Mechanisms of Drug Interactions with Alcohol

Mayer, Joel M.

doi:10.1300/j251v03n04_02

Cited by 8 publications

(4 citation statements)

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“…In our sample, one third of alcohol users and half of nicotine users had an additional SUD, compared to more than 80% of cannabis users and 90% of cocaine users. The accelerated speed of transition from cannabis or cocaine use to dependence given a previous history of a SUD may be mediated by conditioned learning processes, faster neuroadaptations (Leri et al, 2003; Schlaepfer et al, 2008) and drug interactions leading to slower biotransformation, decreases in adverse drug effects and overall enhanced drug effects (Bradberry et al, 1999; Kapusta et al, 2007; Leri et al, 2003; Mayer, 1984). Individuals dependent on more than one substance appear to have higher genetic liability and alleles of several genes have been associated with polysubstance abuse (Agrawal et al, 2008; Drgon et al, 2006; Schlaepfer et al, 2008).…”

Section: Discussionmentioning

confidence: 99%

Probability and predictors of transition from first use to dependence on nicotine, alcohol, cannabis, and cocaine: Results of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC)

López-Quintero

Cobos

Hasin

et al. 2011

Drug and Alcohol Dependence

602

376

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Background This study aims to estimate general and racial-ethnic specific cumulative probability of developing dependence among nicotine, alcohol, cannabis or cocaine users, and to identify predictors of transition to substance dependence. Methods Analyses were done for the subsample of lifetime nicotine (n=15,918), alcohol (n=28,907), cannabis (n=7,389) or cocaine (n=2,259) users who participated in the first and second wave of the National Epidemiological Survey on Alcohol and Related Conditions (NESARC). Discrete-time survival analyses were implemented to estimate the cumulative probability of transitioning from use to dependence and to identify predictors of transition to dependence. Results The cumulative probability estimate of transition to dependence was 67.5% for nicotine users, 22.7% for alcohol users, 20.9% for cocaine users, and 8.9% for cannabis users. Half of the cases of dependence on nicotine, alcohol, cannabis and cocaine were observed approximately 27, 13, 5 and 4 years after use onset, respectively. Significant racial-ethnic differences were observed in the probability of transition to dependence across the four substances. Several predictors of dependence were common across the four substances assessed. Conclusions Transition from use to dependence was highest for nicotine users, followed by cocaine, alcohol and cannabis users. Transition to cannabis or cocaine dependence occurred faster than transition to nicotine or alcohol dependence. The existence of common predictors of transition dependence across substances suggests that shared mechanisms are involved. The increased risk of transition to dependence among individuals from minorities or those with psychiatric or dependence comorbidity highlights the importance of promoting outreach and treatment of these populations.

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Section: Discussionmentioning

confidence: 99%

Probability and predictors of transition from first use to dependence on nicotine, alcohol, cannabis, and cocaine: Results of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC)

López-Quintero

Cobos

Hasin

et al. 2011

Drug and Alcohol Dependence

602

376

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“…(184)(185)(186)(187)(188)(189) Amitriptyline Increase Amitriptyline was reported to decrease methadone clearance. It increases plasma AGP, thus increasing methadone binding.…”

Section: Metabolism and Excretionmentioning

confidence: 99%

“…In a study of five patients, no increase in methadone levels were observed 2 and 4 h after 90 mL of 50% ethanol solution taken 1 h after methadone administration 185 . However, the clinical perception is that alcohol-abusing, opioid-maintained patients have increased withdrawal between daily doses 184 , possibly due to increased drug metabolism by chronic ethanol consumption, whereas acute ethanol ingestion may inhibit microsomal drug metabolism 186 . Blood alcohol concentration (BAC) was reduced in methadone patients after administration of 14.7 g/70 kg of alcohol 1-2 h after methadone dosing (p < 0.05) 187 .…”

Section: Alcohol and Disulfirammentioning

confidence: 99%

Methadone: a review of drug-drug and pathophysiological interactions

Kapur

Hutson²,

Chibber

et al. 2011

Critical Reviews in Clinical Laboratory Sciences

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Numerous established and potential drug interactions with methadone are clinically important in people treated with methadone either for addiction or for chronic pain. Methadone users often have comorbidities and are prescribed drugs that may interact with methadone. Methadone is extensively metabolized by cytochrome P450 (CYP) 3A4 and to a lesser extent by CYP 1A2, 2D6, 2D8, 2C9/2C8, 2C19, and 2B6. Eighty-six percent of methadone is protein bound, predominately to α1-acid glycoprotein (AGP). Polymorphisms in or interactions with CYPs that metabolize methadone, changes in protein binding, and other pathophysiological conditions affect the pharmacokinetic properties of methadone. It is critical for health care providers who treat patients on methadone to have adequate information on the interactions of methadone with other drugs of abuse and other medications. We set out to describe drug-drug interactions as well as physiological and pathophysiological factors that may impact the pharmacokinetics of methadone. Using MEDLINE, we conducted a systematic search for papers and related abstracts published between 1966 and June 2010. Keywords that included methadone, drug-drug interactions, CYP P450 and AGP identified a total of 7709 papers. Other databases, including the Cochrane Database of Systematic Reviews and Scopus, were also searched; an additional 929 papers were found. Final selection of 286 publications was based on the relevance of each paper to the topic. Over 50 such interactions were found. Interactions of methadone with other drugs can lead to increased or decreased methadone drug levels in patients and result in potential overdose or withdrawal, respectively. The former can contribute to methadone's fatality. Prescribers of methadone and pharmacists should enquire about any new medications (including natural products and over-the-counter medications) periodically, and especially when an otherwise stable patient suddenly experiences drug craving, withdrawal or intoxication.

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“…http://thj.hums.ac.ir http concentration. Drug interactions can reduce the drug effectiveness, or even increase the plasma concentration and potential toxicity of a drug, leading to minor or serious unexpected side effects (6).…”

mentioning

confidence: 99%

Tobacco Use, the Missing Cause of Drug Interaction: A Narrative Literature Review

et al. 2022

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Cigarette smoke and nicotine interact with drugs by affecting the absorption, distribution, metabolism, or elimination of other drugs, causing a change in drug response. Therefore, smokers usually need higher doses of medications. Articles were searched through advanced search in ScienceDirect, PubMed, Google Scholar, and SciELO databases. Finally, 28 articles were used in this study. We found that drugs may interact with each other when taking multiple medications, but these interactions are not always related to medications. Sometimes these interactions result from drugs reacting with food, beverages, and tobacco. Smokers have to take more doses of the drug for treatment in the long run, which can cause more side effects. In the long run, the person’s body becomes resistant to the drug and the dose has to be increased. Overuse of the drug causes the person to suffer more emotional and physical symptoms. Cigarettes can also have pharmacokinetic effects on some drugs (clozapine, olanzapine, and haloperidol). Tobacco causes nausea and the drug does not work well enough. In severe cases, the drug has to be injected intravenously, which makes the treatment much more difficult. Therefore, according to the studies, the patient’s history of smoking and alcohol consumption should be studied and medications should be prescribed according to it in order to treat in the best way.

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Mechanisms of Drug Interactions with Alcohol

Cited by 8 publications

References 0 publications

Probability and predictors of transition from first use to dependence on nicotine, alcohol, cannabis, and cocaine: Results of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC)

Probability and predictors of transition from first use to dependence on nicotine, alcohol, cannabis, and cocaine: Results of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC)

Methadone: a review of drug-drug and pathophysiological interactions

Tobacco Use, the Missing Cause of Drug Interaction: A Narrative Literature Review

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