Open J Psychiatry Allied Sci. 2025 Nov 7. Epub ahead of print.

An investigation of various lymphocyte-related ratios in patients with opioids dependence syndrome.

Moirang NS, Mandal R, Das H, Nath K.

Abstract

Background & Aim: Opioid Dependence Syndrome (ODS) features not only neuropsychological effects, but also immune dysregulation and systemic inflammation. Hematological indices including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and monocyte-to-lymphocyte ratio (MLR) may be useful and readily available markers of these immune changes. We aim to evaluate the diagnostic usefulness of lymphocyte-related ratios and socio-demographic and clinical characteristics in patients with opioid dependence syndrome. Method: The cross-sectional study included 50 male ODS patients (ICD-10 criteria) and 50 healthy controls matched for age. Hematological parameters were assessed using a standard analyzer. Group differences were compared, along with correlations with the length of duration of use and the route of opioid use using statistical comparison. Results: ODS patients had significantly higher WBC counts, lymphocyte counts, and NLR, and significantly lower PLR and MLR, compared to controls. There were no significant differences in basophil-to-lymphocyte ratio (BLR). Increased duration of opioid use was associated with increased values of WBC, NLR, and MLR, suggesting a cumulative inflammatory effect. No hematological differences were found across the routes of opioid administration. Conclusions: Systemic inflammation and immune dysfunction are related to opioid use disorder, showing differences in NLR, PLR, and MLR. These ratios may provide easy, inexpensive, clinical markers and follow-up in opioid-dependent patients.

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