Madam,

In Pakistan the proportion of heroin addicts among total drug abusers has risen from 4% in 1980 to 23% in 1985. However, a significant difference in the pattern of drug dependency exists in Europe and Pakistan. Heroin addicts experience both diminished sexual drive and impairment of sexual function. Several studies have been carried out on the endocrine systems of heroin addicts. A significant hormonal depression was observed by heroin treatment during different studies mostly conducted in controlled laboratory conditions and several findings were contradictory to each other^4-8. The hormonal studies on heroin users receiving street heroin are, however, scanty. The present study was designed to examine effect of heroin on serum testosterone (T) levels in active addict popula­tion of Peshawar area in Pakistan where poly-drug abuse is uncommon and illicit heroin is easily available. The serum concentrations of testosterone in 33 males (aged 18-50, receiving street heroin) were measured using RIA kits. Radioimmunoassay kits supplied by Coat-a-Count Diagnostic Product Corporation, U.S.A. The addicts and control males were grouped on the basis of age as adult addicts (18-25 years),mature addicts (26-35 years) and middle age addicts (36-50 years).The results of the study are presented in Table and Figure.


The levels of T in young adults was 623.84 ± 104.92 ng/100 ml which were slightly elevation mature adults and slightly dropped in middle age group. However, these differences were statistically insignificant. Similarly the T level differences among the addicts of different age groups were insignificant although in young addicts the levels dropped to 228.20 ± 122.41 ng/100ml. On respective comparison of the average Travels with the control groups, there was a significant decrease (P <0.05) in T values of young and mature addicts with statistically insignificant effect on middle age group. Our findings are in agreement with previous observations reported during the controlled laboratory experiments where heroin was found to sup­press plasma testosterone (T). Present study therefore suggests that young addicts may be more prone to the adverse effects of heroin as compared to elder addicts. It is likely that heroin has a direct suppressive effect on serum T. it is possible that heroin may inhibit secretion of gonadotrophins from the pituitary in humans since this phenomenon has been demonstrated in some experimental animals⁹. The work is in progress to see the effect of heroin ongonadotrophins in these male addicts.

Yours,
Changez Khan *Salman A Malik **M. Anis Iqbal
Central Laboratories and Blood Banks Ministry of Health, Riyadh, Saudi Arabia.
*National Institute of Health, Islamabad and **Department of Biological Sciences Quaid-i-Azam University, Is­lamabad.

1. National Survey on Drug Abuse in Pakistan, Islamabad. Pakistan Narcotic Board, 1986. p.312.
2. Altaf, M.T., Qureshi, Z. and Ahmad, S.!. Dimensions of depression in heroin addicts. Pakistan J. Pharmacol., 1988; 5: 1.
3. Azizi, F., Vagenakis, A.G., Longcope, C., Ingbar, S.H. and Braver­man, LE. Decreased serum testosterone concentration in male heroin and methadone addicts. Steroids, 1973; 22:467.
4. Mendcison, J.H., Mendelson, J.E and Patch, V.D. Plasma tes­tosterone levels in heroin addiction and during methadone main­tenance. J. Pharmacol. Exp. Ther., 1975; 192: 211.
5. Cicero, J. 3., Wilcox, CE., Bell, RD. and Meyer, E.R. Acute reduc­tions in serum testosterone levels by narcotics in the male rat; stereospecificity, blockade by naloxone and tolerance. J. Phar­macol. Exp. Ther., 1976, 198: 340.
6. Smith, C.G. and Gilbeau, P.M. Drug abuse effect on reproductive hormones, in endocrine toxicology. Edited by Thomas, J.A. New York, Raven Press, 1985, p. 249.
7. Cushman, P. Jr. Sexual behaviour in heroin addiction and methadone maintenance. Correlation with plasma LH. N.Y. State J. Med., 1972; 261.
8. Cushman, P. Jr. Plasma testosterone in narcotics addiction. Am. 3. Med., 1973; 55 : 452.
9. Mirin, S.M., Meyer, R.E. and Ellingobe, J. The effect of heroin and naltrexone on testosterone and gonadotrophin secretion, a pilot study. Psychoneuroendocrinology, 1976; 1 : 359.