Medically Reviewed by Cheryl Mearig, PharmD.
Medically Reviewed by Cheryl Mearig, PharmD.
In this article
The misuse of prescription opioids and the overuse of alcohol are an increasingly dangerous combination. The consequences of mixing these two substances can be life-threatening. Yet, it’s something that too many people continue to do.
Unfortunately, when opioids and alcohol mix, the risk of developing a physical dependency increases. It also heightens the suffering from serious health issues in both the short and long term.
This blog post explores why you should avoid this co-abuse, discusses its effects on your body and mind, and lists resources for seeking help if you or someone you know has started combining these drugs.
Alcohol, or ethanol, is a depressant that affects the central nervous system. Makers produce it by fermenting carbohydrates and sugars.
When you consume it in moderation, alcohol can provide relaxation and increased sociability. It can also help reduce stress and anxiety.
However, alcohol can potentially do serious harm in excessive amounts. Alcohol abuse can lead to health issues, such as:
The symptoms of alcohol intoxication include:2, 3
Alcohol use disorder (AUD) is a medical term that describes an alcohol problem that has become severe.
Certain symptoms characterize it, such as:
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Opioids are natural or synthetic drugs physicians prescribe to reduce pain. Illicit drugs like heroin and prescription painkillers like hydrocodone and fentanyl fall under 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 of the body.
Opioid drugs work by triggering a chemical change in the brain. This 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 you take them together, the effects of each substance can cause adverse symptoms that negatively affect the brain.
Common side effects of prescription opioids include:
Symptoms of opioid intoxication include:
Opioid use disorder (OUD) can happen with illicit and prescription opioids. Like alcohol use disorder (AUD), you may experience cravings, tolerance, withdrawal, and loss of control.
Alcohol and opioids have their own set of risks and side effects. These factors compound when you take the two substances together.
Specifically, mixing alcohol and opioids may lead to higher toxicities and slower excretion rates.4 The combination can cause complications, such as:2, 3, 5
Research has shown that approximately one in five deaths from prescription opioid misuse also involved alcohol. In addition, binge drinkers were nearly twice as likely to misuse prescription opioids as nondrinkers.11
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Withdrawing from opioid or alcohol use is a complex process. Dangers, difficulties, and risks heighten when withdrawing from the two substances simultaneously.
People who use opioids and those with alcohol dependence may experience seizures, delirium tremens (DTs), and other severe symptoms if they quit drinking.
Alcohol misuse interferes with treatment for opioid use disorder (OUD). In addition, opioid misuse leads to poorer alcohol use disorder (AUD) treatment outcomes. 11
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Alcohol and opioids are both depressants. Mixing two depressants can cause symptoms like:2
In the case of an overdose, the body experiences a dangerous surge of alcohol or drugs. This leads to a disruption in critical functions such as breathing, heart rate, and temperature control.7
With respiratory depression, breathing slows down, which decreases oxygen levels. The brain will shut down organ systems, which can lead to coma or possibly even death.9
Statistics on Opioid-Related Deaths
In 2010, there were 21,089 opioid-related overdose deaths. This escalated to 47,600 in 2017 and maintained at a steady level until 2019.5
There was a sharp increase in 2020, with 68,630 reported deaths. This trend continued in 2021, with a staggering 80,411 reported overdose deaths.5
Immediate Responses to Overdoses
If someone overdoses on opioids, call 911 immediately. Excessive alcohol consumption, or alcohol poisoning, is an emergency situation.
A healthcare provider will administer a drug called naloxone to address overdose symptoms. It rapidly reverses opioid overdose by binding to the same brain receptors as opioids, blocking their effects.8
People physically dependent on opioids and alcohol should seek medical care to treat substance use disorder (SUD).
Inpatient rehab or residential treatment is ideal for those with severe addiction or co-occurring disorders. People stay in the facility, receiving 24-hour care to manage withdrawal symptoms.10
Medications play a crucial role in treating opioid addiction. These drugs include:1, 10
Medications for alcohol addiction include:10
The Food and Drug Administration (FDA) also approved Naltrexone 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 you use them with medications. Examples of behavioral approaches include:1, 10
The societal implications of opioid and alcohol misuse are devastating. In addition to the physical risks, substance abuse can cause:
Organizations like the Substance Abuse Mental Health Services Administration (SAMHSA) are committed to strengthening communities by helping those with addiction issues. Their approach emphasizes prevention, early diagnosis, integrated treatment, and recovery support.
Combining opioids and alcohol can be highly dangerous. Taking them together increases the risk of overdose, addiction, or death. Therefore, it’s essential to understand the potential risks and preventative strategies to avoid this substance abuse.
If you suspect someone is misusing opioids or alcohol, call 911 immediately. It’s also important to seek medical care to treat substance use disorder (SUD).
Medication-based approaches and behavioral treatments are available to help those struggling with addiction. It’s also essential to understand the societal implications of substance misuse and take steps to reduce its effects on people and communities alike.
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