Alcohol And Opioids: Health Implications

Last Updated: April 10, 2020

Authored by Isaak Stotts, LP

The consumption of alcohol and opioid has fast become an epidemic, especially in the United States. The use of prescription opioids such as Oxycontin, Lortab, and Percocet concomitantly with alcohol is popular among drug abusers as this is done to enhance the “pleasurable” euphoric effects of these substances. Opioid medications specifically permeate the central nervous system inhibiting the perception of pain and providing a feeling of high, which is also a property of ethanol. Opioids are one of the most addictive prescription drugs, with a high tendency of abuse, and when mixed with ethanol, the side effects are significantly escalated, causing a significant health risk to the user. The consequences of combining opioids and alcohol are dire – health problems can, such as organ failure, addictions, overdose, and death, are possible.

How a Combination Of Opioids And Drinking Affects Health

Opioids and alcohol interactions and metabolism have been found to deviate when taken concomitantly. Ethanol has a high-speed disposal rate when ingested. However, the mixture of opioids and ethanol slows down the rate of disposal of both substances in the body. This inadvertently leads to high levels of substance toxicity. Ethanol can alter opioid receptors, and the drugs itself may increase the levels of intoxication of ethanol. These effects can be detrimental to health.

Oxycontin and alcohol activate the GABA receptors located in the brain. Similar to Vicodin and alcohol, a high level of intoxication is often experienced, which can lead to memory loss, slurred speech, loss of coordination and other side effects.
Hydrocodone and alcohol mixtures can cause a depreciating effect on brain function, intensify sedation with the risk of a coma or death. Possible side effects, dangers, and risks of morphine and alcohol mixtures include:

Short-term effects may include:

  • Nausea
  • Vomiting
  • Numbness
  • Slow pulse rate
  • Low blood pressure
  • Memory loss
  • Slurred speech
  • Suicidal behaviors
  • Apathy
  • Drowsiness
  • Unconsciousness
  • Difficulty in breathing
  • Mental confusion
  • Itchy flushed skin
  • constipation

Long-term effects may include:

  • Irritability
  • Liver problems
  • Constipation
  • Incessant mood swing
  • Overdose
  • Hypoxia
  • Addiction
  • Withdrawal syndrome
  • Brain damage
  • Coma
  • Chronic constipation
  • Death

Statistics On Opioids And Drinking

Numerous surveys have been conducted on opioids and alcohol use, both individually and concomitant uses. Opioids were found to be used by a significantly high population evident through the number of opioid prescriptions as well as average annual alcohol use statistics. In 2007, societal opioid prescription, misuse, and dependence totaled $55.7 billion, while the economic burden of the substance peaked at $78.5 billion in the year 2013.

Ethanol misuse disorder, on the other hand, was responsible for a $249 billion economic burden in 2010. Alcohol-related deaths were recorded at 88,000 persons yearly, with an estimate of 3 million deaths globally. When linked with stimulating meds and alcohol, the death toll rises even higher.

opioid pills and alcohol
There are exceedingly convincing pieces of evidence that the pharmacodynamic interactions of alcohol and opioids are highly problematic. There is evidence of frequent overdose on opioids and alcohol especially as the medication is very frequently prescribed for various chronic health disorders. Chronic pain affects at least 1 in every ten adults in the United States, hence the frequent use of pain relievers. The negative impact of medication and ethanol abuse, such as Codeine and alcohol, also becomes recurring due to the desire to achieve a feeling of high.

Signs A Person Abuses Opioids And Alcohol Together

Ardent abusers of substances such as fentanyl and alcohol often require high levels of these elements in their blood due to dependency and withdrawal symptoms. Mixtures such as heroin and alcohol are highly abused among addicts due to its potency, and often its symptoms can easily be noticed by others. Here are signs that a person may be abusing both ethanol and opioids:

  • Frequent intoxication
  • Slurred speech
  • Moodiness
  • Changes in behavior
  • High attachment to drinks and unknown substances they may possess
  • Detachment from reality
  • Weight fluctuations
  • Itchiness and flushed skin
  • Mixing medication with an unknown liquid
  • Taking more medications than required

Emergency Help For Opioids And Alcohol Overdose

Once tolerance is built by alcohol opioid receptors then dependency is developed by the user. The risk of an overdose greatly increases. Skeletal muscle relaxing meds and alcohol used together are bound to have antagonistic effects on health. Signs that a person may have overdosed on tramadol and alcohol or other opioid ethanol mixtures include:

  • Unresponsiveness
  • A limp posture with the inability to talk
  • Pale, clammy face
  • Blue lips and fingernails
  • Erratic, low, or no pulse
  • Shallow breathing
  • Choking, gurgling noises

There are a few steps to take in situations of overdose from alcohol and Vicodin or other opioids. The first may be to administer an effective opioid antagonist like naloxone if this medication is available and also if there is a professional who understands how to use it.

white pills on a table
In severe cases when opioids are used in combination with alcohol and barbiturates or some other medications, naloxone can be less effective, as it works only for several types of drugs.
Another step is to call for immediate medical support to report a case of overdose. An emergency unit will most likely be sent to the address provided.

In situations where the patient is not breathing, one could administer CPR (mouth-to-mouth) and then lay the victim on their side when they resume breathing independently.

Treating Alcohol and Opioids Addiction

Whether it is opioid or antibacterial drugs and alcohol combination, it always leads to various health mishaps. This can best be avoided by avoiding substance mixtures as well as confiding in a doctor on certain addictions that one may have before accepting prescription drugs. Many consequences can result from mixing alcoholic drinks with opioids, hence it is imperative to seek medical help on the risks of these mixtures.
Opioid ethanol addictions, as well as other combinations like mushrooms and alcohol, can be treated at special rehab facilities. Various techniques and treatment regimen is put in place to inhibit withdrawal symptoms and to ensure that the patient attains complete withdrawal from substance use and maintains sobriety.

Page Sources

  1. Katie Witkiewitz, Kevin E. Vowles. Alcohol and Opioid Use, Co-Use, and Chronic Pain in the Context of the Opioid Epidemic: A Critical Review. Alcohol Clin Exp Res. 2018 Mar; 42(3): 478–488.
  2. Final Report:Opioid Use, Misuse, and Overdose in Women July 19, 2017. Office on Women's Health.

Published on: January 21st, 2020

Updated on: April 10th, 2020

About Author

Isaak Stotts, LP

Isaak Stotts is an in-house medical writer in AddictionResource. Isaak learned addiction psychology at Aspen University and got a Master's Degree in Arts in Psychology and Addiction Counseling. After graduation, he became a substance abuse counselor, providing individual, group, and family counseling for those who strive to achieve and maintain sobriety and recovery goals.


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