Background : Opiates and other related materials may inhibit the physiologic secretion of adrenocorticotropin. The aim of the present study is to determine the association between the cortisol level and adrenal insufficiency in addicted patients.

Materials and methods : For this clinical trial, 100 patients who had elective abdominal surgery or inguinal hernial repairs were selected randomly. They were distributed in two groups: opium addicts (cases), and non-addicts (controls). One day before surgery cortisol was measured by radio immunoassay (RIA).

Results : Of 50 addicted patients, 17 revealed to have lower than normal cortisol levels whereas 5 had higher levels. There exists a non-significant association between the cortisol level and duration of addiction, and also cortisol level and the degree of dependency. Cortisol levels were within normal range in all controls. Post-anesthetic complications and withdrawal syndrome, especially pain and shivering in recovery room, were more obvious among addicted patients as compared to controls and the difference was statistically significant. (P<0.0001) The duration of recovery was much shorter among addicted patients as compared to the controls, (p<0.00001).

Conclusion : Addicts should be considered as high risk patients for elective surgery. Adrenal insufficiency and post-anesthetic complications deserve special attention in this group.