Naloxone for alcohol intoxication?

[pzh200707]

Hi med student here,
I have a question on whether naloxone could be used for alcohol intoxication. I originally believe naloxone, as a part of coma cocktail is no longer recommended routinely with the concern of opioid withdrawal symptoms. But in my country, I've seen many doctors doing that, and our guideline thinks it could hasten the recovery. I did find some old articles saying naloxone has some effect on ethanol intox.
eg. The mechanism of the antagonism by naloxone of acute alcohol intoxication.

My questions are: does naloxone really work? will you order that in real practice?
TIA

---

Members don't see this ad.

 

[turkeyjerky]

I don't know anything about the effects of naloxone on alcohol metabolism. I doubt they'd be clinically significant, if they exist at all. Most alcoholics are going to have their alcohol metabolism system upregulated a fair amount to begin with, and alcohol generally exhibits zero order metabolism because everything is saturated.

In practice, naloxone commonly exhibits a non-specific stimulation. This can confuse people sometimes, because they'll given it to a patient with an undetermined encephalopathy, and the patient will have a mild increase in their level of alertness, leading to an incorrect conclusion that they were opiod-intoxicated. I could see a similiar thing happening w/ ethanol intoxication.

In practice, here in the U.S., nobody administers naloxone to suspected alcohol intoxication. Generally we just allow them to sleep it off, as acute alcohol intoxication usually well-tolerated. (Additionally, naloxone has a t1/2 of about 45 minutes, so it would wear off far before the alcohol, leading to re-intoxication. (a similiar phenomenon happens with long-lasting opiods such as methadone or oral overdose, so sometimes a naloxone infusion is started on these patients)

 

[namethatsmell]

In the US the most common thing you'll see naltrexone used for in patients with alcoholism is in the chronic setting to promote cutting down drinking and abstinence.