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Mixing Opiates and Alcohol

Mixing alcohol with opiates worsens all the effects of drinking and can also be life-threatening. Learn about the dangers of mixing alcohol with opiates.

Almost 143 million prescriptions for opiate/opioid painkillers were written in 2020, making prescription-strength opioid use ubiquitous in the U.S. Opioid use disorder (OUD) is commensurately high, with about 12 percent of those individuals prescribed opioids developing an OUD. More than 2 million U.S. adults abuse one or more of the drugs in the opiate family, with over 130 people dying every day from overdosing on these powerful and addictive substances.

Around 15 percent of all opiate overdose deaths come from mixing opioids with alcohol. Some opioid overdose deaths (OOD) happen when people accidentally drink while taking opioids for their intended purpose. However, most OODs occur when people combine opioids and alcohol to increase the intoxicating effects of both substances.

What Are Opiates and Opioids?

Before we delve into the interactions between opiates and alcohol, it’s important to understand that “opiates” and “opioids” are terms used interchangeably for a good reason. Opiates are chemical substances made from natural plant chemicals found in the poppy plant.

Examples of opiates:

  • Morphine
  • Codeine
  • Heroin
  • Opium

Opioids are lab-made synthetic opiates. They perfectly mimic the activity of naturally-derived opiates. Opiates and opioids have the same effects, including the same addictive properties and the same negative outcomes when used with alcohol.

These are the most common opioids given in the U.S.

  • Fentanyl (Duragesic)
  • Hydrocodone (Vicodin)
  • Oxycodone (Oxycontin, Percocet)
  • Oxymorphone (Opana)
  • Hydromorphone (Dilaudid)
  • Methadone (Dolophine)
  • Dextropropoxyphene (Darvocet, Darvon)

Opiates and opioids are given by physicians to control moderate to severe pain, and they’re very effective in doing so. Not only do they lessen pain, but as with alcohol, opiates and opioids can cause a person to feel an intense euphoria. This sense of intoxication contributes to the addictive nature of opiates and opioids.

The Dangers of Alcohol and Opiate Abuse

Opiates and alcohol can cause serious harm to a person’s health or death by overdose. Combining the two leads to synergistic effects; that is, alcohol and opiates have a greater potential for harm together than either of the two.

These synergistic effects occur because both opiates and alcohol are highly potent central nervous system depressants and decrease the activity of nerves in the brain. This slowdown in the brain impairs the proper functioning of the nerve tissues that control a person’s heart rate and breathing. As a result, most deaths from combining alcohol and opiates come when a person’s respiration becomes shallow, infrequent, and stops.

When a person stops breathing, even for less than a few minutes, damage to their major organs can occur. Permanent brain damage or death occurs after 4 minutes without oxygen.

There is no safe way to combine alcohol and opiates. Even a low amount of an opioid combined with alcohol can be fatal.

Polysubstance Addiction Treatment

When people abuse two or more substances together, it’s called polysubstance abuse. Alcohol and opioids are both habit-forming and can be strongly addictive. Absolute Awakenings is dedicated to treating those who have struggled with alcohol and opiate abuse. If you or someone you love is living with an addiction to opiates, alcohol, or both, our specialists are available around the clock to assist you.

Absolute Awakenings follows an evidence-based approach to treating alcohol and substance abuse disorders. We are committed to providing long-term recovery for those struggling with addiction. Recovery is not a one size fits all approach, so every person that walks through our doors is provided with unique and individualized care. Call us today. Our recovery specialists are waiting to assist you or a loved one in your fight against addiction.


  1. U.S. Opioid Dispensing Rate Maps | Drug Overdose | CDC Injury Center. Published October 19, 2022. Accessed January 20, 2023.
  2. Polysubstance Use Facts. Published September 20, 2022. Accessed January 20, 2023.
  3. Tori ME, Larochelle MR, Naimi TS. Alcohol or Benzodiazepine Co-involvement With Opioid Overdose Deaths in the United States, 1999-2017. JAMA Network Open. 2020;3(4):e202361. doi:10.1001/jamanetworkopen.2020.2361
  4. Alcohol and Drug Policy Commission : Opiates or Opioids — What’s the difference? : State of Oregon. Accessed January 20, 2023.
  5. Synergistic effect – Definition and Examples – Biology Online Dictionary. Biology Articles, Tutorials & Dictionary Online. Published October 8, 2020. Accessed January 20, 2023.
  6. Gudin JA, Mogali S, Jones JD, Comer SD. Risks, Management, and Monitoring of Combination Opioid, Benzodiazepines, and/or Alcohol Use. Postgrad Med. 2013;125(4):115-130. doi:10.3810/pgm.2013.07.2684

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