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Posted by on in Centers of Excellence
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Alcohol metabolism, impairment, and blood alcohol concentration (BAC) has been an active scientific research area for well over a century (Nicloux 1899, Hamil 1910, Widmark, 1932). Research by The American Medical Association (AMA) and the National Safety Council (NSC) prompted the establishment of the first commonly used legal limit of 0.15% BAC for driving in 1983. Since then, BAC determination has been a staple in forensic toxicology; however, its application is often limited to solely determining an individual’s state of inebriation. A 2016 study by Cardno ChemRisk scientists evaluated the best practices for determining a person’s BAC at specific time-points following alcohol ingestion, and proposed a novel model to determine post-mortem alcohol generation (Cowan et al. 2016).

Although alcohol metabolism is well studied, information regarding its interaction with opioids is relatively limited. The “Opioid Crisis” has garnered much attention recently; increased prescription of opioid pain relievers in the late 1990s based on non-addictive claims by the pharmaceutical industry led to widespread misuse and abuse of these medications (NIDA 2017). The National Institute on Drug Abuse (NIDA) described this trend as a “national crisis”: the misuse and addiction to opioids has caused more than 90 deaths per day, causing a serious public health concern (NIDA 2017). The Centers for Disease Control and Prevention (CDC) and others have described the increased prevalence of opioid-related deaths involving alcohol (Gomes et al. 2017; Jones et al. 2014). Both Gomes et al. (2017) and Jones et al. (2014) report that approximately one in five opioid fatalities involve alcohol.

The Federal Drug Administration (FDA) warns of serious risks and death when opioids and alcohol are consumed concurrently (FDA 2016). Symptoms of opioid and alcohol interaction are often described as central nervous system (CNS) depression, including dizziness or lightheadedness, extreme sleepiness, slowed or difficult breathing, or unresponsiveness (FDA 2016; Mozayani and Raymon 2004). Although some researchers have expressed interest in defining this interaction quantitatively, few have reported definitive results (Cushman et al. 1987; Gudin et al. 2013). Additional research to better define this interaction has become both a priority and a necessity in light of the recent crisis.

Cardno ChemRisk’s team of toxicologists and health risk assessment professionals have conducted research into the toxicology and kinetics of alcohol in the body following ingestion, and are currently conducting research on opioid and alcohol interactions, as well as opioid impact on BAC. If you would like to learn more about our areas of expertise in drug and alcohol pharmacokinetics and forensic toxicology, please contact Dr. Ernest Fung.
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