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Heroin Addiction and Related Clinical Problems: 2005, 07, 1 (pages: 31 - 38)

Alcohol abuse in heroin addicts: An unfolding metabolic destiny

Pacini M., Mellini A., Attilia M. L., Ceccanti M., Maremmani I.

Summary: This paper deals with the issue of alcohol-abusing heroin addicts. On the basis of clinical and epidemiological findings, a view is presented which links the two kinds of abuse along a common metabolic pathway. Some data about the former history of opiate abuse in treatment-seeking alcoholics help to indicate which heroin-related features may influence the incidence and severity of alcohol abuse in heroin addicts. Observations point to alcohol abuse as one possible pathological outcome of the opioid metabolic impairment underlying heroin addiction. When alcohol is a surrogate for heroin, social adjustment improves, but the metabolic destiny does not change, and the medical outcome is worsened to some extent by the low chances of curing a possible actual alcoholism to come. Correctly handled agonist treatments are crucial in preventing that kind of negative outcome, whereas alcohol abuse as an opioid equivalent calls for greater attention, to allow adequate assessment of the effectiveness of treatment programmes for opiate addiction.