Dangers of Mixing Alcohol and Prescription Opioids

Polysubstance use, or polydrug use, are terms used to describe the consumption of two or more substances at the same given time.¹ Mixing alcohol and prescription opioids is an example of polysubstance abuse and is incredibly dangerous and can lead to serious consequences including overdose and death.²

This page will explain the dangers and risks of combining opioids and alcohol, the consequences of polysubstance use, and how to get help if you are struggling with a substance use disorder.

What Are Opioids?

Opioids are a class of drug that include illicit substances, such as heroin, and prescription medications like oxycodone. They work by activating opioid receptors in the brain, which can help to block pain signals in the body, which is what makes them effective for treating pain.⁵ However, opioids can also create a euphoric effect (e.g., a “high”) for some people,² which can reinforce misuse, leading to tolerance, dependence, and addiction.²

Common Prescription Opioids

Prescription opioids are most often used for the short-term relief of moderate-to-severe pain after surgery or after a serious injury.⁵ They are also used for the management of pain that accompanies serious illness, like cancer.⁵ Common prescription opioids include:

• Vicodin (hydrocodone).
• OxyContin/Percocet (oxycodone).
• Opana (oxymorphone).
• Morphine.
• Codeine.
• Hydromorphone.

Dangers and Effects of Mixing Alcohol and Opioids

Mixing alcohol with prescription drugs can increase the effects of alcohol and opiates, which can lead to serious health consequences, including overdose, organ damage, dangerously depressed breathing, coma, or death.⁶

 The effects of opioid use include:²

• Slowed breathing.
• Drowsiness.
• Confusion.
• Constipation.
• Nausea.

 The effects of consuming alcohol include:⁷ 

• Slurred speech.
• Incoordination.
• Unsteady gait.
• Nystagmus.
• Impairment in attention or memory.
• Stupor or coma

Possible health risks involved in combining alcohol and opioids are: ⁶ 

• Increased chance of risky behaviors.
• Increased vulnerability to chronic illness.
• Higher likelihood of engagement in violence.
• Greater chance of injury.
• Potential for overdose.
• Increased likelihood of dependence and addiction.

Physical dependence occurs when a person’s body has become so used to the presence of a substance (in this case opioids, alcohol, or both) that withdrawal symptoms occur when use is suddenly cut back or stopped.² 

Addiction is a chronic but treatable disease whose hallmarks are the continued compulsive use of substances despite negative consequences to a person’s quality of life, health, and relationships. ² 

Risk of Alcohol and Opioid Overdose

Mixing painkillers and alcohol can lead to overdose and death.⁶ According to the Centers for Disease Control (CDC), more than 263,000 people died from a prescription opioid overdose between 1999 and 2020.⁸ In 2016, 1 of 5 visits to the emergency department related to opioid misuse also involved the use of alcohol, and alcohol use played a part in 1 of 7 opioid-involved deaths in 2017.⁶ 

Signs of overdose should be addressed as quickly as possible. They include:^{9 signs}

• Pale or clammy skin.
• Limp legs and arms.
• Purple or blue lips and fingernails.
• Nausea, vomiting, or gurgling.
• Difficulty staying awake or being awakened.
• Slowed breathing and heartbeat.
• Small pupils.
• Difficulty or inability to speak.

Treating Alcohol and Opioid Addiction

Treating polysubstance addiction involving alcohol and opioid use can be a complex process because of the unpredictability of the interaction of the substances on the body.¹¹  In order to effectively manage and mitigate the potentially serious outcomes of withdrawal, a medically supervised detox is recommended for individuals with alcohol and opioid addiction.¹¹

While detox is an important part of the treatment process, it is often not sufficient for someone to achieve long-term sobriety. Generally speaking, the longer that someone engages in some form of continued addiction treatment, the better the outcome.¹²

If you are concerned about your drug and alcohol use — or that of a loved one — and want more information about treatment options and types of addiction treatment, contact our admissions navigators 24/7 at phone. At our inpatient rehab in Las Vegas, NV we use addiction-focused healthcare to help people find meaningful recovery from substance use disorders.