Glucose Tolerance And Hormonal Responses In Heroin Addicts. A Possible Role For Endogenous Opiates In The Pathogenesis Of Non-insulin-dependent Diabetes
Abstract Plasma glucose, insulin, glucagon, and growth hormone responses to intravenous glucose stimulation were investigated in 15 heroin-dependent men and in 15 control subjects matched for age, sex, and weight. Although the fasting concentrations of insulin, glucagon, and GH were significantly higher in the heroin addicts, they had markedly reduced plasma insulin responses to intravenous glucose (acute insulin response, calculated as the mean change in insulin levels over 3 to 10 minutes: 10 ± 5 μU/mL in the addicts v44 ± 9 μU/mL in the controls, P < 0.001) and glucose utilization rates in the diabetic range (KG: 0.96 ± 0.09%/min in the addicts v1.65 ± 0.10%/min in the controls, P < 0.01). These results show that chronic heroin administration produces a state of fasting hyperinsulinemia even in the absence of obesity, glucose intolerance, and a marked reduction of the first phase of insulin secretion. A possible role for endogenous opiates in the pathogenesis of non-insulin-dependent diabetes is hypothesized. Continue reading >>
Effects Of Heroin Addiction On The Responses Of Glucose, C-peptide And Insulin To A Standard Meal.
Abstract 1. The aim of the study was to examine the responses of plasma glucose, C-peptide immunoreactivity (CPR) and total immunoreactive insulin (IRI) to a standard meal in heroin addicts, since the presence of immunoreactive beta-endorphin has been demonstrated in human endocrine pancreas. 2. Ten heroin addicts and 10 control subjects participated in the study. The addicts had been taking heroin (from 0.5 to 2 g/day) for at least 2 months and they had no detectable diseases. 3. After a 12 h fast, each subject received a standard meal; blood samples were taken at -15, 0, 15, 30, 60 and 120 min to determine glucose, CPR and IRI. Calculation of the CPR/IRI molar ratio was used as a semiquantitative estimation of the hepatic extraction of insulin. 4. No difference in plasma glucose was observed between the groups. Addicts had lower CPR than normals at 15, 30 and 120 min (P less than 0.01). On the contrary, IRI was higher in addicts than in normals (P less than 0.05 at -15 and 0 min, P less than 0.01 at 15, 30 and 60 min), except at 120 min. The CPR/IRI molar ratio was lower in addicts (P less than 0.01). 5. Heroin addiction seems to produce a beta-cell failure and contemporaneously a state of hyperinsulinaemia; blood glucose remains in the normal range. 6. We conclude that chronic heroin addiction may produce a change in the rate of hepatic extraction of insulin. Continue reading >>
Heroin - Topic Overview
Heroin is an illegal, highly addictive drug. It is a white or brown powder or a black, sticky substance (black tar heroin). It can be sniffed, snorted, smoked, or injected into a muscle or vein. It is often mixed (cut) with other drugs or substances, such as sugar or powdered milk. It may also be cut with poisons, such as strychnine. Other names for heroin are smack, junk, H, and ska. The pleasurable sensation from heroin is called a rush, and the intensity of the rush depends on how much drug was taken and how rapidly the drug entered the brain. When a person injects heroin directly into a vein, the rush occurs within seconds, whereas it takes at least 10 minutes when the drug is sniffed or smoked. Along with the rush, the person using heroin usually has a warm flushing of the skin, small pupils, watery eyes, runny nose, dry mouth, and a heavy feeling in the arms and legs. Heroin may also cause nausea, vomiting, and severe itching. Soon after the rush, the person feels drowsy and very relaxed. Breathing and heart rate slow, thinking becomes cloudy, and the person may fall into a state like a trance that can last 4 to 6 hours. Heroin is often used along with other drugs, especially cocaine and alcohol. Some people snort alternate lines of heroin and cocaine, which is called crisscrossing. Or they may inject it with another drug (speedball). With repeated use, heroin causes the person to need higher and higher doses of the drug to get the same effect (tolerance). It also causes the person's body to need the drug to function (physical dependence), which leads to withdrawal symptoms within a few hours if the person stops using it. Physical and psychological dependence can develop within a few weeks if the drug is used daily. Several health problems can develop with heroin Continue reading >>
Yes To Heroin, Insulin No
IN MOST drugs league-tables, Britain fares poorly. More cocaine disappears up British nostrils than any others in Europe and cannabis is likewise more popular. But amid the gloom there is a success story. Britain's 200,000 or so injecting drug abusers are relatively unlikely to pick up an illness from their habit, thanks to the free needle-exchange services that have existed since the 1980s. These allow them to collect clean needles and ditch their old ones with no questions asked. That is one reason why fewer than 2% of injecting addicts in Britain are HIV-positive. (In Spain, by contrast, which came round to the idea of exchanges much later, more than 20% have the illness.) On February 25th the National Institute for Health and Clinical Excellence (NICE), an official advisory panel, recommended that such services be made more widely available. Oddly, one group of drug-dependants has a tougher time getting and disposing of their needles: diabetics. The 250,000 Britons who have type-one diabetes, and about a third of the 2.3m with type-two diabetes, shoot up with insulin several times a day. Among them they get through almost 900m needles a year. But whereas illicit drug users can pick up needles and sharps bins freely over the counter in many pharmacies (and in a choice of colours, to prevent accidental sharing), diabetics need a doctor's prescription (for which, at least, there is no charge). If that seems mildly unjust, it gets more so when diabetics try to dispose of their needles. “I'm terribly sorry. Unless you've used them for illegal drugs, we're not allowed to take them,” says one London pharmacist. Under a needle-exchange initiative she is paid by the local health authority to get rid of needles handed in by illicit drug users, but not by diabetics and oth Continue reading >>
Did My Heroin Habit Give Me Diabetes?
Having just had a medical, my doctor informed me that my blood sugar level was 7.9 and that I was diabetic. Could this be linked to my former addiction to heroin? I kicked the habit last year, as I was only eating a piece of toast every few days. I have put on weight, but seem unable to build it up past my current weight. It is unlikely to have anything to do with your experience of last year. Diabetes at your age is usually probably of the pancreas which is failing to produce enough insulin. You will need further tests to find out whether or not this is true and it may be that you need some treatment as well as diet advice professionally. I don't mean diet as in losing weight, I mean in what you can healthily eat. Yours sincerely The NetDoctor Medical Team Other Qs & As Last updated 03.04.2011 Continue reading >>
Morphine, Opioid Peptides, And Pancreatic Islet Function
Since the isolation of enkephalins 7 yr ago, there has been an explosive increase in knowledge and an enormous interest in the action of both exogenous and endogenous opiates. This review deals with the interaction of opiates with the endocrine pancreas. The results of animal studies performed in vitro do not allow any conclusion to be drawn, because the effects of opioid peptides on pancreatic hormone release seem dependent on many variables, including the agent investigated, dose administered, concentration of glucose in the medium, and experimental procedure used. The results of in vivo animal studies suggest that central administration of opiates and opioid peptides acts indirectly via the sympathetic nervous system to cause hyperglycemia and impaired insulin secretion, while peripheral administration tends to stimulate insulin and glucagon secretion. This last statement seems also to be true for studies performed in human beings. The narcotic addict offers a model to evaluate the hormonal and metabolic effects of a chronically administered agent that binds and activates endogenous receptors. In these subjects, it is possible to find increased concentrations of glycosylated hemoglobin A1 and a marked reduction of the acute insulin response to intravenous glucose, but not to arginine, which suggests a state of defective glucose recognition by pancreatic β-cells during narcotic addiction. Thus, the heroin addict, like patients with non-insulin-dependent diabetes, does not respond appropriately to glucose signals. Moreover, naloxone, an opiate-receptor blocking agent, can cause a partial restoration of the acute insulin response to i.v. glucose in some subjects with non-insulin-dependent diabetes. An increased sensitivity to endogenous opiates—enkephalins—might be Continue reading >>
Diabetes And Substance Abuse
Managing a diabetes problem means paying close attention to each and every molecule of food and drink that enters the body. Strict control like this can keep blood sugar levels in check, and sometimes a proper diet can reduce a person’s need for diabetes medications. Unfortunately, some people add drugs or alcohol into their dietary mix, and when they do, control of the disease could become elusive. Substance Abuse Among Diabetics Anyone could choose to amend the body’s chemistry with drugs and alcohol. But people with diabetes might be prone to abusing substances, simply because of the pressures they face due to the day-in-day-out pressures of controlling a chronic condition. For example, young people with type1 diabetes grow up under a cloud of restrictions. They can’t eat birthday cake, gorge on Halloween candy or run around barefoot in the springtime. They might feel just different than their peers, and they might long for the day in which they can shed all of their restrictions and live a life that’s free. When these young people hit adolescence, they might choose to rebel against their diagnosis, dabbling in foods they shouldn’t eat and skipping medication doses just to see what might happen. According to an article in Diabetic Medicine, the poorest level of glycemic control is seen in people who are between the ages of 16 to 18, and unfortunately, this is the point at which many young people are also tempted to abuse drugs. The consequences of poor diet control and drug use can be severe, as this article suggests that drug use is associated with death due to diabetes events in this age group. When adulthood arrives, people with diabetes might be slightly more likely to adhere to a strict diet and medication routine. However, people with diabetes might a Continue reading >>
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Signs Of Heroin Addiction
A heroin addiction can be difficult to talk about, even with a loved one. People who experience addiction aren’t always honest about their substance abuse. In fact, they may not even be aware themselves of how far out of control things have gotten. Though it may be difficult, having a conversation about heroin addiction can potentially be lifesaving. If you suspect that someone you care about is addicted to heroin, pay attention to their home, physical characteristics, and lifestyle habits. This may help you discover the truth and learn the depth of the problem. Identifying the signs of heroin addiction is an important first step toward supporting your loved one’s recovery. Learning to recognize the devices used with heroin and what the drug actually looks like may help you identify heroin use in someone you care about. In most cases, a heroin user needs certain paraphernalia to get high. Heroin can be injected, snorted, or smoked. Needles, pipes, and spoons with lighters are often used. In some cases, people who are addicted to heroin use rubber tubing or elastic bands as tourniquets to make their veins larger. This helps them inject heroin into veins that have been damaged by regular heroin use. Heroin itself is a powdery, crumbly substance. It’s often off-white, but its color can range from white to dark brown or black. Black tar heroin gets its name from the way it looks. This type of heroin is a black, sticky substance. The physical symptoms of heroin use occur rapidly. After injecting it, someone will experience drug-induced euphoria quickly, often within seconds. Other means of using heroin don’t produce a reaction as quickly, but users show signs of being high when the drug reaches their brain. Physical symptoms of heroin use include: dry mouth flushed s Continue reading >>
My Life As A Diabetic Heroin Addict
Because I’m a diabetic, I forget that syringes really freak people out. The tragic death of Philip Seymour Hoffman reminded me of this. When he died I was stunned. I called friends and family for help in getting my mind around the fact that he was dead. That he OD’d on heroin made his death seem more shocking. Then I read stories about how he was found with a needle in his arm. In many articles that image was considered more disturbing and off-putting than the very fact of his death. However, for me that image finally grounded his death in reality. It took absolutely no effort to picture the needle. I could see the orange cap that was probably on the ground or somewhere else nearby. As a diabetic I’ve been around syringes for more than 35 years. There’s a box of the things in my bathroom closet. I keep one in a bowl alongside my insulin in my refrigerator so everything I need is close at hand. And I always make sure I have a ½ cc needle in my pocket, along with a few doses of fast acting insulin and a roll of Lifesavers, every time I leave the house. But, while they’re second nature to me, they’re disturbing to most everyone else. I grew up a skinny diabetic on some very mean streets in the late 1980s. I lived on the Lower East Side of New York, near Alphabet City, Tomkins Square Park, and around more junkies per block than the Betty Ford Clinic sees in a year. One time, coming home at night some kid tried to rob me using a broken beer bottle. Having no clue what I was even doing, I reached into my pocket, pulled out my syringe, popped the cap off, and watched my assailant’s eyes grow enormous before he took off running. In my second semester of college I got a new roommate. I breezed into our room quickly between classes and introduced myself. He just st Continue reading >>
Impaired Glucose Metabolism In Heroin And Methadone Users.
Abstract Plasma glucose and insulin responses to both oral and intravenous glucose stimulation were evaluated in heroin and methadone addicts, compared to healthy control subjects. Both groups of addicts had an altered response to oral and intravenous glucose load. These phenomena were linked to a reduced insulin response. Moreover, increased fasting insulin levels in both groups of addicts were observed. These data show that both heroin and methadone addiction may alter glucose metabolism, and, furthermore, stress the findings of similarities between opiate addicts and non-insulin dependent diabetics. Continue reading >>
The Effects Of Diabetes On Drug Addiction
Addiction is always a dangerous disease, but it can be especially life-threatening for diabetics. Wild fluctuations in blood sugar can increase drug cravings and make long-term recovery all but impossible. Frequent drug abuse can also worsen the toll which diabetes already takes on people’s bodies. In order for diabetics to get healthy and stay sober, they need to understand the complex and dangerous relationship between their conditions. Understanding Diabetes Diabetes is a metabolic condition characterized by chronically high blood sugar levels. This phenomenon is caused by a malfunctioning in the body’s production and utilization of insulin – a hormone which normally diverts glucose from the blood into the cells of organs and muscle tissue. Type 1 diabetics are born with pancreases which don’t produce any insulin at all. On the other hand, type 2 diabetics develop their conditions later in life due to insulin insensitivity. Usually through poor diets, they overload their bodies’ insulin receptors, causing permanent damage to their abilities to use this crucial hormone. Most doctors believe this to be the reason why type 2 diabetics tend to be overweight or obese. Blood Sugar and Drug Cravings Although diabetes is a disease of high blood sugar, diabetics who treat their conditions often experience abnormally low levels. Since they either can’t produce insulin or can’t use it efficiently, they usually inject large amounts of it after meals. These injections can lead to the rapid uptake of glucose in their bodies, leaving them with extremely low concentrations of blood sugar – a phenomenon called hypoglycemia. Low blood sugar tends to induce hunger in healthy people, but the body’s feedback mechanisms for food and drug cravings are intertwined. Most ad Continue reading >>
Drug And Alcohol Use With Diabetes
Comprehensive Guide to Research on Risk, Complications and Treatment Substance abuse is described as the excessive use of a substance such as alcohol or drugs that results in significant clinical impairments as well as the loss of ability to function academically, professionally, and socially . An individual who was healthy before the substance abuse began will typically begin to experience serious health problems over time, but extensive damage may be avoided or reversed if effective substance abuse treatment is received. This is not the case, however, for individuals who have been diagnosed with diabetes, and although this is a manageable disease with proper treatment, substance abuse may cause it to become life-threatening. This guide will discuss, in detail, how substance abuse can negatively impact the life and health of a person with diabetes. Diabetes, also referred to as diabetes mellitus, is a condition in which the body is unable to properly regulate blood sugar levels. There are two forms known as type 1 and type 2 diabetes, but in order to better understand the difference between the two types, the role that insulin plays in the regulation of healthy blood sugar levels will be briefly described. During the digestive process, carbohydrates are broken down into glucose, which is a form of sugar that easily enters the bloodstream and is used by the body for energy. The pancreas normally responds to increasing blood sugar levels by initiating the production of the hormone known as insulin. As insulin levels increase, it signals the transfer of glucose into cells throughout the body and it also ensures that excess glucose will be stored in the liver in order to prevent high blood sugar levels. Type 1 diabetes, which is also called juvenile or insulin dependent Continue reading >>
The Relationship Between Opioid And Sugar Intake: Review Of Evidence And Clinical Applications
Go to: THE RELATIONSHIP BEWEEN OPIOID ADMINISTRATION AND SUGAR CONSUMPTION Evidence from both preclinical and clinical studies demonstrates that chronic opioid exposure is associated with increased sugar intake. Preclinical research has attempted to refine the potential pathways and mechanisms of action through which opiates may regulate sugar intake, and how sugar consumption may affect the endogenous opiate system. Preclinical animal studies suggest that direct action of mu agonists at the nucleus accumbens shell, hypothalamus, and paraventricular nucleus is associated with development of sweet preference (2–7). This process possibly involves GABA-b activity in the ventral tegmental area (6). Consumption of palatable foods, especially on intermittent schedules, is associated with acute binding of the endogenous opiate B-endorphin in the hypothalamus, accumbens shell, cingulated, hippocampus, and locus ceruleus of rats (2, 8). Furthermore, in rats, intermittent access to sucrose leads to decreased enkephalin MRNA production (9). It is theorized that this down-regulation of enkephalin MRNA production may be associated with increased mu-opiate receptor agonism associated with the rats’ sugar intake (10). Methadone-maintained patients assessed at entry to treatment, 9 months and 4 years into treatment demonstrate increased consumption of sugary food, fewer complex carbohydrates, less fruits, vegetables and fats from fish or vegetables (11). It was noted that female methadone patients consumed fewer total calories, but maintained similar BMI to the national average (BMI 22.7) with sugar accounting for 31% of caloric intake. The authors speculated that weight was maintained with fewer calories because of the patients’ “sedate lifestyles” (12). Clinical literature Continue reading >>
Opioid Use And Diabetes: An Overview
1 Department of Psychiatry, National Drug Dependence Treatment Centre (NDDTC), All India Institute of Medical Sciences (AIIMS), New Delhi, India 2 Department of Psychiatry, National Drug Dependence Treatment Centre (NDDTC), All India Institute of Medical Sciences (AIIMS), New Delhi, India; International program in Addiction Studies, King's College London, London, UK; International program in Addiction Studies, University of Adelaide, Adelaide, Australia; International program in Addiction Studies, Virginia Commonwealth University, Richmond, Virginia, USA Continue reading >>