serum cortisol level and response to cosyntropin stimulation test in opium addicts under methadone treatment.Materials and Methods: The study was conducted in November of ۲۰۱۹ in Imam Reza Hospital Rehab Center, Birjand, Iran. ۳۸ methadone-treated opium addicts participated in the study. Initially, ۵ cc of blood was taken, then, ۲۵۰ μg intramuscular cosyntropin was injected. After ۳۰ and ۶۰ minutes two other blood samples were obtained. These procedures were performed between ۸ to ۹ AM. The data were analyzed using SPSS.Findings: There was a significant difference between serum cortisol levels in methadone users (۹.۴۶ ± ۵.۴۲ µg / dl) and its normal values (=۱۴ µg / dl) (p <۰.۰۰۱). The mean response to cosyntropin stimulation test in methadone users was ۹.۳۴± ۸.۱۱ µg / dl. ۵۵% of our participants had adrenal insufficiency. Conclusions: Serum cortisol level was significantly different in methadone-treated patients compared to normal values. Therefore, we recommend measuring serum cortisol level in long-term opioid users before major medical procedures to use stress doses of corticosteroids if needed.

کلیدواژه ها:

Adrenal insufficiency ، Cortisol ، Cosyntropin test ، Methadone ، opioids