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2024-03-07 20:23:09
OPIUM中文(简体)翻译：剑桥词典
OPIUM中文(简体)翻译：剑桥词典
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opium 在英语-中文（简体）词典中的翻译
opiumnoun [ U ] uk
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/ˈəʊ.pi.əm/ us
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/ˈoʊ.pi.əm/
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a drug made from the seeds of a poppy (= red flower) that is used to control pain or to help people sleep. It can make a person who takes it want more of it and is sometimes used by people as an illegal drug for pleasure
鸦片
an opium addict
吸鸦片成瘾者
(opium在剑桥英语-中文（简体）词典的翻译 © Cambridge University Press)
opium的例句
opium
Opium intensified their proletarianization, it also allowed some to take not only their own but also their family's life into their own hands.
来自 Cambridge English Corpus
Average annual sales of chests of opium for these reporting periods were: 403, 745, 617 and 928.
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First, there were several scientific advances involving opium early in the century, dramatically altering the drug's status in medical practice.
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Under these circumstances nearly all consumed the proffered substance even though they might not ordinarily take opium.
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Most confusingly, opium seems at times incidental to the text, as the author surrenders his narrative to a more general discussion of commerce.
来自 Cambridge English Corpus
Opium gave women a unique means of survival; thousands made a living for themselves while thousands more supported their families by this means.
来自 Cambridge English Corpus
To give an idea of a town's daily consumption of opium, the amount of money spent on it exceeds that spent on rice.
来自 Cambridge English Corpus
They returned to the mainland with either memories or habits of opium and this was fundamental for the spread of smoking in the eighteenth century.
来自 Cambridge English Corpus
示例中的观点不代表剑桥词典编辑、剑桥大学出版社和其许可证颁发者的观点。
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a type of food similar to a hamburger but made without meat, by pressing together small pieces of vegetables, seeds, etc. into a flat, round shape
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Opium | Drug, Physiological Actions, & History | Britannica
Opium | Drug, Physiological Actions, & History | Britannica
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IntroductionOpium alkaloidsPhysiological actions of opiatesHistory of opium
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opium
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Thomas De Quincey
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drug use
opium trade
opium poppy
laudanum
paregoric
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opium, narcotic drug that is obtained from the unripe seedpods of the opium poppy (Papaver somniferum), a plant of the family Papaveraceae. (See poppy.) Opium is obtained by slightly incising the seed capsules of the poppy after the plant’s flower petals have fallen. The slit seedpods exude a milky latex that coagulates and changes colour, turning into a gumlike brown mass upon exposure to air. This raw opium may be ground into a powder, sold as lumps, cakes, or bricks, or treated further to obtain derivatives such as morphine, codeine, and heroin. Opium and the drugs obtained from it are called opiates.
Opium alkaloids
The pharmacologically active principles of opium reside in its alkaloids, the most important of which, morphine, constitutes about 10 percent by weight of raw opium. Other active alkaloids such as papaverine and codeine are present in smaller proportions. Opium alkaloids are of two types, depending on chemical structure and action. Morphine, codeine, and thebaine, which represent one type, act upon the central nervous system and are analgesic, narcotic, and potentially addicting compounds. Papaverine, noscapine (formerly called narcotine), and most of the other opium alkaloids act only to relax involuntary (smooth) muscles.
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drug use: Opium, morphine, heroin, and related synthetics
Physiological actions of opiates
Opiates (e.g., morphine, codeine, and thebaine) exert their main effects on the brain and spinal cord. Their principal action is to relieve or suppress pain. The drugs also alleviate anxiety; induce relaxation, drowsiness, and sedation; and may impart a state of euphoria or other enhanced mood. Opiates also have important physiological effects: they slow respiration and heartbeat, suppress the cough reflex, and relax the smooth muscles of the gastrointestinal tract. Opiates are addictive drugs; they produce a physical dependence and withdrawal symptoms that can only be assuaged by continued use of the drug. With chronic use, the body develops a tolerance to opiates, so that progressively larger doses are needed to achieve the same effect. The higher opiates—heroin and morphine—are more addictive than opium or codeine. Opiates are classified as narcotics because they relieve pain, induce stupor and sleep, and produce addiction. The habitual use of opium produces physical and mental deterioration and shortens life. An acute overdose of opium causes respiratory depression which can be fatal.
Opium was for many centuries the principal painkiller known to medicine and was used in various forms and under various names. Laudanum, for example, was an alcoholic tincture (dilute solution) of opium that was used in European medical practice as an analgesic and sedative. Physicians relied on paregoric, a camphorated solution of opium, to treat diarrhea by relaxing the gastrointestinal tract. The narcotic effects of opium are mainly attributable to morphine, which was first isolated about 1804. In 1898 it was discovered that treating morphine with acetic anhydride yields heroin, which is four to eight times as potent as morphine in both its pain-killing properties and its addictive potential. The other alkaloids naturally present in opium are much weaker; codeine, for example, is only one-sixth as potent as morphine and is used mainly for cough relief. Since the late 1930s, various synthetic drugs have been developed that possess the analgesic properties of morphine and heroin. These drugs, which include meperidine (Demerol), methadone, levorphonal, and many others, are known as synthetic opioids. They have largely replaced morphine and heroin in the treatment of severe pain.
Opiates achieve their effect on the brain because their structure closely resembles that of certain molecules called endorphins, which are naturally produced in the body. Endorphins suppress pain and enhance mood by occupying certain receptor sites on specific neurons (nerve cells) that are involved in the transmission of nervous impulses. Opiate alkaloids are able to occupy the same receptor sites, thereby mimicking the effects of endorphins in suppressing the transmission of pain impulses within the nervous system.
History of opium
The opium poppy was native to what is now Turkey. Ancient Assyrian herb lists and medical texts refer to both the opium poppy plant and opium, and in the 1st century ce the Greek physician Dioscorides described opium in his treatise De materia medica, which was the leading Western text on pharmacology for centuries. The growth of poppies for their opium content spread slowly eastward from Mesopotamia and Greece. Apparently, opium was unknown in either India or China in ancient times, and knowledge of the opium poppy first reached China about the 7th century. At first, opium was taken in the form of pills or was added to beverages. The oral intake of raw opium as a medicine does not appear to have produced widespread addictions in ancient Asian societies.
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Opium smoking began only after the early Europeans in North America discovered the Indian practice of smoking tobacco in pipes. Some smokers began to mix opium with tobacco in their pipes, and smoking gradually became the preferred method of taking opium. Opium smoking was introduced into China from Java in the 17th century and spread rapidly. The Chinese authorities reacted by prohibiting the sale of opium, but these edicts were largely ignored. During the 18th century European traders found in China an expanding and profitable market for the drug, and the opium trade enabled them to acquire Chinese goods such as silk and tea without having to spend precious gold and silver. Opium addiction became widespread in China, and the Chinese government’s attempts to prohibit the import of opium from British-ruled India brought it into direct conflict with the British government. As a result of their defeat in the Opium Wars, the Chinese were compelled to legalize the importation of opium in 1858. Opium addiction remained a problem in Chinese society until the Communists came to power in 1949 and eradicated the practice.
In the West, opium came into wide use as a painkiller in the 18th century, and opium, laudanum, and paregoric were active ingredients in many patent medicines. These drugs were freely available without legal or medical restrictions, and the many cases of addiction they caused did not arouse undue social concern. Morphine was first isolated from opium about 1804, and the hypodermic syringe was invented at mid-century. Their use in combination on hundreds of thousands of sick or wounded American soldiers in the Civil War produced unprecedented numbers of addicts. Heroin, which was first synthesized in 1898, proved even more addictive than morphine, and by the early decades of the 20th century the legal use of opiates of any kind had been curtailed. The traffic in such drugs then went underground, leading to a vast illicit trade in heroin.
Although opium trade routes extending from the southeastern and southwestern regions of Asia closed temporarily during World War II, cultivation of the plant continued and even prospered in areas of China. In 1948 Burma (Myanmar), located along the southwestern border of China, gained independence and soon after emerged as a major producer of the drug, paralleling the suppression of opium cultivation in China. Throughout the 1960s and ’70s, Southeast Asia experienced substantial growth in illicit opium trade. The border area shared by Myanmar, Laos, and Thailand eventually became known as the Golden Triangle, a region that by the mid-1990s was the world’s leader in opium cultivation.
Smoking of opium declined in the 20th century, partly because it had been supplanted by more-potent derivatives and partly because of determined efforts in China and other developing countries to eradicate it. In the late 1990s, drug-control programs headed by the United Nations and by individual governments contributed to a reduction in opium poppy cultivation in the Golden Triangle. However, the region subsequently became a major producer of other illicit substances, including methamphetamines.
Also in the late 1990s, opium poppy cultivation increased in Afghanistan, and that country became a leading producer of heroin. As cultivation of the plant continued to soar there in the early 2000s, drug trade in the region became associated with terrorism and lawlessness. Near the end of the decade, however, increased law enforcement efforts and the outbreak of a poppy fungal disease caused poppy cultivation and opium production in Afghanistan to drop significantly. As a result, opium prices increased across the region, threatening to undermine the country’s illegal opium and heroin trade. The declines were seen as an opportunity to persuade local farmers to cultivate legal crops. Because of Internet pharmacies that sold the drug illegally, however, global opium trafficking remained high.
The legitimate use of certain opiate alkaloids in medicine has compounded issues surrounding the cultivation of opium poppies. Today P. somniferum is legally grown in some areas for the production of medicinal alkaloids. However, unlicensed cultivation of opium plants remains a serious legal offense in many countries, including the United States, since the substance is the starting product for heroin, which has millions of addicts worldwide.
This article was most recently revised and updated by Kara Rogers.
First Opium War | Definition, Overview, China, Consequences, Treaty, & Facts | Britannica
First Opium War | Definition, Overview, China, Consequences, Treaty, & Facts | Britannica
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First Opium War
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Treaty of Nanjing
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Category:
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Date:
1839 - August 29, 1842
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China
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China
United Kingdom
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Opium Wars
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Treaty of Nanjing
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First Opium War, armed conflict in 1839–42 between China’s Qing dynasty and Britain over the dynasty’s restrictions on British trade and, more broadly, Britain’s dissatisfaction with its diplomatic relationship with the Qing. The catalyst for the conflict was the dynasty’s efforts to suppress the smuggling of opium into China by British traders. The result of the conflict was a British victory and the signing of the Treaty of Nanjing, the first of the unequal treaties imposed by Western powers upon the Qing. The conflict and its aftermath helped weaken that dynasty, which would be replaced by a republic in the early 20th century. Prelude to war How did people respond to To Kill a Mockingbird?Learn about the top questions and answers concerning the First and Second Opium Wars.(more)See all videos for this articleThe First Opium War stemmed from Qing distrust of Western powers and from Western powers’ unhappiness with the limits that the Qing imposed on their trade with China. In 1757 the Qianlong emperor (reigned 1735–96) restricted all Western sea trade to one port, Canton (Guangzhou). The Qing further restricted Western trade by keeping Western traders outside the city walls.
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British merchants were especially dissatisfied with their situation, as there was a great demand for Chinese tea, porcelain, and silk in Britain. The attempt to meet this demand resulted in a large trade deficit for the British, because China did not import many British goods. The difference was paid to China in large amounts of silver. To reduce the trade deficit, the British East India Company and other British merchants turned to opium. The nonmedical use of that drug had been illegal in China since the early 1700s, though this prohibition had not been successfully enforced. Over the next several decades, China repeatedly tried to ban the opium trade. In response, in the early 19th century the East India Company agreed to stop selling opium in China. In reality, however, the company aided other British merchants in smuggling opium into China, primarily from India. The trade was so profitable that not only did it eliminate the British trade deficit but vast amounts of silver now flowed out of China into British hands. The growing number of Chinese addicted to opium as well as the growing amount of silver flowing from China caused the Daoguang emperor (reigned 1820–50) and the Qing court to take action. In 1839 the court sent Lin Zexu, the special imperial commissioner, to Canton to end the smuggling of the drug into China. Lin arrested several Chinese who were involved in the smuggling. In addition, he forced Charles Elliot, the British chief superintendent of trade in China, to instruct British merchants to give up their opium inventory, which they did. More than 20,000 chests of opium—about 1,400 tons of the drug—were then destroyed. This represented a massive financial loss for the British merchants that the British government could not, and the Qing would not, make good. In July 1839 tensions between Britain and China increased when one or more British sailors killed a Chinese villager. The British government refused to turn over the accused men to the Chinese legal system, which the British considered to be barbaric. However, Elliot did pay reparations to the victim’s family, set up a court of inquiry into the incident, and eventually tried several sailors suspected of being involved but on the lesser charges of rioting and assault. His actions did not appease Lin. War breaks out First Opium WarBritish warships attacking a Chinese battery on the Pearl (Zhu) River during the First Opium War, 1841.(more)The First Opium War began in late 1839 when two British warships broke the Chinese blockade of the Pearl (Zhu) River delta. They destroyed 29 Chinese vessels, setting the tone for a war dominated by the vastly superior British navy. The Chinese did have an advantage on land, but land fighting was limited. In early 1840 the British government sent a large naval fleet to China, which arrived in June. Joining that fleet later in the year was a new and advanced warship called the Nemesis.
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After British negotiators’ peace proposals regarding compensation for the destroyed opium and the opening of additional trading ports were rejected by the Qing in 1841, hostilities continued. The British navy advanced up the Yangtze River (Chang Jiang), capturing forts and eventually cutting off the Grand Canal. In August 1842 the British captured the city of Nanjing (Nanking), and the Qing were forced to resume negotiations. The end of the war and the aftermath The war was ended by the Treaty of Nanjing, signed on August 29, 1842. In addition to having to pay heavy war reparations to Britain, China had to open five trading ports. One of these ports was Shanghai, which would be transformed into one of China’s major commercial entrepôts. In addition, China ceded Hong Kong to Britain, and the island would remain under British control until 1997. In 1843 the Treaty of Nanjing was supplemented by the British Supplementary Treaty of the Bogue (Humen), which gave British subjects extraterritoriality in China and gave Britain most-favoured-nation status. Soon other Western countries, such as France and the United States, forced China to give them similar privileges.
After the First Opium War, Britain remained dissatisfied with its position in China. Opium remained illegal (although British merchants continued to smuggle it into the country), Canton was still highly restrictive toward Western traders, British imports in China were heavily taxed, and only five ports were open. All of these factors contributed to the start of the Second Opium War, in 1856. (See Opium Wars: The Second Opium War.) Everett Munez The Editors of Encyclopaedia Britannica
opium是什么意思_opium的翻译_音标_读音_用法_例句_爱词霸在线词典
m是什么意思_opium的翻译_音标_读音_用法_例句_爱词霸在线词典首页翻译背单词写作校对词霸下载用户反馈专栏平台登录opium是什么意思_opium用英语怎么说_opium的翻译_opium翻译成_opium的中文意思_opium怎么读,opium的读音,opium的用法,opium的例句翻译人工翻译试试人工翻译翻译全文简明柯林斯牛津opium英 [ˈəʊpiəm]美 [ˈoʊpiəm]释义n.鸦片; 麻醉剂点击 人工翻译，了解更多 人工释义词态变化复数: opiums;实用场景例句全部鸦片麻醉剂However, the alternatives level traffickers – also drive up opium prices, increasing funds to the Taliban.然而, 其它措施——开发其它作物,以及打击高级毒贩——也会推高鸦片价格, 增加塔利班得到的资金.期刊摘选Strychnine, arsenic, and opium are poison.马钱子碱 、 砷和鸦片都是毒药.《现代汉英综合大词典》The third part reconsiders the opium abolition movement of the financial dilemma.第三部分,对财政困境下的禁烟运动进行反思.期刊摘选They arrested him When they could prove that he trafficked in opium.当他们证实他贩卖鸦片时,就把他逮捕了.期刊摘选Agriculture: opium, wheat, fruits, nuts; wool.农业: 鸦片, 小麦, 水果, 干果, 羊绒.期刊摘选The influx of western medicine enriched Chinese medical science after the Opium War.鸦片战争之后,西方医学的涌入丰富了中国医学.期刊摘选Now, young Chiang turned against his father's benefactor and arrested the opium king's son.现在小蒋竟整了他父亲的恩人,把这个鸦片大王的儿子抓起来了.期刊摘选On the third day, they handed over 20000 chests of opium.第三天, 他们就交出了两万箱鸦片.期刊摘选China remained a feudal society untill the Opium War in 1840.直到1840年鸦片战争为止,中国一直处于封建社会.期刊摘选That man gave her a dose of opium.那男人给了她一剂鸦片.《简明英汉词典》He made a fortune by growing opium.他靠生产土药发了不义之财.期刊摘选Oberon opposed to operating the opera and opium.奥伯龙反对经营歌剧和鸦片的生意.期刊摘选After Opium War, Chinese society groped for the road to save the nation three times.鸦片战争后, 中国社会经历了三次科学救国道路的探索,清政府也被迫实施新政,进行教育改革.期刊摘选Opium taking is prohibited by law.法律禁吸鸦片.《现代汉英综合大词典》It was the custom there to offer opium to guests.当时习惯用大烟敬客.辞典例句Heroin, marijuana, opium are the major drugs.海洛因, 大麻, 鸦片是主要的毒品.期刊摘选The opium addict is craving opium again.这个大烟鬼又犯烟瘾了.期刊摘选Opium is classed under the head of narcotic.鸦片是归入麻醉剂一类的东西.《简明英汉词典》Morphine is a white bitter substance obtained from opium and used in medicine to reduce pain.吗啡是从鸦片中提炼出的苦味的白色物体,用作减痛的药物.《现代汉英综合大词典》Opium is a narcotic drug.鸦片是麻醉剂.《现代英汉综合大词典》The use of opium was not criminalized until fairly recently.直到最近抽鸦片才被判定为非法。《牛津高阶英汉双解词典》"Opium" is a provocative, sensual, and voluptuous fragrance which makes all your senses vibrate.“鸦片”是一种刺激性的、能引起感官快感的香料，能使你所有的感官兴奋起来。柯林斯例句Aurora felt the opium haze enfold her.奥萝拉感觉自己被笼罩在鸦片烟霾中。柯林斯例句They use opium as a sedative, rather than as a narcotic.他们把鸦片用作镇静剂而不是毒品。柯林斯例句He was forced to take opium to kill the pain.他被迫服用鸦片来止痛。柯林斯例句收起实用场景例句英英释义Noun1. an addictive narcotic extracted from seed capsules of the opium poppy收起英英释义词组搭配Germansomething regarded as inducing a false and unrealistic sense of contentment among people精神鸦片收起词组搭配同义词narcotic行业词典动物学寄生群落 医学〔USP〕鸦片，阿片：切开罂粟(Papaver Somniferum L.)或其亚种未成熟的荚，得到的一种风干的乳状渗出物，可提取9.5％以上的无水吗啡、粗制阿片(rude o.)和鸦片膏(gum o.)。鸦片的各种成分和衍化物，包括约20种生物碱，特别是吗啡、可待因、罂粟碱和蒂巴因，被用来发挥它们的麻醉和止痛作用。因它有高度的成瘾性，所以鸦片的生产受到限制，可供提取鸦片的植物的种植，在大多数国家也受到禁止 在这方面有一国际协议 生态学寄生群落 寄生生物与其所依赖的寄主构成的生物群落。 释义词态变化实用场景例句英英释义词组搭配同义词行Opium’s History in China - JSTOR Daily
Opium’s History in China - JSTOR Daily
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Politics & History Opium’s History in China
Opium has been used as a medicinal and recreational substance in China for centuries, its shifting meanings tied to class and national identity.
Two wealthy Chinese opium smokers
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By:
Livia Gershon
January 9, 2023
July 26, 2023
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Opium has a complicated global history as a remarkably effective medicine and an instigator of moral panics. As historians Frank Dikötter, Lars Laamann, and Zhou Xun write, in China, this intersected with complex international and class politics.
Starting as early as the Tang period (618–907 CE), opium arrived in China by sea and caravan. Over centuries, it became a common medical treatment. But, the authors write, recreational smoking of opium only became a thing after Europeans introduced tobacco from the Americas to China in the late sixteenth century. Tobacco smoking and cultivation spread rapidly. Some doctors credited it with medicinal properties, including fighting malaria. Officials smoked and drank tea during meetings to stimulate their minds.
Like brewing and drinking tea, preparing and smoking opium involved a complex ritual.
Smoking opium, a far more expensive pastime that built on the smoking culture, was introduced to China by Dutch merchants in the seventeenth century. It became a luxury for the wealthy, usually smoked together with tobacco. But, by the nineteenth century, Chinese doctors were becoming concerned about the health risks of tobacco smoking, so people became more likely to smoke pure opium. Over these centuries, many people valued opium for its exotic association with Europe and as a status symbol perfect for social climbers. Like brewing and drinking tea, preparing and smoking opium involved a complex ritual. Wealthy families hired specialists to prepare pipes for their gatherings.
“By smoking opium, a high official or wealthy merchant took pleasure in displaying his privileged social position,” the authors write.
In the early nineteenth century, the drug became more accessible to ordinary people, who enjoyed it as part of social occasions either at home or at opium houses. But this popularization of the drug soon became a scapegoat for larger political and economic problems facing China. Dikötter, Laamann, and Xun argue that bans on opium smoking at this time “had little to do with its pharmacological effects. The imperial government was far more concerned with its social consequences among politically ‘dangerous’ groups.” By the time the first Opium War began in 1839, the government had connected opium with deviant behavior and foreign threats.
Nonetheless, people of all classes kept using opium. The second Opium War ended in 1860, with China forced to agree to an unequal trading arrangement with Europe including continued importation of opium. After that, opium prices declined and the market became increasingly segmented. Elites generally chose the expensive stuff, often imported from India. The middle class could get cheaper opium from Sichuan, and the poor were left with dross—essentially a waste product from boiling opium.
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The changes Europe forced on China’s economy also pushed many people to leave the declining rural areas for coastal cities. This led to the growth of opium houses that offered migrants cheap places to stay. Here, smoking provided relief from stress, boredom, and hunger.
Things changed again in the early twentieth century. The government stepped up efforts to suppress opium smoking, driving the drug’s price too high for many people. But opium smokers soon found alternatives in the form of new drugs from Europe: morphine and heroin.
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Narcotic Culture: A Social History of Drug Consumption in China
By: Frank Dikötter, Lars Laamann and Zhou Xun
The British Journal of Criminology, Vol. 42, No. 2 (Spring 2002), pp. 317–336
Oxford University Press
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CausesThe Opium Wars arose from China’s attempts to suppress the opium trade.Foreign traders (primarily British) had been illegally exporting opium mainly from India to China since the 18th century, but that trade grew dramatically from about 1820.Addiction to opium became widespread in China, causing serious social and economic disruption. In the Spring of 1839 the Chinese government confiscated and destroyed more than 20,000 chests of opium—some 1,400 tons of the drug—that were warehoused at Canton (Guangzhou) by British merchants.Later that year British warships destroyed a Chinese blockade of the Pearl River (Zhu Jiang) estuary at Hong Kong. The British soon decided to send an expeditionary force against Canton. Effects The more powerful British were easily victorious against the Chinese forces. The first Opium War was ended by the Treaty of Nanjing, which was signed on August 29, 1842.The treaty required China to pay an indemnity of $21 million, to cede Hong Kong to the British, and to increase the number of treaty ports where the British can trade and reside from one to five.The outbreak of the second war resulted in the treaties of Tianjin (1858), which required further Chinese concessions.When China later refused to ratify the treaties, Beijing was captured and the emperor’s summer palace burned.In 1860 the Chinese signed the Beijing Convention, by which they promised to observe the 1858 treaties.The Opium Wars greatly expanded Western influence in China.The wars also led to the weakening of the Chinese dynastic system and paved the way for uprisings such as the Taiping and Boxer rebellions.
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The Cultural Biography of Opium in China | The Oxford Handbook of Global Drug History | Oxford Academic
The Cultural Biography of Opium in China | The Oxford Handbook of Global Drug History | Oxford Academic
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The Oxford Handbook of Global Drug History
Paul Gootenberg (ed.)
https://doi.org/10.1093/oxfordhb/9780190842642.001.0001
Published:
2022
Online ISBN:
9780190842666
Print ISBN:
9780190842642
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Contents
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Front Matter
Copyright Page
Notes
Notes
Acknowledgments
Notes
Notes
List of Contributors
Notes
Notes
Introduction: A New Global History of Drugs
Notes
Notes
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Part I
Ancient Drug Worlds
1
Africa: The Forgotten Drug Continent
Notes
Notes
2
Psychoactive Drugs in European Prehistory
Notes
Notes
3
Plant Drugs and Shamanism in the Americas
Notes
Notes
4
Ancient American Civilizations, States, and Drugs
Notes
Notes
5
Soma and Drug History in Ancient Asia
Notes
Notes
Notes
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Part II
Precolonial to Colonial Drug Trades and Cultures
6
New Imperial Drug Trades, 1500–1800
Notes
Notes
7
Tobacco’s Cultural Shifts as an Early Atlantic Drug
Notes
Notes
8
Forbidden Drugs of the Colonial Americas
Notes
Notes
9
Drugs in Early South Asia
Notes
Notes
10
Drugs in Africa from the Slave Trade to Colonialism
Notes
Notes
Notes
Collapse
Part III
The Nineteenth-Century Transition to Dangerous Drugs
11
Dangerous Drugs From Habit to Addiction
Notes
Notes
12
Middle East Drug Cultures in the Long View
Notes
Notes
13
Colonialism, Consumption, ControlDrugs in Modern Asia
Notes
Notes
Collapse
14
The Cultural Biography of Opium in China
Transformation and Transmission
Transformation and Transmission
Taste and Social Distinction
Taste and Social Distinction
Extensification and “McDonaldization”
Extensification and “McDonaldization”
Institutionalized and Globalized
Institutionalized and Globalized
Conclusion
Conclusion
Notes
Notes
Notes
Bibliography
Bibliography
Notes
Notes
Notes
15
French Drug Control from Poisons to Degeneration
Notes
Notes
Notes
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Part IV
Modern Prohibitions and Its Drug Culture Aftermaths
16
The Creation and Impact of Global Drug Prohibition
Notes
Notes
17
Origins and Outcomes of the US Medicine-Drug Divide
Notes
Notes
18
Interwar Drug Scenes and Restrictive Regulation in Britain
Notes
Notes
19
The Making of Pariah Drugs in Latin America
Notes
Notes
20
Modern Russian and Soviet Drug Suppression
Notes
Notes
21
Germany’s Role in the Modern Global Drug Economy
Notes
Notes
22
Drugs, Nation, and Empire in Japan, 1890s–1950s
Notes
Notes
Notes
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Part V
Illicit Drugs Traffic and the Modern War on Drugs
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1.
The Global North: The United States and Europe
23
The Globalization of US Drug Enforcement
Notes
Notes
24
Illicit Drug Cultures in the Postwar United States
Notes
Notes
25
The Impact of the US Drug War on People of Color
Notes
Notes
26
The French Connection as an Illicit Trade Network
Notes
Notes
Notes
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2.
The Global South: Latin America, the Middle East, Asia, and Africa
27
Latin American and Caribbean Drug Trafficking Groups
Notes
Notes
28
Turkey and the Formation of the Global Heroin Trade
Notes
Notes
29
De-Orientalizing Drugs in the Modern Middle East
Notes
Notes
30
The Origins of Drug Trafficking Networks in China
Notes
Notes
31
The Post-1950s Rise of Illegal Opium in Asia
Notes
Notes
32
West Africa and the Global Illegal Drug Trade
Notes
Notes
Notes
Notes
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Part VI
Current Dilemmas with Global Illicit Drugs
33
Twenty-First Century Global Drug Trades and Consumption
Notes
Notes
34
Global Drug Debates in the Twenty-First Century
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Notes
35
DrugsThe Lessons from History?
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Chapter
14
The Cultural Biography of Opium in China
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Yangwen Zheng
Yangwen Zheng
History, University of Manchester
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Yangwen Zheng is Professor of Chinese History at the University of Manchester. She has written or edited nine books, including The Social Life of Opium in China (2005) and China on the Sea: How the Maritime World Shaped Modern China (2011).
https://doi.org/10.1093/oxfordhb/9780190842642.013.15
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Zheng, Yangwen, 'The Cultural Biography of Opium in China', in Paul Gootenberg (ed.), The Oxford Handbook of Global Drug History (2022; online edn, Oxford Academic, 18 Mar. 2022), https://doi.org/10.1093/oxfordhb/9780190842642.013.15, accessed 7 Mar. 2024.
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Abstract
Opium is central in the history of nineteenth- to early twentieth-century late imperial and modern China. Opium’s shift from herbal medicine into a larger narco-economy helped shape China’s foreign relations and economic life, affecting Chinese culture and the long struggle for modern China. This chapter puts together researched social history issues of who smoked opium, when, and why. By considering opium as a consumer item, historians “decriminalize” and depoliticize thinking about the drug and its consumption. Opium, during the eighteenth and nineteenth centuries, began to appeal to millions of consumers from different regions and backgrounds as they indigenized, integrated, enhanced, and reinvented opium smoking as something Chinese. The demand for drugs’ rising consumption drove its rising trade, foreign conflicts, prohibition, and modern state “opium regimes.” Drug consumer culture offers a window on how a commodity and its consumption impacted the course of Chinese history.
Keywords:
opium, opium regimes, traditional Chinese medicine (TCM), consumer culture, conspicuous consumption, commodities
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World History
History
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Opium Use and Cancer Risk: A Comprehensive Systematic Review and Meta-Analysis of Observational Studies - PMC
Opium Use and Cancer Risk: A Comprehensive Systematic Review and Meta-Analysis of Observational Studies - PMC
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Int J Clin Pract
v.2022; 2022
PMC9159125
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Int J Clin Pract. 2022; 2022: 5397449. Published online 2022 Feb 18. doi: 10.1155/2022/5397449PMCID: PMC9159125PMID: 35685572Opium Use and Cancer Risk: A Comprehensive Systematic Review and Meta-Analysis of Observational StudiesMasoume Mansouri,
1
Sina Naghshi,
2
,
3
Mahbobeh Parsaeian,
4
Sadaf G Sepanlou,
1
Hossein Poustchi,
1
Zahra Momayez Sanat,
1
Omid Sadeghi,
5
and Akram Pourshams
1
Masoume Mansouri
1Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Shariati Hospital, Tehran, IranFind articles by Masoume MansouriSina Naghshi
2Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
3Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, IranFind articles by Sina NaghshiMahbobeh Parsaeian
4Department of Biostatistics, Tehran University of Medical Sciences (TUMS), Tehran, IranFind articles by Mahbobeh ParsaeianSadaf G Sepanlou
1Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Shariati Hospital, Tehran, IranFind articles by Sadaf G SepanlouHossein Poustchi
1Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Shariati Hospital, Tehran, IranFind articles by Hossein PoustchiZahra Momayez Sanat
1Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Shariati Hospital, Tehran, IranFind articles by Zahra Momayez SanatOmid Sadeghi
5Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, IranFind articles by Omid SadeghiAkram Pourshams
1Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Shariati Hospital, Tehran, IranFind articles by Akram PourshamsAuthor information Article notes Copyright and License information PMC Disclaimer
1Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran
2Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
3Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
4Department of Biostatistics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
5Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, IranCorresponding author.Omid Sadeghi: moc.oohay@96ihgedasdimo Academic Editor: Manish GuptaReceived 2021 Oct 27; Accepted 2022 Jan 15.Copyright © 2022 Masoume Mansouri et al.This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Associated DataSupplementary MaterialsSupplementary Materials: Supplemental Figure 1: flowchart of study selection. Supplemental Table 1: terms used to search articles on the association between opium use and cancer risk. Supplemental Table 2: characteristics of included studies on the association between opium use and cancer risk in adults aged >18 years. Supplemental Table 3: characteristics of included studies on the association between duration of opium use and cancer risk in adults aged >18 years. Supplemental Table 4: characteristics of included studies on the association between routes of opium use and cancer risk in adults aged >18 years. Supplemental Table 5: characteristics of included studies on the association between types of opium use and cancer risk in adults aged >18 years.5397449.f1.docx (139K)GUID: 28611B8D-8328-4C8D-B1D6-B657D1655A65Data Availability StatementThe datasets generated and/or analyzed during this study are available from the corresponding author upon reasonable request.AbstractBackground Epidemiological studies have reported inconsistent associations between opium use and cancer risk. We therefore conducted a systematic review and meta-analysis to investigate the relationship between opium use and cancer risk. Methods We searched PubMed, Scopus, ISI Web of Knowledge, and Google Scholar until February 2021 and references of retrieved relevant articles for observational studies that reported the risk of cancer in relation to opium use. Random-effects models were used to calculate pooled effect sizes (ESs) as well as 95% confidence intervals (CIs) for the association between opium use and cancer risk by considering opium doses and types, duration of consumption, and routes of opium use. Results In total, 21 observational articles, with a total sample size of 64,412 individuals and 6,658 cases of cancer, were included in this systematic review and meta-analysis. Ever opium users, compared with never opium users, had 3.53 times greater risk of overall cancer (pooled ES: 3.53, 95% CI: 2.60–4.79, P ≤ 0.01). This positive association was also seen for some individual types of cancers except for esophageal and colon cancers. Also, we found that higher opium doses and higher duration of consumption were associated with an increased risk of overall and individual types of cancer. However, the associations between opium doses and the risk of head and neck and larynx cancers were not significant. In terms of the routes of opium use, both opium ingestion and smoking were positively associated with the risk of cancer. Regarding opium types, we found that using teriak, but not shireh, could increase the risk of cancer. Conclusions Our findings showed that opium use, particularly in the form of teriak, is a risk factor for cancer.1. IntroductionOpium, the raw extract of opium poppy, is an addictive substance that has been used for recreational or medical purposes [1]. It has been estimated that 16.5 million individuals around the world are addicted to different types of opiates; of them, 4 million people use raw opium [2, 3]. These people are mostly from Asia, while the prevalence of addiction to opium is low among western countries because of the criminalization of opium use and availability of other psychoactive drugs [2]. Opium may be prescribed for patients due to its analgesic, hypnotic, antitussive, and antidiarrheal effects [1, 4]. However, the health hazards of opium misuse have raised concerns about the long-term effects of opium use [5, 6].An older generation of physicians and researchers believed that a low-dose consumption of opium for a long time can increase longevity by reducing the risk of chronic diseases such as diabetes mellitus, cardiovascular diseases, and cancer [2, 7]. This belief might be explained by the analgesic effect of opium. Contrary to this belief, recent publications have shown a positive relationship between opium use and some of the mentioned chronic diseases [5, 6]. Among these diseases, cancer has received great attention [8–28]. It has been proposed that opium consumption produces carcinogenic compounds such as heterocyclic and polycyclic aromatic hydrocarbons, primary aromatic amines, and N-nitrosamines [29, 30]. Despite the proposed mechanisms, findings from prospective and retrospective studies are conflicting. Some studies have shown a positive association between opium use and some cancers such as bladder and lung cancers [18, 26, 27] and some others reported that the link between opium use and cancer risk is due to cigarette that is usually smoked along with opium [16, 23]. Nevertheless, there are reports on the null association between opium consumption and cancer risk [8, 10]. In addition, it is not clear whether opium types and doses, as well as the duration and routes of using opium (smoking or ingestion), are involved in the carcinogenic effects of opiates or not.Overall, there is a need for a comprehensive meta-analysis to reveal the above-mentioned uncertainties. A 2017 meta-analysis summarized available findings on the link between opium use and bladder cancer [31]; however, it was not comprehensive and did not take into consideration all types of cancers. Therefore, this comprehensive systematic review and meta-analysis of observational studies was conducted to summarize current evidence on the association between opium use and cancer risk by taking into account types, dosage, routes, and duration of opium use.2. MethodsThis systematic review and meta-analysis was conducted and reported according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines [32].2.1. Search StrategyWe performed a systematic search in the online databases of PubMed, Scopus, ISI Web of Science, and Google Scholar to find eligible papers which were published up to January 2021 and investigated the association between opium use and cancer risk. In the search strategy, appropriate keywords including MeSH (medical subject heading terms) and non-MeSH terms were used (Supplemental Table 1). We took into consideration no restrictions in terms of publication time or the language of papers. Furthermore, the reference lists of the included papers and recent reviews were reviewed to detect articles not found in the literature search.2.2. Inclusion CriteriaThe studies with the following criteria were included: (1) studies with prospective or retrospective (i.e., case-control) design; (2) those that were conducted on adults (≥18 years); (3) studies that evaluated opium use or different aspects of using opium (i.e., types, doses, routes, and duration of opium use) in relation to cancer risk, whether overall cancer or specific cancers; (4) articles that reported relative risk (RR), hazard ratio (HR), or odds ratio (OR) with 95% confidence intervals (CI) for the relation between opium use and cancer risk. If results from one study were published in >1 paper, we selected the most recent one; otherwise, the one with the greatest number of cases or with higher quality was included.2.3. Exclusion CriteriaIn the current meta-analysis, we did not include letters, comments, retracted articles, reviews, and ecological studies. Also, studies with insufficient data, those that were conducted on children and adolescences, studies with a cross-sectional design, and those with duplicate results were excluded.2.4. Data ExtractionRequired data for the systematic review and meta-analysis were extracted from each paper by two independent investigators. Any reported effect sizes (ESs) including ORs, RRs, or HRs along with 95% CIs for the relation between opium use and cancer risk were extracted to be used in the meta-analysis. For articles with several ESs for one association, the one that was adjusted for the most confounding variables was extracted. Moreover, additional information on the first author name, publication year, study design, sample size, number of cases, demographic characteristics of participants (age range or mean age, gender, and health condition), study location, duration of follow-up (for prospective studies), methods used to assess opium consumption or cancer, and confounding variables adjusted in the statistical analysis was extracted from each included article.2.5. Risk of Bias AssessmentThe quality of included studies was determined using the Newcastle-Ottawa Scale (NOS), designed for nonrandomized studies [33]. Based on this scale, an article can get a maximum of 9 scores given the following parameters: 4 scores for the selection of participants, 2 scores for comparability, and 3 scores for the assessment of outcomes. When a study received more than median scores, it was deemed to be of relatively high quality (or low risk of bias); otherwise, it was considered to be of low-quality (or high risk of bias) article.2.6. Statistical MethodsWe included the ORs, RRs, and HRs (and 95% CIs) reported for the association between opium use and cancer risk into the meta-analysis. These ESs were reported for cancer risk in relation to ever versus never use of opium, doses and duration of consumption (the highest versus lowest doses and duration), routes of opium (smoking or ingestion versus never use of opium), and types of opiates [raw opium (teriak) or refined opium (shireh) versus never use of opium]. To perform meta-analysis, we first calculated the natural log form (and its standard error) of the ESs (ORs, RRs, and HRs), and then we combined them using a random-effects model that takes between-study heterogeneity into account [34]. If a paper presented the ESs based on gender or any other variables, we first combined them using a fixed-effects model, and then we included the pooled ES in the meta-analysis. By the random-effects model, we calculated both Q-statistic and I2 values as the indicators of heterogeneity. I2 values >50% were considered to indicate significant between-study heterogeneity [35]. In the case of significant heterogeneity, we performed subgroup analyses based on predefined criteria including study design (prospective versus case-control studies), methods used for cancer ascertainment (histological or pathological methods versus medical records), quality of studies (high quality versus low quality), and statistical adjustments for tobacco use and dietary factors (adjusted versus not adjusted). Publication bias was determined using Egger's linear regression test [36]. In the case of substantial publication bias, the trim-and-fill method was used to detect the effect of probable missing studies on the overall ES [37]. To assess if the overall ES depended on one study, the sensitivity analysis was conducted using a random-effects model in which each study was excluded to determine the influence of that study on the overall estimate. Statistical analyses were conducted using STATA version 14.0. P < 0.05 was considered as statistically significant for all tests.3. Results3.1. Literature SearchBy searching relevant keywords in the online databases, we found 600 articles. We excluded duplicate papers and studies that did not meet the inclusion criteria and, finally, 30 full articles of potentially relevant studies remained for further assessment (Figure 1). Of the 30 papers, six reported no effect sizes for the relation between opium use and cancer risk and, therefore, were excluded [38–43]. Two articles were published on a case-control dataset [15, 44] and three other articles were published on the dataset of Golestan Cohort Study [27, 45, 46]. Since these articles assessed similar exposure and outcome variables, we included only the one with higher quality or with the most number of cases for each dataset [15, 27] and excluded the duplicate papers [44–46]. After the exclusions, 21 papers with full data were included in the present systematic review and meta-analysis [8–28].Open in a separate windowFigure 1Forest plot for the association between opium use and cancer risk in adults aged ≥18 years by comparing ever with never users of opium. ES: effect size.3.2. Characteristics of Included StudiesCharacteristics of studies included in the current systematic review and meta-analysis are shown in Supplemental Table 2. All papers were published between 2003 and 2020. Two articles had a prospective design [22, 27] and the rest of the papers were of case-control design. The number of participants in these studies ranged from 181 to 50,045 subjects aged 18 years and older. In total, 64,412 subjects with 6,658 cases of cancer were included in the 21 papers we assessed. In all studies, both males and females were recruited. In addition, all studies were conducted in the Middle East, Iran. Among the 21 articles, different types of cancers including gastrointestinal (GI) [10, 13, 16, 18, 20–25, 27, 28], bladder [8, 11, 12, 14, 26, 27], lung [15, 19, 27], head and neck [9, 16, 27], ovarian [27], prostate [27], cervical [27], and breast [27] cancers, as well as leukemia and lymphoma [27], were studied. In addition, among GI cancers, the risk of gastric [18, 22, 25, 27], esophageal [10, 21, 24, 27], oral and pharynx [16, 27], pancreatic [23, 27], liver [27], and colorectal cancers [13, 20, 27] was assessed. Cancer ascertainment was done using histological or pathological methods in fifteen articles [10–17, 21–25, 27, 28], while six articles used the information from medical records for this purpose [8, 9, 18–20, 26].In terms of exposure, opium use was evaluated using interview-based questionnaires in all studies. All articles except one [21] presented risk estimates for ever versus never consumers of opium, 11 papers considered duration of opium use as an exposure variable [8, 9, 13, 15, 16, 18–20, 23, 24, 27], and some publications assessed doses [8, 9, 13, 15, 16, 18–21, 23] and types [16, 21, 27] of opiates in relation to cancer risk. Furthermore, the routes of opium use were investigated with cancer risk in five papers [12, 15, 16, 21, 27]. In the most included publications, some important confounders including age (n = 20), tobacco use (n = 16), dietary factors (n = 9), and alcohol consumption (n = 6) were adjusted in the analysis. Based on the NOS tool and by considering the median score of 7 among the included studies, 17 papers were of high-quality studies and the remaining 5 articles were considered as low-quality publications (Supplemental Table 3).3.3. Findings from the Systematic ReviewOf 20 articles that compared ever with never consumers of opium, 17 publications revealed a positive association between opium use and cancer risk [8, 9, 11–15, 17–20, 22–26, 28], whereas 3 papers found evidence of a nonsignificant association [10, 16, 27]. In terms of opium doses, 7 papers revealed that high doses of opiates were associated with an increased risk of cancer [9, 13, 15, 18–21] and other articles showed a null association between opium doses and cancer risk [8, 16, 23]. Regarding the duration of opium use, seven papers indicated a positive association with cancer risk [8, 9, 13, 15, 18–20] and three articles did not find any significant association [16, 23, 24]. Also, in a cohort study [27], the authors concluded that the association between duration of opium use and cancer risk depended on cancer type: a positive association with non-GI cancers and a null association with overall risk of GI cancer. Two papers showed that the association between opium use and cancer did not depend on the routes of consumption (smoking versus ingestion) [12, 21]; however, three articles presented different results for opium smoking and ingestion [15, 16, 27]. Based on their findings, opium smoking was associated with an increased risk of lung, pharynx, gastric, esophageal, and laryngeal cancers, whereas opium ingestion was associated with a greater risk of liver and oral cancers. Three papers assessed the types of opiates (teriak and shireh) in relation to cancer risk; of them, two revealed different results for each type of opiates [16, 27] and one reported the same result for both types [21].3.4. Findings from the Meta-AnalysisAll studies included in the systematic review contained complete data needed for the meta-analysis. Meta-analysis findings are reported separately for each type of exposure.3.5. Ever versus Never Use of Opium and Risk of CancerCombining twenty ESs from 20 articles [8–20, 22–28] regarding overall cancer risk, we found a significant positive association between ever use of opium and overall cancer risk (pooled ES: 3.53, 95% CI: 2.60–4.79, P ≤ 0.01) (Figure 1). However, heterogeneity between studies was significant (I2 = 89.5%, P ≤ 0.01). We performed subgroup analyses to detect possible sources of heterogeneity (Table 1). Subgroup analyses based on methods used to assess cancer and statistical adjustments for dietary factors and tobacco use could explain the between-study heterogeneity. In all subgroups of studies, except prospective cohort studies, we found a significant positive relationship between ever opium use and overall cancer risk. Regarding different types of cancers, ever opium use was associated with an increased risk of GI (pooled ES: 2.49, 95% CI: 1.81–3.43, P ≤ 0.01), bladder (pooled ES: 3.85, 95% CI: 2.96–5.00, P ≤ 0.01), head and neck (pooled ES: 4.35, 95% CI: 2.61–7.26, P ≤ 0.01), lung (pooled ES: 5.00, 95% CI: 2.70–9.28, P ≤ 0.01), and larynx (pooled ES: 8.85, 95% CI: 6.16–12.74, P ≤ 0.01) cancers. For GI cancers, a similar finding was observed for oral, gastric, pancreas, and colorectal cancers, but the associations of ever opium use with esophageal and colon cancers were not significant. Data for other types of cancers were insufficient for performing the meta-analysis.Table 1Subgroup analyses for the association between opium use and cancer risk in adults aged ≥18 years. #ES1Pooled ES (95% CI)2
P
3
I
2 (%)4
P-heterogeneity5
Ever versus never use of opium and cancer
Overall203.53 (2.60–4.79)≤0.0189.5≤0.01 Subgroup analysis Study design Cohort Case-control21.86 (0.79–4.39)0.1575.30.04 Cancer type183.71 (2.93–4.70)≤0.0173.8≤0.01 GI122.49 (1.81–3.43)≤0.0177.5≤0.01 Bladder63.85 (2.96–5.00)≤0.0126.90.23 Lung35.00 (2.70–9.28)≤0.0166.20.05 Head and neck34.35 (2.61–7.26)≤0.0160.30.08 Larynx58.85 (6.16–12.74)≤0.0124.50.25 Oral31.81 (1.23–2.65)≤0.019.70.33 Pancreas22.14 (1.37–3.36)≤0.0100.55 Esophageal32.05 (0.93–4.55)0.0862.30.07 Colorectal24.49 (2.81–7.16)≤0.0100.99 Colon33.01 (0.89–10.11)0.0784.9≤0.01 Gastric42.38 (1.40–4.06)≤0.0174.0≤0.01 Cancer assessment Medical records64.27 (2.99–6.10)≤0.0133.80.18 Histological/pathological methods143.24 (2.24–4.69)≤0.0192.0≤0.01 Adjustment for tobacco use Yes163.32 (2.35–4.69)≤0.0191.0≤0.01 No44.40 (2.63–7.36)≤0.0157.40.07 Adjustment for dietary factors Yes94.35 (3.43–5.51)≤0.0100.62 No112.97 (1.96–4.50)≤0.0193.6≤0.01 Study quality High153.18 (2.27–4.45)≤0.0190.5≤0.01 Low55.03 (2.43–10.43)≤0.0179.5≤0.01
Highest versus lowest doses of opium use and cancer
Overall104.29 (2.15–8.54)≤0.0182.7≤0.01 Subgroup analyses Cancer type GI72.82 (1.31–6.05)≤0.0174.4≤0.01 Lung210.06 (3.84–26.35)≤0.0100.90 Head and neck22.79 (0.28–27.88)0.3895.9≤0.01 Larynx23.33 (0.25–44.05)0.3695.5≤0.01 Oral20.86 (0.35–2.10)0.7300.33 Colorectal27.40 (3.28–16.71)≤0.0100.81 Colon28.34 (3.54–19.63)≤0.0100.77 Cancer assessment Medical records58.15 (5.02–13.24)≤0.0100.40 Histological/pathological methods52.47 (1.09–5.58)0.0381.1≤0.01 Adjustment for tobacco use Yes73.80 (1.44–10.02)≤0.0183.4≤0.01 No35.66 (1.92–16.63)≤0.0181.9≤0.01 Adjustment for dietary factors Yes67.94 (5.03–12.51)≤0.0100.53 No42.04 (0.86–4.85)0.1082.6≤0.01 Study quality High93.87 (1.91–7.88)≤0.0180.9≤0.01 Low19.22 (4.19–20.28)≤0.01——
Duration of opium use and cancer risk
Overall113.74 (2.41–5.82)≤0.0175.8≤0.01 Subgroup analysis Study design Cohort Case-control11.81 (1.27–2.57)≤0.01—— Cancer type104.23 (2.55–7.02)≤0.0174.8≤0.01 GI82.86 (1.69–4.83)≤0.0171.8≤0.01 Lung33.95 (2.37–6.60)≤0.0100.77 Head and neck25.50 (1.09–27.72)0.0489.9≤0.01 Larynx25.77 (1.19–28.11)0.0387.4≤0.01 Oral22.03 (0.87–4.75)0.1000.91 Colorectal26.99 (3.68–13.28)≤0.0100.61 Colon28.24 (3.50–19.38)≤0.0100.80 Cancer assessment Medical records59.26 (5.60–15.29)≤0.0100.81 Histological/pathological methods62.25 (1.62–3.11)≤0.0152.30.06 Adjustment for tobacco use Yes93.19 (2.05–4.97)≤0.0170.2≤0.01 No26.47 (1.74–24.03)≤0.0182.20.01 Adjustment for dietary factors Yes68.34 (5.37–13.08)≤0.0100.81 No52.02 (1.54–2.64)≤0.0131.10.21 Study quality High103.18 (2.13–4.74)≤0.0168.1≤0.01 Low113.16 (5.32–32.54)≤0.01——
Opium smoking versus never use
Overall52.43 (1.46–4.04)≤0.0192.2≤0.01 Cancer type GI41.47 (1.07–2.02)0.0152.10.10 Bladder23.55 (2.59–4.86)≤0.0100.36 Lung23.00 (1.12–7.98)0.0270.70.06 Head and neck21.45 (0.40–5.35)0.5788.4≤0.01 Larynx23.66 (2.24–5.97)≤0.0134.60.21 Oral31.71 (0.88–3.32)0.1158.00.09
Opium ingestion versus never use and cancer
Overall52.66 (1.40–5.07)≤0.0192.5≤0.01 Cancer type GI41.82 (1.15–2.89)0.0147.40.12 Bladder24.02 (2.96–5.47)≤0.0100.75 Lung22.00 (1.05–3.83)0.0354.00.14 Head and neck24.29 (1.11–16.62)0.0386.8≤0.01 Larynx26.82 (1.05–44.17)0.0489.6≤0.01 Oral32.59 (0.92–7.29)0.0720.70.28
Teriak use versus never use and cancer
Overall31.98 (1.08–3.62)0.0394.8≤0.01 Cancer type GI31.98 (1.08–3.62)0.0394.8≤0.01 Head and neck22.08 (0.73–5.89)0.1689.4≤0.01 Larynx23.97 (1.69–9.36)≤0.0176.40.04
Shireh use versus never use and cancer
Overall33.03 (0.82–11.14)0.1094.6≤0.01 Cancer type GI33.03 (0.82–11.14)0.1094.6≤0.01 Larynx27.54 (2.13–26.63)≤0.0169.70.07Open in a separate windowGI: gastrointestinal, ES: effect size; 1number of effect sizes; 2obtained from the random-effects model; 3overall effect sizes, and 4inconsistency, the percentage of variation across studies due to heterogeneity; 5obtained from the Q-test.3.6. Opium Doses and Cancer RiskThere were ten papers with ten ESs in this regard [8, 9, 13, 15, 16, 18–21, 23]. Combining these ESs, comparing the highest with lowest doses of opium use, a significant positive association was found with overall cancer risk (pooled ES: 4.29, 95% CI: 2.15–8.54, P ≤ 0.01) with a significant between-study heterogeneity (I2 = 82.7%, P ≤ 0.01) (Figure 2). Findings from the subgroup analyses (Table 1) showed that this heterogeneity might be due to differences of included studies in terms of methods used for cancer ascertainment and controlling for dietary factors in their analysis. In addition, the positive association between opium doses and overall cancer risk was significant in all subgroups of studies except those studies that did not control for dietary factors in their analysis. When the analyses were confined to individual types of cancers, we found that higher doses of opium use were associated with greater risk of GI (pooled ES: 2.82, 95% CI: 1.31–6.05, P ≤ 0.01), lung, colorectal, and colon cancers; however, this relationship became nonsignificant for head and neck and larynx cancers. It should be noted that, except for GI cancers that had six studies, other mentioned cancers were analyzed with only two studies.Open in a separate windowFigure 2Forest plot for the association between opium dose and cancer risk in adults aged ≥18 years by comparing the highest with lowest consumption of opium. ES: effect size.3.7. Duration of Opium Use and Cancer RiskConsidering 11 ESs from 11 papers [8, 9, 13, 15, 16, 18–20, 23, 24, 27], comparing the highest versus the lowest duration of opium use, we found that higher duration of opium use was associated with 3.74 times greater risk of overall cancer (95% CI: 2.41–5.82, P ≤ 0.01) (Figure 3). There was evidence of a significant between-study heterogeneity in this association (I2 = 75.8%, P ≤ 0.01). In the subgroup analyses, categorizing studies based on methods used for cancer assessment and statistical adjustments for dietary factors could decrease the observed heterogeneity (Table 1). In all subgroups of studies, the positive association between the duration of opium use and overall risk of cancer remained significant. In terms of cancer types, when combining seven studies for GI cancers [13, 16, 18, 20, 23, 24, 27] and three studies for lung cancer [15, 19, 27], a significant positive association was seen with the duration of opium use (GI cancers, pooled ES: 2.86, 95% CI: 1.69–4.83, P ≤ 0.01; lung cancer, pooled ES: 3.95, 95% CI: 2.37–6.60, P ≤ 0.01). Also, meta-analysis of two studies for each of head and neck [9, 16], larynx [9, 16], colorectal [13, 20], and colon [13, 20] cancers revealed such a positive relationship.Open in a separate windowFigure 3Forest plot for the association between duration of opium use and cancer risk in adults aged ≥18 years by comparing the longest with shortest duration of opium use. ES: effect size.3.8. Routes of Opium Use and Cancer RiskIn total, five articles assessed the routes of opium use (smoking and ingestion) in relation to overall cancer risk [12, 15, 16, 21, 27]. Combining five ESs from these studies, comparing opium ingestion or smoking with never use of opium, indicated that both routes of opium use were associated with an increased risk of overall cancer (opium smoking, pooled ES: 2.43, 95% CI: 1.46–4.04, P ≤ 0.01; opium ingestion, pooled ES: 2.66, 95% CI: 1.40–5.07, P ≤ 0.01) (Figure 4). Although between-study heterogeneity was significant in these associations (I2 > 90%, P ≤ 0.01), a limited number of studies did not allow us to find sources of heterogeneity using subgroup analysis. For different types of cancers, combining three studies for GI cancers [16, 21, 27] and two studies for bladder [12, 27], head and neck [16, 27], lung [15, 27], larynx [16, 27], and oral [16, 27] cancers showed a pooled ES of 1.47 (95% CI: 1.07–2.02, P = 0.01), 3.55 (95% CI: 2.59–4.86, P ≤ 0.01), 1.45 (95% CI: 0.40–5.35, P = 0.57), 3.00 (95% CI: 1.12–7.98, P = 0.03), 3.66 (95% CI: 2.24–5.97, P ≤ 0.01), and 1.71 (95% CI: 0.88–3.32, P = 0.11) for these cancers, respectively, when comparing opium smokers versus never opium users (Table 1). The same studies as mentioned for opium smoking presented ESs for comparing opium ingestion with never use of opium. Combining these ESs indicated that opium ingestion was associated with an increased risk of GI (pooled ES: 1.82, 95% CI: 1.15–2.89, P = 0.01), bladder (pooled ES: 4.02, 95% CI: 2.96–5.47, P ≤ 0.01), head and neck (pooled ES: 4.29, 95% CI: 1.11–16.62, P = 0.03), lung (pooled ES: 2.00, 95% CI: 1.05–3.83, P = 0.04), and larynx (pooled ES: 6.82, 95% CI: 1.05–44.17, P = 0.04) cancers. Such finding was not seen for oral cancer (Table 1).Open in a separate windowFigure 4Forest plot for the association between routes of opium use and cancer risk in adults aged ≥18 years by comparing opium smoking or ingestion with never use of opium. ES: effect size.3.9. Opium Types and Cancer RiskIn the present meta-analysis, we assessed the use of teriak as a raw opium and shireh as a refined opium in relation to cancer risk. Data on the other types of opiates were insufficient for doing a meta-analysis. In total, three papers provided data on the link between opium type and overall cancer risk [16, 21, 27]. Combining ESs from these papers revealed that using teriak, but not shireh, was associated with an increased risk of overall cancer compared with never use of opium (pooled ES: 1.98, 95% CI: 1.08–3.62, P = 0.03) (Figure 5). There was evidence of a significant heterogeneity between studies for both associations (I2 > 90%, P ≤ 0.01). Unfortunately, due to the limited number of published papers, subgroup analyses in these associations were not possible. Regarding specific types of cancer, we had three papers for GI cancers [16, 21, 27] and two articles for larynx cancer [16, 27] in relation to teriak or shireh use. In addition, two papers had ESs of association between teriak use and the risk of head and neck cancers [16, 27]. Combining ESs from these papers, we found that teriak users, compared with never opium users, had an increased risk of GI (pooled ES: 1.98, 95% CI: 1.08–3.62, P = 0.03) and larynx (pooled ES: 3.97, 95% CI: 1.69–9.36, P ≤ 0.01) cancers and also shireh users had an increased risk of larynx cancer compared with never opium users (pooled ES: 7.54, 95% CI: 2.13–26.63, P ≤ 0.01) (Table 1). No significant association was seen between shireh use and the risk of cancer (Figure 5).Open in a separate windowFigure 5Forest plot for the association between routes of opium use and cancer risk in adults aged ≥18 years by comparing teriak and shireh use with never use of opium. ES: effect size.3.10. Publication Bias and Sensitivity AnalysisFor all associations assessed in the current meta-analysis, no publication bias was found based on Egger's linear regression test. However, the Egger test revealed a possible publication bias for the association between duration of opium use and overall cancer risk. By using the application of the trim-and-fill method, the pooled ES for this association remained significant. Therefore, our results were not affected by publication bias. Sensitivity analysis showed that, after the exclusion of Nasrollahzadeh et al.'s study [21] from the analysis, the significant positive association between teriak use and overall cancer risk became nonsignificant (pooled ES: 2.16, 95% CI: 0.91–5.16, P = 0.08). In addition, excluding the study of Sheikh et al. [27] from the analysis of shireh use and overall cancer risk caused that the nonsignificant association became significant (pooled ES: 5.51, 95% CI: 2.75–11.06, P ≤ 0.01). For other associations, the pooled ESs did not depend on one study.4. DiscussionIn this study, we found the significant positive relationships between ever opium use and the risk of overall and individual types of cancers except for esophageal and colon cancers. In addition, the duration of consumption and opium doses were associated with an increased risk of overall cancer risk and the risk of different cancer types. However, the associations between opium doses and the risk of head and neck and larynx cancers were not significant. Also, we found that both opium ingestion and smoking were positively associated with overall cancer risk. In terms of routes of opium types, teriak use, but not shireh, was associated with an increased risk of overall and GI cancers.The relationship between opium use and cancer risk has long been a research interest for researchers. Several observational studies have examined this association; however, findings from these studies are conflicting. In this meta-analysis, we found a positive association between opium use and the risk of overall and individual types of cancers. Such findings were also seen for opium doses and the duration of opium use. In line with our findings, a meta-analysis of opium use and bladder cancer risk in 2017 revealed a significant positive relationship [31]. Moreover, in a systematic review, Kamangar et al. concluded that opium use is an independent risk factor for esophagus, gastric, larynx, lung, and urinary bladder cancers [2]. Given the lack of significant association between ever opium use and esophagus cancer risk in this meta-analysis, our findings in this regard are in contrast to those reported from Kamangar et al.'s study. This inconsistency can be explained by the design and publication data of Kamangar's et al. study in which no meta-analysis was performed on the association between opium use and esophagus cancer risk. Also, since the publication of that review, two studies on the link between opium use and esophagus cancer risk were published [10, 11]. However, it must be kept in mind that the lack of significant association between opium use and esophagus cancer risk in the current meta-analysis may be due to the different quality of studies included in the association. Of three studies that assessed this association, only one with a low quality (quality score 5 of 9) and a low sample size reported no significant association [10], while two other studies with higher quality and a greater number of participants showed a significant positive association in this regard [11, 24]. Further studies are needed to reveal facts on the association.In the current study, there was no difference between opium smoking and ingestion in relation to the risk of overall and individual types of cancers except for head and neck cancers. Opium ingestion, but not opium smoking, was associated with an increased risk of head and neck cancers. Although there were only two studies on the meta-analysis of opium routes and head and neck cancers [16, 27], the different findings on these routes might be due to the different substances produced through opium ingestion and smoking. Opium ingestion can expose consumers to a high amount of morphine and other alkaloids which all potentially affect the brain and nervous system [29]. However, smoking opium can also increase the levels of carcinogenic agents such as heterocyclic and polycyclic aromatic hydrocarbons and aromatic amines in different organs [47, 48].Regarding opium types, we found that consuming teriak, but not shireh, was associated with a greater risk of overall and GI cancers. These differences might be explained by different processes used in teriak production compared with producing shireh [48]. Teriak is the air-dried extract of the opium poppy plant that is obtained from the ripened capsules of this plant. In contrast, shireh is produced with three additional processes compared to teriak which include boiling teriak of raw opium in water, filtering the mixture several times, and evaporating the filtrate [27, 48]. These additional processes may affect the compounds of opium and, therefore, alter the health effects of opium in the form of shireh.Some mechanisms by which opium use increases the risk of cancer are suggested. It has been shown that opium pyrolysis during opium smoking produces multiple carcinogenic compounds including heterocyclic and polycyclic aromatic hydrocarbons, primary aromatic amines, and N-nitrosamines, which all can absorb through the respiratory system and induce their carcinogenic effects in different organs [29, 30, 49]. Also, some compounds produced through opium ingestion or smoking such as alkaloids may have genotoxic and mutagenic properties [29, 50]. Moreover, it has been proposed that opium plays a role in cancer promotion [51]. Some compounds produced during opium use can stimulate angiogenesis and neovascularization in tumors and also may activate cancer cell proliferation and migration [51]. Opium can also increase the effects of nonopium carcinogens through modifying the pharmacokinetics of these carcinogens, increasing their bioavailability, impairing the physiological function of target organs, and finally prolonging their exposure to the potential carcinogens [52].This study is the first systematic review and meta-analysis that comprehensively assessed current evidence on the association between opium use and cancer risk. Also, different aspects of opium use including opium doses, duration of consumption, opium types, and routes of opium use were assessed in the current meta-analysis. Our findings also need to be interpreted by considering several limitations. First, since the studies included in the current meta-analysis were observational, mostly with a case-control design, causality cannot be established. Second, the effects of residual confounders including unmeasured behavioral and biological factors can affect the findings obtained in the current meta-analysis. Third, errors in the measurement of opium use and covariates cannot be entirely excluded owing to the observational design of included studies. Misclassification due to the measurement errors could result in an underestimation of the association between opium use and cancer risk. Fourth, there was evidence of considerable heterogeneity among included studies which might be explained by variations in the methods used for cancer ascertainment and variables adjusted in the statistical analysis. Finally, some included articles were of low-quality studies; however, we performed subgroup analysis based on the quality of studies to show the findings of high-quality studies separately.In conclusion, we found that opium use was positively associated with the risk of overall and some individual types of cancers. Opium doses and duration of consumption were also involved in these associations such that higher doses and longer duration of opium use were associated with an increased risk of cancer. However, the associations between opium use and esophageal and colon cancers as well as the associations between opium doses and the risk of head and neck and larynx cancers were not significant. Since a limited number of studies were included in these associations, further studies are needed to confirm our findings for these types of cancers. Both routes of opium ingestion and smoking were associated with a greater risk of cancer. Regarding opium types, we found that using teriak, but not shireh, could increase the risk of cancer. Given the recent increase in using opium derivatives, further global proceedings to reduce the misuse and prevent hazardous long-term effects of opiates are urgently required.Data AvailabilityThe datasets generated and/or analyzed during this study are available from the corresponding author upon reasonable request.Additional PointsWhat is already known about this topic?Opium is an addictive substance that has been used for recreational or medical purposes. It has been estimated that 16.5 million individuals around the world are addicted to different types of opiates; of them, 4 million people use raw opium.What does this article add?Higher opium doses and longer duration of consumption were associated with an increased risk of overall and individual types of cancer. Among opium types, teriak, but not shireh, could increase the risk of cancer.Conflicts of InterestThe authors declare no personal or financial conflicts of interest.Authors' ContributionsOS and SN contributed to the literature search, data extraction, and statistical analysis. OS and MM drafted the manuscript which was critically revised for important intellectual content by all authors. SGS and HP contributed to manuscript drafting. AP contributed to manuscript editing. All authors have read and approved the final manuscript.Supplementary MaterialsSupplementary MaterialsSupplemental Figure 1: flowchart of study selection. Supplemental Table 1: terms used to search articles on the association between opium use and cancer risk. Supplemental Table 2: characteristics of included studies on the association between opium use and cancer risk in adults aged >18 years. Supplemental Table 3: characteristics of included studies on the association between duration of opium use and cancer risk in adults aged >18 years. Supplemental Table 4: characteristics of included studies on the association between routes of opium use and cancer risk in adults aged >18 years. Supplemental Table 5: characteristics of included studies on the association between types of opium use and cancer risk in adults aged >18 years.Click here for additional data file.(139K, docx)References1. Heydari M., Hashempur M. H., Zargaran A. Medicinal aspects of opium as described in Avicenna’s Canon of Medicine.
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Chemistry and synthesis of major opium alkaloids: a comprehensive review | Journal of the Iranian Chemical Society
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Journal of the Iranian Chemical Society
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Chemistry and synthesis of major opium alkaloids: a comprehensive review
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Published: 20 May 2021
Volume 18, pages 3177–3218, (2021)
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B. Kaboudin
ORCID: orcid.org/0000-0003-0495-00061 & M. Sohrabi1
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AbstractAmong analgesic drugs, the opioid class of compounds still remains one of the most important medicines for severe and chronic pain treatment. Hence, developing novel and effective synthetic method of morphine and its related compounds is still an important task in modern synthetic organic chemistry. Achieving this goal demands a comprehensive knowledge of these valuable alkaloids. The present review study aims to summarize the history of five major opioid alkaloids and their pharmacologic effects, as well as various synthetic and biosynthetic methods.
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Download referencesAuthor informationAuthors and AffiliationsDepartment of Chemistry, Institute for Advanced Studies in Basic Sciences (IASBS), Gava Zang, 45137-66731, Zanjan, IranB. Kaboudin & M. SohrabiAuthorsB. KaboudinView author publicationsYou can also search for this author in
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B. Kaboudin.Rights and permissionsReprints and permissionsAbout this articleCite this articleKaboudin, B., Sohrabi, M. Chemistry and synthesis of major opium alkaloids: a comprehensive review.
J IRAN CHEM SOC 18, 3177–3218 (2021). https://doi.org/10.1007/s13738-021-02268-yDownload citationReceived: 13 December 2020Accepted: 02 May 2021Published: 20 May 2021Issue Date: December 2021DOI: https://doi.org/10.1007/s13738-021-02268-yShare this articleAnyone you share the following link with will be able to read this content:Get shareable linkSorry, a shareable link is not currently available for this article.Copy to clipboard
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KeywordsOpium alkaloidsMorphineCodeineThebainePapaverineNoscapine
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