Effects of alcohol on brain oxygenation and brain hypoxia induced by intravenous heroin

Thomas, Seddon Y.; Curay, Carlos M.; Kiyatkin, Eugene A.

doi:10.1016/j.neuropharm.2021.108713

Cited by 5 publications

(4 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As alcohol induces CNS depression and modest respiratory depression at higher doses ( 58 – 60 ), it presents a risk of exacerbating the hypoxic effects of opioid drugs. To explore this, we examined the effects of alcohol at different doses on brain oxygenation and its effects on brain oxygen responses induced by iv heroin ( 61 ).…”

Section: Interaction Of Heroin and Fentanyl With Other Neuroactive Su...mentioning

confidence: 99%

“…(B) shows changes induced by iv saline and alcohol at 2.0 g/kg dose and changes induced by three heroin injections (0.2 mg/kg) delivered 20, 80 and 140 min after alcohol administration. Original data were published in Thomas et al ( 61 ).…”

Section: Interaction Of Heroin and Fentanyl With Other Neuroactive Su...mentioning

confidence: 99%

“…The second component of the NAc oxygen response, the tonic increase, was also an unexpected finding, and its mechanisms remain unclear. Interestingly, this change was associated with decreases in brain temperature and brain-muscle differentials ( 61 ), markers of central inhibition ( 62 ). We propose cerebral vasodilation and increased cerebral blood flow as a potential mechanism, since they are known effects of alcohol ( 63 – 65 ).…”

Section: Interaction Of Heroin and Fentanyl With Other Neuroactive Su...mentioning

confidence: 99%

See 2 more Smart Citations

Brain oxygen responses induced by opioids: focus on heroin, fentanyl, and their adulterants

Kiyatkin,

Choi

2024

Front. Psychiatry

Self Cite

View full text Add to dashboard Cite

Opioids are important tools for pain management, but abuse can result in serious health complications. Of these complications, respiratory depression that leads to brain hypoxia is the most dangerous, resulting in coma and death. Although all opioids at large doses induce brain hypoxia, danger is magnified with synthetic opioids such as fentanyl and structurally similar analogs. These drugs are highly potent, act rapidly, and are often not effectively treated by naloxone, the standard of care for opioid-induced respiratory depression. The goal of this review paper is to present and discuss brain oxygen responses induced by opioids, focusing on heroin and fentanyl. In contrast to studying drug-induced changes in respiratory activity, we used chronically implanted oxygen sensors coupled with high-speed amperometry to directly evaluate physiological and drug-induced fluctuations in brain oxygen levels in awake, freely moving rats. First, we provide an overview of brain oxygen responses to physiological stimuli and discuss the mechanisms regulating oxygen entry into brain tissue. Next, we present data on brain oxygen responses induced by heroin and fentanyl and review underlying mechanisms. These data allowed us to compare the effects of these drugs on brain oxygen in terms of their potency, time-dependent response pattern, and potentially lethal effect at high doses. Then, we present the interactive effects of opioids during polysubstance use (alcohol, ketamine, xylazine) on brain oxygenation. Finally, we consider factors that affect the therapeutic potential of naloxone, focusing on dosage, timing of drug delivery, and contamination of opioids by other neuroactive drugs. The latter issue is considered chiefly with respect to xylazine, which strongly potentiates the hypoxic effects of heroin and fentanyl. Although this work was done in rats, the data are human relevant and will aid in addressing the alarming rise in lethality associated with opioid misuse.

show abstract

Section: Interaction Of Heroin and Fentanyl With Other Neuroactive Su...mentioning

confidence: 99%

Section: Interaction Of Heroin and Fentanyl With Other Neuroactive Su...mentioning

confidence: 99%

Section: Interaction Of Heroin and Fentanyl With Other Neuroactive Su...mentioning

confidence: 99%

See 1 more Smart Citation

Brain oxygen responses induced by opioids: focus on heroin, fentanyl, and their adulterants

Kiyatkin,

Choi

2024

Front. Psychiatry

Self Cite

View full text Add to dashboard Cite

show abstract

“…3,4 Among the significant risks for overdose that persist among those prescribed opioid medications is co-use of alcohol. Increased risk stems from increased abuse liability 6,7 and the potentiating analgesic effects of these substances to produce possible severe sedation, hypoxia, respiratory depression, [8][9][10][11][12][13] and thus heightened overdose risk. 14,15 Consequently, labeling by the Food and Drug Administration (FDA) of marketed formulations of opioid medications contains strong warnings advising against concomitant use of opioids and any other central nervous system depressants, specifically citing alcohol.…”

Section: Opioids and Alcoholmentioning

confidence: 99%

Co-use of Opioid Medications and Alcohol Prevention Study (COAPS)

Cernasev,

Hohmeier,

Field

et al. 2023

Substance Abuse

View full text Add to dashboard Cite

While there is limited research in the field regarding the various dimensions of co-use of alcohol and opioid medication, particularly related to co-use and levels of severity, our research has shown 20% to 30% of community pharmacy patients receiving opioid pain medications are engaged in co-use. Co-use of alcohol and opioid medications is a significant risk factor for opioid-related overdose. Community pharmacy is a valuable yet underutilized resource and setting for addressing the US opioid epidemic, with an untapped potential for identification of and intervention for risks associated with co-use of alcohol and opioids. This commentary describing the “Co-use of Opioid Medications and Alcohol Prevention Study (COAPS)” offers an innovative and promising approach to mitigating serious risks associated with co-use of alcohol (risk and non-risk use) and opioids in community pharmacy. COAPS aim 1involves adapting an existing opioid misuse intervention to target co-use of alcohol and opioid mediations. COAPS aim 2 involves testing the adapted intervention within a small-scale pilot randomized controlled trial (N = 40) to examine feasibility, acceptability and preliminary efficacy of the intervention versus standard care. COAPS aim 3 involves conducting key informant interviews related to future implementation of larger scale studies or service delivery in community pharmacy settings.

show abstract

Basic metabolic and vascular effects of ketamine and its interaction with fentanyl

et al. 2023

View full text Add to dashboard Cite

Effects of alcohol on brain oxygenation and brain hypoxia induced by intravenous heroin

Cited by 5 publications

References 36 publications

Brain oxygen responses induced by opioids: focus on heroin, fentanyl, and their adulterants

Brain oxygen responses induced by opioids: focus on heroin, fentanyl, and their adulterants

Co-use of Opioid Medications and Alcohol Prevention Study (COAPS)

Basic metabolic and vascular effects of ketamine and its interaction with fentanyl

Contact Info

Product

Resources

About