Journal of Substance Abuse Treatment
Volume 30, Issue 3 , Pages 191-196, April 2006

Effect of opioid substitution therapy on alcohol metabolism

  • Nicolas C. Clark, M.B.B.S, M.P.H, FAChAM

      Affiliations

    • Turning Point Alcohol and Drug Center Inc., Victoria, Australia
    • Monash Medical Center, Victoria, Australia
    • Corresponding Author InformationCorresponding author. Turning Point Alcohol and Drug Center Inc., Fitzroy, VIC 3065, Australia. Tel.: +61 3 8413 8447; fax: +61 3 9416 3420.
    • ,
  • Paul Dietze, Ph.D

      Affiliations

    • Turning Point Alcohol and Drug Center Inc., Victoria, Australia
    • Institute for Health Services Research, Monash University, Victoria, Australia
    • ,
  • Michael G. Lenné, Ph.D

      Affiliations

    • Accident Research Center, Monash University, Victoria, Australia
    • Department of Psychology, Monash University, Victoria, Australia
    • ,
  • Jennifer R. Redman, Ph.D

      Affiliations

    • Department of Psychology, Monash University, Victoria, Australia

Received 15 April 2005; received in revised form 22 November 2005; accepted 23 November 2005.

Abstract 

Forty opioid substitution patients (methadone, n = 14; LAAM, n = 14; and buprenorphine, n = 12) who were participating in a study on the impact of opiate substitution treatment on driving ability and 22 non-opiate-using control subjects were administered 14.7 g/70 kg of alcohol in two separate sessions, one 2–3 hours before opioid pharmacotherapy dosing and the other 1–2 hours after dosing. The mean blood alcohol concentration (BAC) in the post-opioid dose session was significantly lower than that in the pre-opioid dose session (p < .05). There was a significant effect of experimental group (LAAM, methadone, buprenorphine, or control) on BAC in sessions conducted 1–2 hours after the opioid substitution dose (p < .01). There was a trend for a reduced effect of experimental group on BAC in the pre-opioid substitution dose session (p = .06). The BAC of non-opioid substitution control subjects was significantly higher than that of the LAAM (before and after LAAM dosing) and methadone (after methadone dosing; p < .05) patients. These findings provide evidence for the first time of an interaction between opiates and alcohol in humans that is strongest at the time of peak opiate plasma levels in the hours after opioid dosing.

Keywords: Opioid, Alcohol, Pharmacokinetics, Methadone, Buprenorphine, LAAM

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PII: S0740-5472(05)00250-3

doi:10.1016/j.jsat.2005.11.010

Journal of Substance Abuse Treatment
Volume 30, Issue 3 , Pages 191-196, April 2006

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