HYPERIMMUNOGLOBULINEMIA IN HEROIN ADDICTION: SOME EPIDEMIOLOGIC OBSERVATIONS, INCLUDING SOME POSSIBLE EFFECTS OF ROUTE OF ADMINISTRATION AND MULTIPLE DRUG ABUSE1
Epidemiologic and clinical features of hyperimmunoglobulinemia in heroin addiction were studied in 250 New York City, 131 Washington, D.C., 36 Tucson and 7 Honolulu heroin addicts. The frequency with which increased serum IgG levels was found was similar in all groups studied. Increased serum IgM was found in about 75% of the New York addicts, 41% of the Washington, D.C., addicts; 25% of the Tucson addicts; and 57% of the Honolulu addicts. Demographic and clinical differences between the groups may have contributed to the different frequencies of increased serum IgM. The route of heroin administration was significant since patients who seemed to have used only intranasal heroin had generally normal serum IgM levels. Concomitant use of barbiturates, cocaine and amphetamines, when recognized, did not appear to be a factor in hyperimmunoglobulinemia. Since the diluents used in the eastern seaboard cities differed significantly from those in use in Arizona, the finding of hyperimmunoglobulinemia in both regions makes it unlikely that the diluents were a significant factor. Reduction in serum IgM abnormality was associated with methadone maintenance treatment in some patients.