Taking opioids, such as oxycodone or morphine, in combination with alcohol can have severe consequences and be fatal. Because opioids and alcohol are both depressants, combining them can have a synergistic effect. This means the effect of each substance is stronger when taken together than when taken separately.

This article looks at how opioids affect the body, how alcohol affects the body, the lethal potential of combining the two, and other harmful side effects of mixing alcohol and opioids.

We also look at treatment for a person who has taken both alcohol and opioids, treatment options for alcohol use disorder and opioid use disorder, and how to find these treatment options.

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A doctor may prescribe opioids, such as oxycodone, for pain relief. Depending on the type of opioid, they can control pain for up to 12 hours, as they are a time-release drug. Rather than releasing all at the same time, the medication’s effects continue to release over an extended period.

Opioids work by binding to and activating opioid receptors on nerve cells in the brain, spinal cord, and other areas of the body. These receptors are a type of protein known as G protein-coupled receptors. By binding to the receptors, opioids block pain signals to the brain and produce an analgesic or pain-relieving effect.

Opioid pain relievers are generally safe when a doctor prescribes them, and a person takes them for a short amount of time. However, opioids can become addictive, as they produce a euphoric “high” feeling. This can lead to overdose and death if a person takes them regularly for nonmedical reasons. According to the World Health Organization, about 115,000 people died of an opioid overdose in 2017.

When a person drinks alcohol, their bloodstream quickly distributes it to the brain, liver, kidneys, and lungs. It takes, on average, 1 hour for the body to break down one unit of alcohol. This can depend on a person’s age, weight, gender, and other factors.

Alcohol affects various parts of the body in different ways. These include:

  • Stomach: A person absorbs around 20% of the alcohol in their bloodstream via their stomach and the rest through their small intestine. Drinking a small amount of alcohol can increase hunger, as it increases the flow of stomach juices. Drinking a large amount can cause malnutrition and stomach ulcers, irritating the stomach lining.
  • Blood: Alcohol widens blood vessels as it enters the bloodstream, leading to blushing, a drop in pressure, heat loss, and a temporary feeling of being warm.
  • Liver: Responsible for most of the body’s breakdown of alcohol, the liver is especially susceptible to damage due to alcohol consumption. Up to 90% of people who drink heavily will develop a type of liver disease known as fatty liver.
  • Kidneys: Alcohol increases urine production, as it is a diuretic. A person may need to urinate more often while drinking alcohol, which can lead to dehydration.
  • Brain: Alcohol can dull parts of the brain that control bodily functions. This can influence a person’s decision-making and mood and cause loss of coordination, slurred speech, and blurred vision.

If a person takes opioids and alcohol together, they may experience severe and dangerous consequences. A 2017 study found that taking even one tablet of the opioid oxycodone with a modest amount of alcohol can increase the risk of respiratory depression. This causes breathing to become extremely shallow or stop altogether.

The study found that when a person combines alcohol with oxycodone, the number of times they temporarily stop breathing increases significantly, especially in elderly participants.

If a person takes alcohol in combination with opioid medications, their breathing rate may become so depressed that their brain does not receive enough oxygen. If this happens, organs may begin to shut down, and the person may eventually experience brain complications, coma, or death.

If a person appears to have ingested a dangerous amount of both substances, call the poison control helpline for assistance: 1-800-222-1222.

If the person has had a seizure, collapsed, does not wake up immediately, or has trouble breathing, immediately call emergency services.

A person can speak with a doctor about keeping a rescue medication called naloxone (Narcan) to take in case of an overdose of opioids. This medication can block the effects of opioids, which may relieve some of the symptoms of overdose.

A person can decide on a treatment plan with a health care professional or specialist in addiction and recovery. This may include counseling, medication for the treatment of addiction, and regular visits to a treatment facility or support groups.

Groups that can support people experiencing an addiction include:

  • The National Institute on Drug Abuse, which provides many resources and research on addictive substances.
  • Alcoholics Anonymous, which provides information, help, and support for people with alcohol use disorder.
  • Narcotics Anonymous, which provides help, support, and information for people trying to overcome addiction to narcotics.
  • Al-Anon, which provides support to family and friends of people with an alcohol abuse disorder.

People can also find help through the resources listed below.

Help is available

Seeking help for addiction may feel daunting or even scary, but several organizations can provide support.

If you believe that you or someone close to you is showing signs of addiction, you can contact the following organizations for immediate help and advice:

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Opioids work by binding to opioid receptors, creating an analgesic effect by blocking pain signals to the brain. They can also produce a feeling of euphoria. Alcohol works by spreading through the body via the bloodstream.

If a person combines opioids and alcohol, the effects of each can become stronger than they would be alone, which can have dangerous side effects. The most serious potential side effect is depressed breathing, which can result in death. If someone has mixed alcohol and opioids and appears to be at risk of complications, a person should call emergency services.

Treatment for alcohol and substance addiction may vary between people, facilities, and programs. It may include counseling, medication, and regular visits to a support group or treatment facility.