{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:50:40Z","timestamp":1787032240054,"version":"build-2736575974"},"reference-count":27,"publisher":"Brieflands","issue":"3","license":[{"start":{"date-parts":[[2023,4,14]],"date-time":"2023-04-14T00:00:00Z","timestamp":1681430400000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["brieflands.com"],"crossmark-restriction":false},"short-container-title":["Anesth Pain Med"],"abstract":"<jats:p>Background: Opium has been used for thousands of years for medical and analgesic purposes, and its misuse has also increased in recent years. Methadone, a synthetic opioid, has been used as an analgesic and to help patients quit opium addiction. However, some evidence suggests that long-term use of opioids can affect the hypothalamic-pituitary-adrenal axis. Objectives: We aimed to evaluate the serum cortisol level and response to the cosyntropin stimulation test in opium addicts on methadone treatment. Methods: The study was conducted in November 2019 at Imam Reza Hospital Rehab Center, Birjand, Iran. Thirty-eight methadone-treated opium addicts participated in the study. A blood sample was initially obtained, then 250 \u00b5g intramuscular cosyntropin was injected. After 30 and 60 minutes, two other blood samples were obtained. The data were analyzed using SPSS. Results: There was a significant difference between serum cortisol levels and the normal value in methadone users (9.46 \u00b1 5.42 vs. 14 \u00b5g\/dL) (P &lt; 0.001). The mean response to the cosyntropin stimulation test in methadone users was 9.34 \u00b1 8.11 \u00b5g\/dL. Also, 55% of the participants had adrenal insufficiency. Conclusions: Serum cortisol levels significantly differed from normal values in methadone-treated patients. Therefore, we recommend measuring serum cortisol levels in methadone-treated patients before major medical procedures to consider the stress doses of corticosteroids.<\/jats:p>","DOI":"10.5812\/aapm-135206","type":"journal-article","created":{"date-parts":[[2023,6,3]],"date-time":"2023-06-03T12:40:57Z","timestamp":1685796057000},"update-policy":"https:\/\/doi.org\/10.5812\/crossmark_update_policy","source":"Crossref","is-referenced-by-count":3,"title":["Evaluation of Serum Cortisol Levels and Response to Cosyntropin Test in Methadone-treated Opium 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