Opioids and Alcohol: What You Should Know

Opioids are strong painkillers that are prescribed to individuals when milder medications, such as OTC pain killers, are ineffective. They’re common in treating a severe injury or post-surgery recovery as they can help block pain signals in the nervous system and subdue the sensation of pain. Unfortunately, opioids also cause sedation and euphoria, which can lead to dependency and abuse. 


Even for those individuals who take opioids exactly as prescribed, a common question for doctors and pharmacists might be, can I drink alcohol while taking opioids? The more serious side to this question, however, is for those who are abusing opioids. That’s why we’ll examine the effects of alcohol when combined with opioid use and abuse.



In the U.S alone, roughly 2 million Americans who engage in opioid misuse do so while also binge drinking, and approximately 2 in 3 Americans above the age of 26 who misuse opioids binge drink as well.


As both alcohol and opioids are central nervous system depressants, both acting together can amplify the sensation of numbness and relaxation, which makes it attractive to be used concurrently by individuals addicted to this ‘high.’ However, at high enough doses, this pairing can cause a wide range of effects ranging from memory loss to cardiac arrest.

Given the prevalence of alcohol use with opioid abuse, it’s essential to understand the main effects of combining these two substances. 


Effects of using Alcohol and Opioids Together


Since both alcohol and opioids are depressants, they can give off a strong sense of relaxation when consumed together. Alcohol, in this case, amplifies the effects that opioids produce and can lead to an individual feeling extremely drowsy and dizzy-a perfect recipe for accidents to occur such as a dangerous slip or fall. 


Naturally, the effects of drowsiness or dizziness correlate to motor function impairment. Mixing alcohol and opioid use significantly reduces an individual’s motor reflex times and can be dangerous when engaged in activities such as driving. This can mean that any flight or fight response is subdued dramatically and can put an individual in harm’s way.

Respiratory Arrest or Depression

One of the most important reasons to never mix alcohol with opioids is the high risk of respiratory depression. The depressant effect is amplified when both substances are mixed together and after initial doses. At low doses, individuals feel an extreme sense of relaxation, but as the dosage increases, it starts to affect their organs such as the lungs. Shallow breathing and instances of hypoxia can occur that cause brain damage, and at high enough doses it can begin to suppress core vital organ functions such as breathing.

Heart Attack or Stroke

The depressant nature of alcohol and opioids also affects other organs such as the heart. Opioid use alone is tied to a reduction in heart rate and when combined with alcohol at high doses can lead to cardiac arrest or a stroke. 

Memory Loss

Opioids are pain inhibitors and work by restricting nervous signals to the brain that help perceive pain. This can have added effects of causing short or long-term memory loss, and when combined with alcohol, increases the risk of this occurring. 




Emergency Treatment


Individuals who are experiencing severe effects of an overdose to alcohol and opioid abuse can reverse the effects of the overdose with a dose of naloxone, more commonly known by the brand name, Narcan.


Long Term Treatment


When it comes to long term abuse and addiction treatment, various strategies exist that begin with gradually weaning the individual off both substances known as detoxification. Common strategies during or after detoxification include counseling or therapy, coupled with Medication Assisted Treatment, which uses medications such as buprenorphine to slowly wean patients off of opioids. What is important to note is that opioid and alcohol dependency exist as co-occurring disorders and each one needs to be treated separately with its own treatment plan.


group therapy

The use of prescription painkillers such as oxycodone can be a regular activity for individuals in managing pain, and the dangers of combining it with alcohol can go unnoticed. It’s common to think that a prescribed medication could be mixed with a few glasses of wine over dinner. However, this is all it takes for the depressant effects to be amplified and prove dangerous to one’s health. Because of this, it’s crucial to have a zero-alcohol policy whenever any form of opioid pain medication is ingested. 





About the Author

Paula Nicola, M.D.
Dr. Nicola is the Facility Director at Renu. She is a trained and board certified medical doctor with specialized training in addiction medicine.

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