Table 3.

Metabolic dysfunctions in opioid addicts.

Authors	Findings from the study	Reference number (year)
Rezaei et al.	Systematic review showing that opioids ↑ serum triglycerides and ↓ blood glucose and low-density lipoproteins.	Rezae and Rezaei (2021)
Ojo et al.	Meta-analysis showing that levels of total cholesterol were ↓ in diabetic patients, abusing of opium. Nutritional deficiencies, weight loss, and lipid dysregulation, due to liver dysfunction, may explain the findings.	Ojo et al. (2019)
Passariello et al.	Chronic heroin administration produced a state of fasting hyperinsulinemia even in the absence of obesity.	Passariello et al. (1983)
Passariello et al.	Alteration of glucose metabolism evidenced similarities between opiate addicts and non-insulin dependent diabetics.	Ceriello et al. (1987)
Gosnell et al.	Preference/consumption of sweet substances often parallels the self-administration of several drugs of abuse, and the termination of intermittent access to sweet substances produces symptoms that resemble those observed during opiate withdrawal.	Gosnell and Levine, (2009)
Zahmatkesh et al.	Opioids ↑ the levels of ROS and ↓ those of the activity of superoxide dismutase, catalase, and glutathione peroxidase that function as enzymatic antioxidants. Furthermore, they ↑ the risk of vitamin deficiency and modify gene expression of target cells through ROS production.	Zahmatkesh et al. (2017)
Nabipour et al.	Many opiate and alcohol addicts present with ↓ Ca and ↓ Mg due to poor diet and inadequate intake of Ca.	Nabipour et al. (2014)
Skrabalova et al.	Production of ROS/nitrogen species can contribute to degenerative diseases and organ dysfunction, likely of liver, occurring in morphine abusers or morphine-treated patients.	Skrabalova et al. (2013)
Reece et al.	1,602 patients with SUD compared with 2,858 non-SUD patients showed an acceleration of age-related and degenerative pathologies in many tissues, evaluated by the higher levels of serum glucose, HbA1c elevation, fructosamine, concentrations, and microalbumin levels.	Reece et al. (2013)
Duailibi et al.	A systematic review of the RCTs present into literature until 2017 showed the safety profile of N-acetylcysteine and its favorable tolerability, in addition to being an over-the-counter medication with an interesting potential clinical use for craving in SUDs.	Duailibi et al. (2017)
Lewinska et al.	Paradoxically, researchers have found that a preconditioning of one potent, short-acting synthetic opioid analgesic drug that is remifentanil could protect against hypoxia-induced cellular senescence.	Lewinska et al. (2020)
Dimidi et al.	Playing gastrointestinal microbiota a primary role in constipation, modification of the gut luminal environment, with certain probiotic ends up in improvement of the motility and secretion in the gut, resulting in bifidobacteria and lactobacilli.	Dimidi et al. (2017)
Jang et al.	A link between constipation from opioids and the underlying NAFLD is hypothesized by the fact that Lactobacillus decreases intestinal lipid absorption, consequently protecting against diet-induced steatosis in vivo.	Jang et al. (2019)
Mallappallil et al.	Opioid use can lead to a reduced fluid intake.	Mallappallil et al. (2017)
Van Vugt et al.	Administration of opiates produces a rapid increase in release of ADH.	Van Vugt and Meites (1980)