Opium - an Unusual Cause of Lead Poisoning: A Case Series

Background Lead is a widely distributed metal in the environment and can be toxic to the human body. Lead poisoning has different clinical features. Recently, there have been increasing reports about lead poisoning following oral opium use. We report on a series of patients presented with abdominal pain attributable to lead-contaminated opium. Materials and Methods We recruited all patients presented with abdominal pain and opium addiction, referring to the emergency room of a university-affiliated hospital. Demographic, clinical, and laboratory data, as well as abdominal imaging and blood lead level, were collected for all patients. Results Of 208 patients enrolled, 183 were male (88%), and the mean age was 51.2±14.1 years.  They all had a minimum of one-year history of oral opium consumption. 112 (53.8%) patients had a blood lead level of more than 20 μg/dL, and 22 patients (10.5%) had a blood lead level of more than 100 μg/dL. Half of the patients had a history of several hospital admissions for abdominal pain. Among patients with a lead level of more than 20 μg/dL, 87 (78%) had anemia with a hemoglobin level of less than 13 g/dL (mean hemoglobin 11.1 ± 2.5 g/dL). Conclusion Our case series highlights the role of opium administration as a possible emerging cause of acute abdominal pain of unknown cause.