Diamorphine + Ethanol Interactions?!

[honeywhite]

As a consequence of some chronic pain, I have been prescribed diamorphine 30mg, to be taken more or less as needed (I also have Zomorph, to be taken morning and night, as well as phenobarbitone for nerves). The diamorphine comes in injectable ampoules for IM/IV/IN use. The doctor recommends intranasal administration unless absolutely necessary (I think she doubted my proficiency at finding a vein). Anyway, I don't have much of a problem with the diamorphine; it's an old-school, but above all RELIABLE, analgesic. If I inject it, I get hives, but that's apparently a known side effect as regards this medication. Needless to say, I've ended up following my doctor's instructions.

That said, if I take my medicine and then have a drink or two (half a bottle of absinthe), I wake up with a hellacious hangover. If I take JUST morphine and diamorphine, I get nothing of the sort. Similarly, if I drink without taking my meds. Is there some sort of morphine/alcohol/possibly barbiturate interaction? Or is it my own wiring to blame?

 

[Speed King]

Overusing gaba receptors can cause that pain, but forget that part, you are playing Russian roulette. Whatever tolerance you think you have, doesn't matter. All those drugs that you ingest stay in your system for a while.
Barbiturates will raise that chance of death real fast. There is absolutely no correct way to take those medications and mix alcohol with it.

 

[honeywhite]

Overusing gaba receptors can cause that pain, but forget that part, you are playing Russian roulette. Whatever tolerance you think you have, doesn't matter. All those drugs that you ingest stay in your system for a while.
Barbiturates will raise that chance of death real fast. There is absolutely no correct way to take those medications and mix alcohol with it.

So what you're saying is that it's an either-or situation? Either diamorphine/pheno or get drunk? All right, that's what I thought, but I've also heard it's all right to mix diamorphine and alcohol, so I'm not sure *what* to think anymore.

P.S. I thought diamorphine *wasn't* GABA-ergic. It's a pure mu-opioid agonist, isn't it?

 

[RTrain]

So what you're saying is that it's an either-or situation? Either diamorphine/pheno or get drunk? All right, that's what I thought, but I've also heard it's all right to mix diamorphine and alcohol, so I'm not sure *what* to think anymore.

P.S. I thought diamorphine *wasn't* GABA-ergic. It's a pure mu-opioid agonist, isn't it?

No but alcohol and barbs do.

 

[Speed King]

So what you're saying is that it's an either-or situation? Either diamorphine/pheno or get drunk? All right, that's what I thought, but I've also heard it's all right to mix diamorphine and alcohol, so I'm not sure *what* to think anymore.P.S. I thought diamorphine *wasn't* GABA-ergic. It's a pure mu-opioid agonist, isn't it?

You have an potent opiate which is a strong CNS depressant, a barbiturate which is a strong downer/CNS depressant, and alcohol which messes with everything and is a downer/CNS depressant. Any which way that you use it, it is very dangerous.

 

[honeywhite]

You have an potent opiate which is a strong CNS depressant, a barbiturate which is a strong downer/CNS depressant, and alcohol which messes with everything and is a downer/CNS depressant. Any which way that you use it, it is very dangerous.

All right. So no pheno with alcohol. I'm just curious how in the blue blazes morphine (or a prodrug thereof) interacts with alcohol - is there some sort of science behind it?

 

[F.U.B.A.R.]

Fuck the science mate, all you need to know is that opiates, barbiturates and ethanol are all potent CNS depressants. Mixing the three can have extremely negative consequences on your life...

 

[Lorne???]

The science is far more complicated than the truth: That is a crazy combo - Even I don’t think I’ve ever mixed those things at once

You really shouldn’t be too surprised, mixing any 4 potent CNS depressants(quite potent, at that)

The Hangover is self explanatory - The danger is because they all depress breathing, and mixing them haphazardly can exponentially increase the respiratory depression and the risks therof

Just Be Careful man

 

[honeywhite]

The science is far more complicated than the truth: That is a crazy combo - Even I don?t think I?ve ever mixed those things at once

You really shouldn?t be too surprised, mixing any 4 potent CNS depressants(quite potent, at that)

The Hangover is self explanatory - The danger is because they all depress breathing, and mixing them haphazardly can exponentially increase the respiratory depression and the risks therof

Just Be Careful man

There's only three drugs though (in four formulations, but three active ingredients): Diamorphine Hydrochloride BP and Zomorph are both morphine (60 mg Zomorph morning/night, plus 30mg Diamorphine PRN for breakthrough pain)

I very rarely take barbs and alcohol on the same day. My question was chiefly about (dia)morphine + alcohol. I was told by my doctor that I could drink in moderation with my pain meds. Every time I do, I get a splitting headache the morning after. That's what I was puzzled about. Diamorphine on its own - no headache. Whole bottle of ouzo - no headache. Mix the two, and I want to die in the morning.

 

[Lorne???]

Morphine has more side effects than diamorphine, and has a gradual onset; they are not the "same " drug

Your still talking about diamorpine ~ MAM, ~ Morphine, mixed with ethanol which is all over the place; used simultaneously, its not surprising you feel wrecked the next day/morning

It's two powerful drugs, I would curb my curiosity and just keep in mind YOU have this reaction, and although not surprising, I wouldn't have had that problem from "modest " ethanol intake

No one knows how your body processes it; your probably sensitive to the histamine, because hives may not be rare, but they are not common for diamorphine - Your doc was probably thinking of morphine classic, which has more, or rather causes a larger histamine release than heroin does - So, that is something else that isn't a shocker and is explained, yet, has never happened to me or a lot of other people

Drugs are far more complex than one could think, yet what's more useful is having common sense and decent judgement (which your question illustrates, I am just making an observation)