<b>urine metal levels in </b><b>substance </b><b>abusers</b>

Increasing illicit drug use is one of the main problems in most countries or societies. The monitoring of heavy metals and trace elements in this vulnerable group seems to be necessary. So, we assessed the urinary trace element and toxic metals/metalloids concentrations (Zinc (Zn), Iron (Fe), Cupper (Cu), Chromium (Cr), Lead (Pb), Cadmium (Cd), Arsenic (As), Nickel (Ni), and Mercury (Hg)) in opium, tramadol, and cannabis users compared to healthy subjects. In this cross-sectional study patients with substance use disorder (SUD) (n= 74) were divided into four groups: cannabis, tramadol, opium, and mixed (Simultaneous use of more than one of three studied substances), along with a healthy group (n= 60). Urine samples were prepared by dispersive liquid-liquid microextraction method so that heavy metals/metalloids can be measured by ICP-MS. The mean urinary concentration of Cu (48.15 vs. 25.45; 89.2%, p&lt; 0.001), Hg (1.3 vs. 0.10; 1200%, p&lt; 0.001), and Zn (301.95 vs. 210; 43.8%, p &lt; 0.001) were markedly lower among patients with SUD. The mean urinary concentration of other elements including As (1.9 vs. 4.1; 115.8%), Cd (0.1 vs. 1.10; 1000%), Cr (6.80 vs. 11.65; 71.3%), Ni (2.95 vs. 4.95; 67.8%), and Pb (1.5 vs. 7.9; 426.6%) were significantly higher among patients with SUD compared to healthy subjects. when sub-groups were compared, no significant differences were observed between their trace element levels (Kruskal-Wallis test, P &gt; 0.05). This can be an indication that regardless of the type of drug, the levels of trace elements are changed with respect to the healthy individuals. Our results showed that the illicit drug use causes changes in urinary trace element/ heavy metal/metalloid levels and they highlight the need for monitoring of heavy metals and trace elements in individuals with substance use disorder. Assessment of different elements in biological samples of drug dependents may be useful for implementing the new prevention and treatment protocols. In the case of changes in their levels, complementary recommendations, attention to diet, and periodic assessment of toxic metal levels within treatment programs will be needed.非法药物滥用问题日益严峻，已成为多数国家与社会面临的主要公共卫生难题之一。对此类药物成瘾易感人群开展重金属与微量元素监测，具备重要的现实必要性。为此，本研究对比分析了鸦片、曲马多、大麻使用者与健康受试者尿液中的微量元素及有毒金属/类金属浓度，检测指标包括锌（Zinc, Zn）、铁（Iron, Fe）、铜（Cupper, Cu）、铬（Chromium, Cr）、铅（Lead, Pb）、镉（Cadmium, Cd）、砷（Arsenic, As）、镍（Nickel, Ni）以及汞（Mercury, Hg）。本研究为横断面研究，共纳入74名物质使用障碍（Substance Use Disorder, SUD）患者，分为大麻组、曲马多组、鸦片组以及混合使用组（同时滥用三种研究物质中的两种及以上），另设60名健康对照人群。采用分散液液微萃取法对尿液样本进行前处理，随后通过电感耦合等离子体质谱法（Inductively Coupled Plasma Mass Spectrometry, ICP-MS）对重金属/类金属进行定量检测。与健康对照相比，物质使用障碍患者尿液中铜（Cu）、汞（Hg）与锌（Zn）的平均浓度显著降低：铜浓度分别为48.15与25.45，差异达89.2%（p<0.001）；汞浓度分别为1.3与0.10，差异达1200%（p<0.001）；锌浓度分别为301.95与210，差异达43.8%（p<0.001）。其余检测元素的平均浓度则在物质使用障碍患者中显著高于健康对照：砷（As）为1.9 vs. 4.1，差异达115.8%；镉（Cd）为0.1 vs. 1.10，差异达1000%；铬（Cr）为6.80 vs. 11.65，差异达71.3%；镍（Ni）为2.95 vs. 4.95，差异达67.8%；铅（Pb）为1.5 vs. 7.9，差异达426.6%。亚组间比较结果显示，不同药物滥用亚组的微量元素水平无显著统计学差异（克鲁斯卡尔-沃利斯检验，P>0.05）。该结果提示，无论滥用何种类型的非法药物，患者的微量元素水平均与健康人群存在显著差异。本研究结果证实，非法药物滥用会导致尿液中微量元素、重金属及类金属水平发生改变，同时也凸显了对物质使用障碍患者开展重金属与微量元素监测的必要性。对药物依赖者的生物样本中各类元素进行检测分析，可为新型预防与治疗方案的制定提供参考依据。若检测发现患者体内元素水平异常，则需在临床治疗过程中辅以针对性饮食指导，并定期开展有毒金属水平的监测评估。