It is important to take care with any substance we use, especially when we mix them. Interactions of different substances can cause unpredictable and dangerous results that put lives at risk.
Polydrug use, the practice of using two or more drugs at the same time or within the same period, is common among users. One popular mix is combining prescription drugs and the world’s most widely used recreational substance—alcohol. Hydrocodone, an opioid, and alcohol is one such mix, and its effects on the body, particularly the liver, can be toxic.
Hydrocodone is a powerful pain reliever that is generally prescribed to treat moderate-to-severe pain. The opioid medication belongs to a group of drugs called narcotic analgesics and has a potency similar to that of morphine. It can also be prescribed as a cough suppressant.
People who use hydrocodone report feeling happy, relaxed, and euphoric, which are reasons why some abuse the addictive drug.
According to the U.S. Drug Enforcement Administration (DEA), the most frequently prescribed combination is hydrocodone and acetaminophen, an ingredient in over-the-counter and prescription medicines that reduces fever and pain. The Schedule II drug is sold under the brand names Vicodin, Norco, Lorcet, and Lortab, among others.
Pure hydrocodone, sold under the label name Zohydro ER, comes as an extended-release capsule.
Hydrocodone works by binding to pain receptors in the central nervous system and blocks nerves from sending pain signals to the user’s brain. This means the drug changes the way the user perceives pain, but the medication does not actually reduce or affect the source of the user’s pain.
Alcohol, also known as ethyl alcohol (ethanol), acts mostly as a depressant when ingested. It slows down the body’s central nervous system, making users relaxed, playful, drowsy, restless, or irritable. It can also make people have:
The substance affects many of the body’s organs, including the brain, small intestines, and liver. Alcohol is widely available and accessible to people from all walks of life. The legal substance, however, is highly addictive when abused.
It is estimated that some 14 million people struggle with alcohol addiction in the U.S., according to the National Institute on Alcohol Abuse and Alcoholism (NIAAA).
While hydrocodone is sold in abuse-deterrent forms, according to Drugs.com, that does not keep some people from mixing it with other drugs, including other opioids and alcohol. In some cases, mixing the two could be accidental, while in others, recreational users combine the drugs on purpose.
Either way, a hydrocodone-alcohol combination can create a life-threatening health emergency.
The liver works to break down and filter out the toxins of substances that enter the body, a list that includes alcohol and hydrocodone. Excessively using either of these drugs can overtax and impair the liver’s functioning.
Using alcohol and certain formulations of hydrocodone can each damage the liver on their own, as well.
Using too much hydrocodone with acetaminophen can cause the drug to build up in the body. Acetaminophen accounts for much of the risk. The U.S. Food and Drug Administration (FDA) says acetaminophen is safe for use when taken according to the label’s directions. Taking more than that is a problem.
Liver damage can result, which includes normalities in liver function blood tests to acute liver failure and death.
Medical News Today says that taking these two substances with a third one can affect the liver and cause side effects, such as breathing problems.
Excessive alcohol use is also dangerous to this vital organ. Abusing alcohol can lead to liver disease and, ultimately, liver failure. When the liver has too much alcohol to process, the substance can back up in the bloodstream, causing alcohol poisoning, which can happen without any particular warning.
As Healthline writes, “When you drink more than your liver can effectively process, alcohol and its byproducts can damage your liver.”
Medical News Today reports that the liver can process 1 ounce of alcohol hourly. Heavy drinking often involves far more than that, so having that excess supply of alcohol in the body is damaging.
How fast a person can metabolize alcohol varies, as several personal factors affect their metabolism rate. A person’s age, weight, overall health, genetics, sex, and gender all play a role in the liver’s ability to function well enough to process substances.
Overindulgence in alcohol can create increased fat in the liver that can lead to inflammation and scar tissue, which are signs of liver disease.
Because the liver must use the same enzymes to break down substances in the body, it will have to do double duty to metabolize alcohol and hydrocodone at the same time. It takes the liver time to do its job, but how long this takes again depends on the person who took the drugs.
If the person’s liver health is compromised, it can take longer for the liver to metabolize the substances. HxBenefit advises that the hydrocodone’s half-life increases the longer it takes to metabolize. It also says kidney health is also critical to the clearance of substances.
Mixing and using alcohol and hydrocodone together just compounds the risks of both. Users will undoubtedly experience intense, intoxicating effects from using both together, but they also put themselves in harm’s way when they do. The alcohol can increase the effects of hydrocodone, bringing on overdose, excessive sedation, depressed breathing, and coma. Both potent drugs can also bring on increased liver damage and death, as noted earlier.
The FDA advises that anyone who has three or more alcoholic drinks a day should let their doctor know about their alcohol intake if they are being considered for acetaminophen use.
If you suspect a person has abused or overdosed on alcohol and hydrocodone, know that it is a health emergency that requires immediate medical care. Signs and symptoms of an overdose on this combo include:
Call 911 or get to a hospital emergency room right away.
If you or someone you know is struggling to stop using hydrocodone and alcohol, it is time to think about getting professional help for an addiction that is putting your life in danger and keeping you bound to using substances in ways that are harmful to your mind, body, and spirit.
Many alcohol-drug combinations can impair your ability to function, and if you survive the experience, you risk continuing to use in an attempt to satisfy strong cravings that will only leave you just wanting more.
You can get off the merry-go-round and seek professional addiction treatment at an accredited facility that specializes in treating people with substance use disorders.
Medication-assisted treatment (MAT) is one approach to helping people end or manage their opioid use disorder (OUD) or their alcohol use disorder (AUD). MAT uses FDA-approved prescription medications, such as buprenorphine and naloxone, along with behavioral therapies and counseling to help people work through their addiction.
MAT has been recognized for its various benefits, including helping people manage uncomfortable withdrawal symptoms that can help them focus on ending their dependence on addictive substances.
If you seek addiction treatment, you likely will start with medical detox to remove alcohol, hydrocodone, and other toxins from the body to stabilize you. Medical professionals will monitor your vitals and oversee the entire process, which assures you that someone will be able to help you should you have complications.
Once you have cleared detox, extended treatment is recommended to help you stay focused on understanding your addiction and learning healthy coping strategies that help you avoid relapse and keep you committed to your decision to end your substance abuse.
Where you are on the continuum of care will help determine the best treatment placement for you. If your addiction is moderate to severe, residential treatment may be recommended for you. This on-site, inpatient treatment requires a 30-day or longer stay allows you more time to get the help you need.
If you are in the milder stages of addiction, you may be able to get treatment on an outpatient basis, which allows you more options to live on your own and create a treatment schedule that works for you.
The Palm Beach Institute, located in West Palm Beach, Florida, is committed to helping you end substance abuse and starting a new life. We offer intensive outpatient programs as well as partial hospitalization. Our programs are focused on meeting clients where they are and tailoring addiction treatment and recovery to their unique needs.
We understand the path to healing from addiction does not look the same for everyone, so we partner with our clients to give them the treatment experience that they need and want.
If you or a loved one is struggling with alcohol or opioid addiction, reach out to us today to let us know how we can help you get started on your recovery. Call us or connect with us online anytime.
CDC (January 2021) About Alcohol. from https://www.cdc.gov/alcohol/faqs.htm
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NIAAA. (2020, December) Understanding Alcohol Use Disorder. from https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/understanding-alcohol-use-disorder
CDC (January 2021) About Alcohol. from https://www.cdc.gov/alcohol/faqs.htm
Commissioner, O. (n.d.). Acetaminophen: Avoiding Liver Injury. from https://www.fda.gov/consumers/consumer-updates/acetaminophen-avoiding-liver-injury
Acetaminophen-hydrocodone: Side effects, dosage, uses and more. (n.d.). from https://www.medicalnewstoday.com/articles/acetaminophen-hydrocodone-oral-tablet
Mayo Clinic. (2018, January 19). Alcohol Poisoning. from https://www.mayoclinic.org/diseases-conditions/alcohol-poisoning/symptoms-causes/syc-20354386
Seladi-Schulman, J. (2020, August 28). Early Signs of Liver Damage From Alcohol: How to Tell, What to Know. from https://www.healthline.com/health/early-signs-of-liver-damage-from-alcohol
(November 2017) How the Body Processes Alcohol. Medical News Today. from https://www.medicalnewstoday.com/articles/319942#how-does-the-body-process-alcohol
Team, H., & Team, A. (2017, April 29). HxBenefit. from https://www.hxbenefit.com/how-long-does-hydrocodone-stay-in-your-system.html
Substance Abuse and Mental Health Services Administration. (2020, April 29). Medication and Counseling Treatment. from https://www.samhsa.gov/medication-assisted-treatment/treatment#medications-used-in-mat