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Alcohol, or ethanol, is a chemical substance that produces an intoxicating effect. Drinking alcohol is legal in the U.S. for people 21 years of age or older. However, drinking in excess can lead to harmful health consequences.
People who regularly drink alcohol can develop tolerance, requiring them to drink more to feel the same effects. They may also experience withdrawal symptoms if they quit suddenly.
Opioids are a type of natural or synthetic drug prescribed to reduce pain. Illicit drugs, like heroin, and prescription painkillers, like hydrocodone and fentanyl, are included in this class.
Doctors prescribe opioid medications for moderate-to-severe pain. These drugs block pain signals by binding to opioid receptors in the brain, spinal cord, and other areas in the body.
Opioids cause a chemical change in the brain, which results in pain relief and mood changes such as intense pleasure or euphoria. These chemical changes can reinforce repetitive drug use, making opioids highly addictive.1
Both alcohol and opioids are central nervous system (CNS) depressants. When taken together, the effects of each substance can cause adverse symptoms that negatively affect the brain.
Some symptoms of alcohol intoxication include:2, 3
People with alcohol use disorder (AUD) may have symptoms like:
Common side effects of prescription opioids include:
Symptoms of opioid intoxication include:
Opioid use disorder (OUD) can happen with both illicit and prescription opioids. Like alcohol use disorder (AUD), cravings, tolerance, withdrawal, and loss of control may be experienced.
Both alcohol and opioids are associated with their own set of risks and side effects. These factors compound when the two substances are taken together.
Mixing alcohol and opioids may lead to higher toxicities and slower excretion rates.4
The combination can cause complications like:2, 3, 5
Research has shown that approximately one in five deaths attributed to prescription opioid misuse also involved alcohol. In addition, binge drinkers were nearly twice as likely to misuse prescription opioids as nondrinkers.11
Withdrawing from opioid or alcohol use is a complex process. Dangers, difficulties, and risks are increased when withdrawing from the two substances simultaneously.
People who use opioids, and who have alcohol dependence, may experience seizures, delirium tremens (DTs), and other severe symptoms if they quit drinking.
Research has shown that alcohol misuse interferes with treatment for opioid use disorder (OUD). In addition, opioid misuse has been linked with poorer alcohol use disorder (AUD) treatment outcomes. 11
An overdose happens when there is a high level of alcohol or drugs in the body. Functions like breathing, heart rate, and temperature control become disregulated.7
Roughly 500,000 people died from opioid overdoses between 1999 and 2019.8 Over half of the opioid overdose cases involved alcohol abuse.5
Alcohol and opioids are both depressants. Mixing two depressants can cause symptoms like:2
With respiratory depression, breathing slows down which decreases oxygen levels. The brain will shut down organ systems, and can lead to coma or possibly even death.9
If someone overdoses on opioids, call 911 immediately. A drug called naloxone should be given to anyone who shows symptoms of overdose. It rapidly reverses opioid overdose by binding to the same brain receptors as opioids, blocking their effects.8
Excessive alcohol consumption, or alcohol poisoning, is an emergency situation. If someone experiences alcohol poisoning, call 911 and seek medical help immediately.
People with a physical dependence on opioids and alcohol should seek medical care for treatment of substance use disorder (SUD).
Inpatient rehab or residential treatment is recommended for people with severe addiction or co-occurring disorders. People stay in the facility where they are given 24-hour care to manage withdrawal symptoms.10
Medications may also be used for opioid addiction, including:1, 10
Medications for alcohol addiction include:10
Naltrexone is approved by the Food and Drug Administration (FDA) to treat both AUD and OUD. It can block opioid receptors and decrease opioid cravings. It can also reduce cravings for alcohol.1, 10
Behavioral treatments are effective, especially when used with medications.
Examples of behavioral approaches include:1, 10
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