Pancytopenia in Narcotic Addicts: A 3-Year Study in a South-South Nigerian Tertiary Hospital (Ages 21–35)

Abstract

Background: Pancytopenia reflects a failure of normal hematopoiesis or excessive destruction or sequestration of blood cells and is frequently associated with significant morbidity and mortality if not promptly identified and managed. Despite growing global recognition of the systemic complications associated with substance use disorders, there remains a substantial gap in the understanding of the relationship between narcotic addiction and pancytopenia, particularly in low- and middle-income regions such as Sub-Saharan Africa. Aim: This study aimed to evaluate the haematological profile of young adult narcotic addicts aged 21-35 years and determine the occurrence of pancytopenia among this population in a tertiary healthcare setting in South-South Nigeria. Study design:  This was a hospital-based retrospective descriptive study. Place and Duration of Study: The study was conducted in a tertiary healthcare institution in South-South Nigeria over a three-year period. Methodology: A total of 22 young adult patients aged 21–35 years with documented history of narcotic addiction who had undergone full blood count investigations during the study period were included. Relevant demographic and laboratory data including age, gender, packed cell volume (PCV), total white blood cell (WBC) count, and platelet count were extracted from laboratory records using a structured data extraction format. Haematological parameters were analyzed using a Mindray BC-5000 5-part differential automated haematology analyzer. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 27. Descriptive statistics were presented as mean ± standard deviation, minimum and maximum values. Comparison of haematological parameters across age groups (<30 years and ≥30 years) and gender (male and female) was performed using the Mann-Whitney U test. Statistical significance was set at P < 0.05. Results: The mean age of participants was 28.09 ± 3.7 years. The mean packed cell volume was 23.86 ± 6.81%, mean total white blood cell count was 2890.90 ± 3437.49 cells/µL, and mean platelet count was 43,759.09 ± 30,922.78 cells/µL, indicating reductions across all three haematopoietic cell lines consistent with pancytopenia. Comparison across age groups showed no statistically significant differences in PCV (P = 0.688), WBC (P = 0.591), or platelet count (P = 0.640). Similarly, gender-based comparisons revealed no statistically significant differences in PCV (P = 0.457), WBC (P = 0.566), or platelet count (P = 0.110). Conclusion: This study demonstrated the presence of pancytopenia among young adult narcotic addicts in a hospital-based population in South-South Nigeria. In the absence of HIV and viral hepatitis coinfection among participants, the observed haematological abnormalities are more likely attributable to opioid-related immune modulation, nutritional deficiencies, and possible exposure to toxic adulterants associated with illicit drug use. Routine haematological evaluation should therefore form an essential component of clinical assessment in individuals with narcotic addiction.