Possible Interaction: Ethanol and Heroin

“Consumption of ethanol is a considerable risk factor for death in heroin overdose.”

“In HepG2 cells, high alcohol concentrations (300 mM) during long exposure (4 days) increased the synthesis of H and L ferritin subunits, in association with increased levels of ferritin mRNAs.”

“Interactions of both a pharmacodynamic and also dispositional type may occur between ethanol and either the short-acting exogenous opioids, such as heroin and morphine, or the long-acting exogenous opioid, methadone.”

“Over half of the so-called "overdose" cases in which exogenous opioids heroin or methadone) are implicated, are in fact cases in which concomitant abuse of alcohol has played a prominent role.”

“ Heroin addicts maintained on prolonged methadone treatment who became secondarily addicted to ethanol develop a syndrome with a tenfold increase in mortality rate over those on methadone maintenance alone.'”

“… heroin … alcohol (Adj OR = .71 CI[.58, .86]), marijuana (Adj OR = 3.79 CI[3.17, 4.52]), and hard drugs (Adj OR = 16.33 CI[… (Adj OR = 2.13 CI[1.93, 2.36]) and repeating more school grades (Adj OR = 1.66 CI[1.37, 2.01]).”

“We report about a 43-year-old woman with polyvalent drug addiction (i.e. alcohol , nicotine, methadone maintenance program with parallel consumption of heroin ) who presented to the emergency department with peripheral edema, generalized weakness, and arthralgia.”

“RESULTS Unexpectedly, those who identified as heterosexual were significantly more likely to concomitantly abuse al ohol an d her oin th an those who identified as lesbian, gay, bisexual and transgender.”

“INTRODUCTION Ethanol and heroin are both depressant drugs on the central nervous system, and combined use is known to be dangerous due to pharmacodynamic interactions, leading to an even higher risk of respiratory depression and death.”

“In addition, previous studies have suggested a pharmacokinetic interaction between ethanol and the metabolism of heroin.”

“This pharmacokinetic interaction could further complicate the outcome after combined use of heroin and ethanol , in addition to the already well-known pharmacodynamic interactions.”

“Prevalence of alcohol (OR = 2.12, 95% CI = 1.38–3.25) and heroin (OR = 2.67, 95% CI = 1.50–4.77) dependence was significantly higher among Native Americans.”

“In this article we present a case of a patient that developed clinical signs of acute rhabdomyolysis after consumption of heroin and alcohol.”