Mixing Opioids and Alcohol Doubles Addiction Risks

One often overlooked aspect of our country’s opioid epidemic is the high number of individuals who are abusing both opioids and alcohol. This behavior, sometimes referred to as polydrug use, poses serious dangers and requires additional care during the detox process.

Legal Doesn’t Mean Risk-Free

Since alcohol and prescription opioids are both legal substances, many people underestimate the effect of using both substances together. Physicians will warn patients not drink while taking their medication, but someone who is accustomed to regular alcohol consumption may believe a few drinks won’t hurt. However, mixing alcohol and opioids is very dangerous. According to the Centers for Disease Control (CDC), almost 19% of opioid painkiller emergency room visits involve cases where alcohol was also consumed. In just over 22% of deaths related to prescription opioids, alcohol was also involved. Although addiction is commonly viewed as a problem that only affects young people, both alcohol and opioid abuse rates are growing among seniors. This is concerning because a 2017 study in the journal Anesthesiology found that adults over age 66 were more likely to experience episodes of respiratory depression (stopped breathing) when mixing opioids with a modest amount of alcohol.

Potential Effects of Mixing Alcohol and Opioids

The effects of alcohol use can include:

• Loss of coordination
• Impaired judgement
• Mood swings
• Slurred speech
• Blurry or double vision
• Confusion
• Dizziness
• Sleepiness
• Slowed breathing
• Irregular heart rate

The effects of opioid use can include:

• Confusion
• Nausea
• Vomiting
• Slowed breathing
• Drowsiness

Drinking alcohol within two hours of taking opioid painkillers is the riskiest type of polydrug use. When you mix alcohol and opioids in this way, the side effects of each drug are intensified. Some of the potential side effects can include:

• Nausea
• Vomiting
• Dehydration
• Seizures due to changes in blood sugar
• Dizziness
• Loss of coordination, leading to increase in falls or other accidents
• Fainting
• Changes in blood pressure
• Irregular heart rate
• Inability to concentrate
• Memory loss
• Abnormal behavior
• Organ damage, especially damage to the liver
• Coma

Alcohol and opioids are both depressants. Essentially, alcohol enhances the sedative effects of opioid medication while slowing a person’s heart rate and breathing rate. This means that someone who is using both substances may fall asleep and not wake up. Opioids with an extended release formula can have a “dumping effect” when mixed with alcohol. Instead of having the painkiller released slowly throughout the day as intended, the drug will suddenly flood the body all at once.

How Tolerance Affects Risk

Overtime, someone who regularly uses alcohol and/or opioids develops a tolerance. This means that he or she needs to take more of a substance to achieve the same intoxicating effects. An increased tolerance increases the risk of dangerous side effects. As a result, you can’t assume that mixing alcohol and opioids previously without experiencing any side effects means that this behavior is safe to continue.

Treatment for Overdose

Whenever you suspect someone is suffering from an overdose caused by mixing alcohol and opioids, call 911 immediately. You can’t sleep it off or counteract the effects by drinking a few cups of coffee. This is a medical emergency. While you wait for help, try to keep the person sitting upright. If the person must lay down, turn him or her to the side to prevent choking. Opioid overdoses can be treated with naloxone to provide time for the person to get more extensive medical treatment, but there is no medication that can reverse the effects of alcohol poisoning. Typically, treatment involves administering activated charcoal or pumping the stomach.

Detoxing Safely

Someone who is addicted to alcohol and opioids should never try to quit cold turkey without supervision. Detoxing from either alcohol or opioids can be fatal, so someone who is abusing both substances has an increased risk of deadly complications. A medical detox is the safest way to begin the recovery process if you suffer from addiction to both alcohol and opioids. You will be supervised 24/7 by a team of care professionals who monitor vital signs, administer medication to ease withdrawal symptoms, and provide emotional support as you work through the detox process. Completing detox means that your body is free of addictive substances, but it does not mean that you’ve conquered addiction. Detox is only the first step. If you don’t follow up with residential treatment that includes intensive counseling, you are likely to relapse within a short timeframe. Fair Oaks Recovery Center provides evidence-based treatment for individuals suffering from alcohol and/or drug addiction. Our treatment services provide the support necessary for a lasting recovery, incorporating counseling as well as holistic therapies and participation in 12-Step groups.