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Opioids Can a codeine overdose be treated with grapefruit juice?

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Bomb319

Bluelighter
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Nov 26, 2011
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Codeine is one of the few opiates that have a lethal dose limit on their own without requiring other drugs present, or having toxicity mediated by respiratory depression. Is it codeine itself that is the problem, or its biotransformation into morphine? If it's the latter, then GFJ should act as an antidote to a potentially fatal OD by blocking the conversion of codeine to morphine - at least if it can act quickly enough.

One other grapefruit juice question - does anyone know if the active furanocoumarins in GFJ are destroyed by heat? I was just thinking about a potentially time-saving and efficient way to prepare it in advance if it is NOT denatured by low-medium heat; get a bunch of pure, white GFJ and slowly heat or slow-boil it to evaporate the water, producing a concentrate which can be packaged into capsules and roughly measured. Instead of having to go out and buy new juice all the time and swallow several liters of the stuff, you could theoretically just take one of these capsules instead.
 
Codeine and other metabolites are active but morphine is much more powerful than any of them so imagine it is the primary culprit (although maybe 15% of codeine is converted to morphine). But how will you quickly administer to someone ODing something by mouth? And you are aware that it takes some time (minutes to hours depending) for substances to empty from the stomach? Someone could be dead by then. And last, GFJ is not a very effective inhibitor of the enzyme that converts codeine to morphine anyway.

If someone is ODing you get them some naloxone and/or medical attention.
 
If someone is ODing you get them some naloxone and/or medical attention.
This
If someone OD'ed, enough of the codeine was already metabolized to morphine to cause respiratory depression etc., by now inhibiting the metabolism of codeine to morphine no more morphine will be produced, but there's already enough of it present to cause the OD...

And don't forget that naloxone has a short half life of 30-90min, so calling an amublance is still important.
 
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