Opium Dependency in Recurrent Painful Renal Lithiasis Colic

BACKGROUND: The main goal of this study is to determine the relationship between opium dependency and frequency of urolithiasis renal colics. METHODS: In a cross sectional study we compared opium dependency in urolithiasis patients (case group) with non-urolithiasis patients (control group) and assessed urolithiasis related renal colics as risk factor to opium dependency prevalence. Dependency was defined as the diagnostic criteria specified in DSM-IV questionnaire and Urolithiasis was diagnosed by standard methods (imaging modalities as US, X-Ray). FINDINGS: From 450 urolithiasis adult patients (120 female and 370 male with the age range of 18-67 years) 157 (34.88%) were opium addicts, however from the 340 non-urolithiasis patients (matched age group and gender ratios) only16 (4.70%) were opium addicts (P < 0.001). 56.68% of urolithiasis patients (who had a history of more than 15 renal colics (related to stone forming frequencies) were addicts for more than 10 years (P < 0.05). A strong positive correlation between the duration of dependency and renal colic rate was detected in these patients (P < 0.001, r = 0.999). CONCLUSION: This study showed that the risk of opium dependency is higher among urolithiasis patients. Moreover, there was a relation between urolithiasis frequencies (renal colics) and the duration of dependency. Other factors such as severity of pain, perception and faith of patients in the therapeutic effects of opium or local availability of opium were also effective in opium dependency.