People everywhere

are miserable, it seems. A study of 50,000 opium users in the Golestan province in Iran demonstrated that opium users experience an 86% higher death rate than non-users. Among women, that rate was 143%.

If you're a woman living in the Golestan province of Iran, and you happen to indulge in opium (which is widespread and socially "acceptable") your risk of death goes up by 143%. 

More than half the participants were women, and mean age at enrollment was 52. The majority were married, living in rural areas, and nonsmokers (83%). More than two-thirds had no formal education.

For a second, I assumed these women are unhappy, oppressed by the men in their lives, wearing the Chador, too many mouths to feed, etc. That must drive them to the opium use, I reason. However, I must pause to make sure I'm not viewing this problem through Americanized eyes: Opium smoking is an engrained part of the culture, and even the article admits that daily use only amounted to 0.6 grams, "which was a relatively small amount, the researchers noted." 

The major cause of death among those surveyed were infections, followed by respiratory conditions, then digestive disorders. It is easy to argue that lifelong opium use can weaken the immune system, weaken the lungs, etc. causing vulnerability to infections. However, the article doesn't mention the level of professional healthcare these residents are accustomed to receiving. Since more than two-thirds had no formal education, my American Perception equates that with lack of healthcare. It also doesn't discuss the rate of pregnancy.

So what do we really have here? A report on the effects of opium? I don't think so. If this article were to be placed in a different context, such as the American west in the early 1900's, opium use might be replaced with tobacco use (whether smoked or chewed) and I bet the results would be the same. Women would are more likely to die than men. Infection is the most common cause of death. Two-thirds of the population have no formal education. It's very easy to blame these numbers on a single common factor, but I hope that a cautious researcher will remember that the research is only as honest as its subjects and circumstance.