Persistent increased immunoglobulin M in treated narcotic addition. Association with liver disease and continuing heroin use

The increased serum IgM in treated narcotic addiction was studied using quantitative radial diffusion techniques. Seventy per cent of 68 untreated heroin addicts had serum IgM levels above 880 mg. per deciliter, the upper limit of normal. Only 7 per cent of 15 abstinent patients had high serum IgM, while 36 or 33 per cent of 109 patients maintained on methadone for at least one year had high serum IgM levels. Fourteen of these 36 had known heroin use and 10 others abused other drugs including alcohol, whereas only 2 of the 73 methadone-maintained patients with normal serum IgM had known drug abuse. The association between positive urine spots for morphine and elevated serum IgM levels was significant (p < 0.01). There was a significant relationship between laboratory evidence of liver disease and increased serum IgM levels. Increased serum alkaline phosphatase correlated better (p < 0.01) than the serum glutamic oxaloacetic transaminase (SGOT) (p < 0.05) with high serum IgM levels in methadone-maintained patients. High serum IgM levels in treated addicts are associated with continuing drug abuse and/or with laboratory evidence of continuing mild liver disease.