Respiratory Depression: Synergistic Effect of Opioids + Alcohol = Increased Risk

The risk of opioid induced respiratory depression (OIRD), especially among elderly patients, may be even more pronounced than previously thought, according to findings from a new study published online this week in the journal Anesthesiology. The study reports that a single dose of oxycodone taken in conjunction with even moderate amounts of alcohol can elevate the risk for OIRD, and that the effect is more likely in older patients. Study author Albert Dahan, MD, PhD, head of the Anesthesia and Pain Research Unit at Leiden University Medical Center, Leiden, the Netherlands, commented, “Respiratory depression is a potentially fatal complication of opioid use. We found alcohol exacerbated the already harmful respiratory effects of opioids.”

The study compared the effect on breathing of a combined intake of oxycodone and alcohol in 12 volunteers aged 21 to 28, and 12 participants aged 66 to 77. The researchers reported a “synergistic” effect” between opioids and alcohol on both baseline minute ventilation rate, and on the frequency with which a subject experienced temporary breathing cessation. The latter effect was especially pronounced among the older study cohort due, the study surmised, to reduced physiological reserve in this population.

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The journal abstract may be read here.

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