Alcohol, opiates, barbiturates, and some street drugs have been reported to cause allergic reactions.

Types of Reactions

The symptoms and signs of immediate hypersensitivity reactions are hives, wheezing, swelling of face and lips, or full-blown anaphylaxis, a combination of all the above symptoms plus a dangerous drop in blood pressure. Abdominal pain and irregular heartbeat may also occur with anaphylaxis. Allergies to bee stings or penicillin cause similar reactions.

Symptoms of delayed hypersensitivity reactions include skin rashes, which may be red, itchy, or blistered. Also, the lymph nodes can become enlarged and nodules (small lumps) may appear in the skin or in organs. Poison ivy and cosmetic allergies cause symptoms of this type.

Alcohol

True allergic reactions to alcohol (ethanol) are rare. A person who appears to have an allergic reaction to an alcoholic beverage is usually reacting to other chemicals in the beverage, such as yeasts, metabisulfite, papain, or dyes. Some people get hives after drinking alcohol, and some people of Asian background have a high risk of developing hives from contact with alcohol.

Opiates, Barbiturates, and Street Drugs

Morphine, an opiate, can cause hives in some people. Anaphylaxis may also occur with either morphine or codeine. Heroin may cause some people to wheeze. Patients who have anaphylactic reactions to local anesthesia during surgery often are reacting to the preservative methylparaben rather than to the opiate itself. Numerous reports exist of anaphylactic reactions following the use of barbiturates, which are given to lower a patient's anxiety before surgery. Skin rashes also occur frequently following barbiturate usage.

Street drugs have been reported to cause asthma symptoms (shortness of breath, wheezing) and/or anaphylaxis. Drug users who smoke cocaine or who inject heroin experience wheezing. This may occur more often in patients who have a previous history of asthma. The asthma may persist after the subjects have stopped smoking cocaine. Pulmonary edema (fluid in the lungs) may also occur with freebasing, a way of preparing pure cocaine so that it can be smoked. Marijuana does not appear to increase the incidence of either asthma or anaphylaxis.

Because it is hard to predict how severe an allergic reaction may become, someone who develops allergic symptoms should immediately contact his or her healthcare provider, or go immediately to a hospital emergency department.

See Also

Complications from Injecting Drugs.