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Effects of Mixing Opioids and Alcohol

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Medically Reviewed By: Diana Vo, LMFT

March 13, 2024

Table of Contents

Combining central nervous system depressants like alcohol and opioids, whether the opioids are prescribed or not, poses serious risks to health and safety. This guide explores the effects of mixing alcohol and opioids so you can make more informed decisions if using these substances.

Opioids and Alcohol Interaction

Both alcohol and opioids – a class of drugs that include prescription pain relievers as well as illicit substances like heroin – produce effects that, while potentially damaging on their own, can lead to dire outcomes when combined.

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At a biochemical level, opioids bind to MORs (mu opioid receptors) in the brain and body, relieving pain and depressing the respiratory system. Alcohol, a CNS depressant, impacts the central nervous system by altering the levels of neurotransmitters, disrupting the brain’s communication pathways. Mixing opioids and alcohol produces a synergistic effect that is greater than the sum of their individual effects.

The interaction between these two depressants amplifies the risks associated with each. Not only does this combination increase the potency of each substance’s depressant effects, but it also creates a more complex challenge for the body’s ability to metabolize and eliminate the substances efficiently. The liver, which is primarily responsible for detoxifying the body, is particularly strained when forced to process both opioids and alcohol.

Individual variations in tolerance to opioids and alcohol can also contribute to unpredictable reactions. Factors such as age, body weight, genetics, and overall health status can dramatically influence how severely a person might be affected by mixing alcohol and opioids.

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Opioids and Alcohol Side Effects

Mixing opioids and alcohol can intensify the side effects of each, potentially triggering dangerous or life-threatening conditions. Both substances carry risks individually, but when combined, these risks are significantly amplified and may include:

  • Increased risk of overdose: Both opioids and alcohol depress the CNS, causing heart rate and breathing to slow down. Combining them can lead to intensified effects, greatly increasing the risk of accidental overdose and death.
  • Enhanced sedation: Opioids and alcohol can both cause drowsiness and sedation. When taken together, the level of impairment and sedation is much higher, increasing the risk of accidents, injuries, and the inability to perform daily tasks safely.
  • Respiratory depression: One of the most dangerous effects of mixing opioids and alcohol is severe respiratory depression, where breathing becomes slow or stops altogether. This can lead to hypoxia, a condition where the brain doesn’t get enough oxygen, sometimes resulting in coma or death.
  • Increased side effects: The combination of opioids and alcohol can enhance each other’s side effects, from dizziness, confusion, and impaired motor control to nausea and vomiting. These heightened side effects can make it difficult for people to summon help in an emergency.
  • Greater risk of long-term health issues: Chronic use of opioids and alcohol can lead to more severe long-term health complications, including liver damage, brain damage, and worsening of mental health disorders like depression and anxiety.
  • Development of substance use disorders: The simultaneous use of opioids and alcohol can increase the likelihood of developing substance use disorders, as the combination may enhance the addictive properties of each substance.

Given the severe risks associated with mixing opioids and alcohol, avoid using these substances together. If you or someone that you care about is struggling with substance use involving opioids and alcohol, seeking professional help is the first fundamental step toward recovery while ensuring safety and comfort during detox.

Is it Dangerous to Mix Opioids and Alcohol?

Mixing opioids with alcohol significantly raises the risk of overdose, a critical concern given the lethal potential of both alcohol and opioid overdoses.

Both substances independently suppress the central nervous system, affecting vital functions like breathing and heart rate. When combined, their depressant effects are magnified, leading to a much higher chance of overdose than when either substance is used in isolation.

This increased risk is due to the compounded effects on the body’s respiratory and cardiac systems, making it easy to exceed a safe level of consumption inadvertently.

Opioids and Alcohol Overdose Symptoms

Indicators of an opioid or combined alcohol and opioid overdose may include:

  • Significantly changed mental state
  • Unconsciousness
  • Lack of responsiveness
  • Weak heartbeat
  • Diminished or sluggish breathing
  • Choking noises
  • Lips or fingernails turning blue

Seek immediate medical assistance if you believe that someone is experiencing an opioid and alcohol overdose. Prompt action could be life-saving. Here’s how you can engage with compassionate and effective ongoing treatment.

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Get Treatment for Opioids and Alcohol Addiction at Renaissance Recovery

Addictions to opioids and alcohol can be highly disruptive, but they’re also treatable. We can help you achieve and maintain abstinence at Renaissance Recovery in Southern California.

For the safest and most seamless start to your recovery, inquire about supervised medical detox. We can connect you with licensed medical detox centers in California, enabling you to access medications and continuous care, streamlining the withdrawal process, and preparing you physically for ongoing treatment at our rehab center in Huntington Beach, CA.

When you engage with outpatient treatment at Renaissance, you can maintain your everyday obligations while accessing treatments proven effective for treating opioid and alcohol addictions, such as:

To move beyond opioid and alcohol addiction, call 866.330.9449 for immediate assistance.



At Renaissance Recovery our goal is to provide evidence-based treatment to as many individuals as possible. Give us a call today to verify your insurance coverage or to learn more about paying for addiction treatment.

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Joseph Gilmore has been in the addiction industry for three years with experience working for facilities all across the country. Connect with Joe on LinkedIn.

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