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EN
Objectives The aim of this study, conducted at the Military Institute of Hygiene and Epidemiology in Warsaw in 2017, was to evaluate the effects of a single (15 min) and repeated (5 times for 15 min) radio-frequency radiation (RFR) exposure of 1800 MHz frequency on the analgesic efficacy of morphine in healthy rats and rats with complete Freund’s adjuvant (CFA) induced inflammation. Material and Methods Rats were injected intraperitoneally with morphine (MF) in the dose of 8 mg/kg or drug vehicle 15 min before RFR exposure. The authors used the plantar analgesia meter and the radiant heat paw-withdrawal test to assess the pain threshold. Results A single RFR exposure slightly influenced paw withdrawal latency (PWL) in healthy rats in the single exposure baseline group, and influenced PWL, 30 and 60 min after morphine or vehicle injection, in the repeated exposure group. There were differences between the sham-exposed groups (vehicle), 30, 60 and 90 min after injection, both in the single and repeated RFR-exposure groups. The antinociceptive effect of morphine in healthy rats was slightly decreased by RFR exposure at 60 and 90 min, both in the single and repeated exposure groups. The PWL was slightly decreased, both in the single and repeated exposure groups with inflammation (CFA and CFA/MF), at 30, 60 and 90 min, and PWL was increased in the sham-exposed groups (CFA and CFA/MF), both in the single and repeated exposure groups, at 30, 60 and 90 min. The antinociceptive effect of morphine in healthy rats was significantly increased by RFR exposure at 30 min after drug injection in the single exposure group, and increased at 30 and 60 min in the repeated exposure group. Conclusions The authors observed a minor influence of RFR exposure on the antinociceptive effects of morphine in healthy rats after repeated exposures and a statistically significant influence of repeated exposure on morphine mediated antinociceptive effects in the inflammation group. Int J Occup Med Environ Health. 2019;32(4):465–74
EN
Morphine is an opiate alkaloid characterized by various clinical effects, among which the most prominent are its analgesic and psychoactive effects. It also has a prominent depressive effect on the respiratory and cardiovascular system. Because of its psychoactive effect, morphine is very addictive and often used as a recreational narcotic. As a medication, it has found its use as an analgesic agent in chronic pain treatment, in hemorrhagic shock, and in acute heart failure with pulmonary edema. Albeit, morphine use in heart failure is controversial, based on many observational studies showing the negative effect on the outcomes of the patients treated with morphine during acute cardiovascular incidents. In this report, the authors present a case of cardiogenic shock (CS) with transient left ventricular ejection fraction reduction, occurring in a patient attempting suicide using a high dose of intravenous morphine sulphate administration. Other CS causes were ruled out. To the best of the authors’ knowledge, this is the second case of a morphine-related CS reported in literature.
EN
The phenomenon of drug addiction has been known in Poland for at least several dozen years. In the period of the second Republic, it was not a major social problem. In 1933, the total of 295 addicts were hospitalized in Poland. According to pre-war researchers, the number of drug addicts could be estimated at over 5 thousand persons in the early 1930s. The pre-war addicts took first of all classic drugs: morphine, heroin, and cocaine. Also codeine, Somniphrene and Pantopon were rather frequently taken. Less frequent was the use of hashish, mescaline and peyotl. Headache wafers played the part of substitutes.             According to the data of the health service and the Warsaw public prosecutor's office, about three – fourth of drug addicts were men. Most addicts were in their thirties; hardly any could be found among the youth, as far as morphinism is concerned in particular. This type of addiction could be found nearly exclusively among persons aged over 30. The situation shaped ,somewhat differently as regards codeine addicts: also younger persons. could be found in this group. In the socio professional structure of addicts included in the files of the Warsaw public prosecutor's office, clerks prevailed; their percentage amounting to 30. The second most numerous group were craftsmen and tradesmen-,13 per cent, and the third on -representatives of medical professions (chemists, doctors, surgeon, assistants, nurses, midwifes) of whom there were 9 per cent. The percentage of workers was 2, of prostitutes-5, and artists-4. In the opinion of the most of the pre-war researchers, the above socio-professional structure is distorted. According to them, drug-addiction was much more widespread among officers (of the air force and navy in particular), artists, writers and journalists. As regards religion, pre-war addicts constituted as varied a mosaic as the entire society in those days. There were among them representatives of all of the most numerous religious groups then found in Poland. Roman Catholics were most, and members of the orthodox church-least :susceptible to drug addiction. The pre-war researchers of drug addiction devoted a lot of attention to the problem of etiology of this ,,social disease'' Some of them stressed above all the medical-others-the economic and political, and still others - the cultural or those related to civilization causes. There were also conceptions that laid particular emphasis on physiology and biochemistry of the human body.              The evolution of drug addiction in the post-war forty years may be divided into four stages.             The first of them lasted till about mid-1960s. The extent of the phenomenon was then limited, with the average of about 400 persons treated in out-patient clinics, and about 150 -in psychiatric hospitals. Also the police statistics point to small sizes of this phenomenon. In 1967, as few as 9 offences directly related to drug addiction were recorded in Poland. Drug addicts of those days descended from rather specific circles. They were mostly representatives of medical professions, that is persons with a relatively easy access to drugs. Over 90 per cent of all morphine addicts were employees of the health service. Drugs taken most frequently were the classical ones;(morphine, cocaine), tranquilizers (Glimid, Tardyl) and stimulants (amphetamines). In thest period, one could hardly speak of drug addiction as a subcultural phenomenon. It was mainly a medical problem. The majority of the drug taking persons were those already dependent. The addicts of those days formed no close groups sharing a given ideology, specific symbols or language. The taking of narcotic drugs was not a social but an individual behaviour in most cases.             The second stage are the late 1960s and the early 1970s. In that period, a rapid growth in the extent of drug addiction can be noticed. In the years 1969-1973, the number of patients treated because of drug addiction in out-patient psychiatric clinics was quintupled, and in psychiatric hospitals, tripled. In 1972, there were about 3,150 patients treated in psychiatric clinics, and about 600 in psychiatric hospitals.             Also the number of offences directly related to drug addiction grew rapidly. While in 1967 there was not a single instance of unauthorized giving of narcotic drug (art. 161 of the Penal Code) or of forging prescriptions (art. 265 § 1 of the Penal Code), 105 and 417 such acts respectively were recorded five years later. In 1971, over 3,000 persons "taking narcotic drugs" were registered in the police files. As found in a sociological study carried out in 1972 among students of all grammar, vocational and elementary vocational schools in Gdańsk, Sopot and Gdynia, 8.3 per cent of the respondents had contacts with narcotic drugs. In the case of about 45 per cent of this group, these contacts were occasional. According to the authors of the study, this percentage is the "minimum frequency of occurence" of drug taking "in the population of school youth in Gdansk, Gdynia and Sopot.'' In this early 1970s, the number of persons in danger of becoming addicts (i.e. those who took drugs regularly) and those already dependent was estimated at about 30 thousand.             In the discussed period, also the character of addiction underwent changes: it became a subcultural phenomenon. The base on which it developed were the youth contestation movements which emerged in Poland as well. Addiction was given a cultural dimension by the ideology of the hippie movement. Taking drugs ceased to be an individual behaviour and became a social one which expressed certain attitudes and symbolized the affiliation to a given subculture. The young who took drugs formed smaller or bigger groups with strong internal bonds and a great sense of solidarity. They used specific symbols (way of dressing, recognition signals, rich repertoire of gestures, aliases, etc.) and quite a rich language (characteristic names of drugs and activities related to their taking). The very taking of drugs was acompanied by more or less developed rituals (narcotic coctails, seances, etc.).             In that period - and later on as well -the phenomenon of drug addiction was concentrated among the youth and in highly urbanized and industrialized regions. In 1972, nearly 75 per cent of persons hospitalized for the first time were those aged under 25, and over 60 per cent-under 29. In 1970, over 90 per cent of addicts treated in hospitals lived in towns. The limited drug marked. caused the youth to resort to substitutes on the unpracedented scale. In those years, general use of such substances as trichloroethylene, Ixi (washing powder), Butaprene (glus), ether, benzene, solvents and others started. Yet the major typ of addiction still remaind that to opium and its derivates, particularly in men, and to sleeping-draught and tranquilizers in women.             The third stage in the evolution of drug addiction are the years 1973-1976. In that period, a nearly 27 per cent decrease in the total of patients of psychiatric clinics, and a 40 per cent one in the case of those treated for the first time could be noticed. The morbidity index went down from 3.5 to 2.0. A similar trend, though less dynamic one, concerned also hospital service. In an attempt at explaining this phenomenon, three factors should be mentioned. Firstly, the early 1970s are the period when youth movements started to die out. Also a relative social peace reigned in those years, which caused drug addiction lose its socio-cultural base. Secondly, the medical authorities introduced a number of limitations in the accessibility of drugs in that period. Thirdly, repressive action of the police also influenced this tendency to a high degree. The prosecution agencies not only increased their efficiency greatly, but also acquired a much better knowledge of the addicts circles. These actions however proved insufficient to fully control addiction.             The fourth stage in the evolution of addiction started in the late 1970s. In the years 1977-1984, the number of patients treated in out-patient clinics increased twice over, and that of hospitalized persons - five times over. The indicates of dissemination and morbidity grew rapidly. Beginning from mid-1970s, the number of persons registered in the police files grew nearly two and a half times over. Also the number of deaths due to over dosage went up from year to year. In 1978, 18 such cases were recorded, with the number amounting to as many as 117 in 1986. The number of offences directly related to drug addiction went up from 1,093 in 1978 to 3,014 in 1983. The number of persons taking narcotic drugs was estimated at about 500-800 thousand in 1983; that of persons in danger of becoming addicts - at 99-95 thousand, and of actual addicts - about 40 thousand. Such is the minimum spread of the discussed phenomenon.             The unprecedented dissemination of drug addiction may be attributed to the emergence of two factors of which one is technological, and the other one psycho-social. In mid-1970s, the technology of production of a strong drug from poppy was worked out in Poland, which resulted in a great amount of strong narcotics appearing on the market. on the other hand, crisis started to accumulate in Poland in mid-1970s, which resulted in a growing frustration among the youth. The concurrence of these two factors brought about the explosion of drug addiction.
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