Alcohol is among the most commonly used recreational substances in the United States, and it’s the most common cause of substance use disorders. So what happens when it’s combined with hydrocodone, one of the most commonly prescribed opioids? Opioids are used both as a prescription and as an illicit recreational drug. What happens if you accidentally drink when you’re taking an opioid? What happens if you intentionally mix the substances seeking a more intense high?
Learn more about mixing hydrocodone and alcohol and whether or not it’s safe to mix the two substances.
Hydrocodone is a prescription opioid used to treat moderate-to-severe pain symptoms. It’s one of the most frequently prescribed opioids in the United States. It’s sold under the popular brand name Vicodin. Hydrocodone can bind to opioid receptors throughout the body that are designed to bind with a natural chemical called endorphins. Endorphins help to manage your body’s pain response by blocking nerve cells from sending and receiving pain signals.
However, endorphins don’t block pain completely. Pain is an important response that lets you know when something is damaging you so you can stop or avoid it. But when it comes to moderate-to-severe pain, endorphins may not be enough to make uncomfortable symptoms. Pain can hinder your recovery and prevent relaxation.
Chronic pain can get in the way of your daily life and lower your quality of life. Opioids like hydrocodone can bind to opioid receptors and block pain to a much higher degree of success than your endorphins. In fact, pain relief is so comprehensive that it can lead to a comfortable euphoric state, which is what recreational drug users seek.
Opioids can cause chemical dependence and addiction when they’re used for too long or misused. Long-term use or high doses can cause your brain to adapt to the drug. Hydrocodone acts like powerful endorphins and influences other “feel-good” chemicals in the brain like dopamine. Dopamine is closely tied to reward and motivation in the brain. Misusing hydrocodone can trick your brain into treating opioid use like other important, rewarding activities like eating, connecting with a friend, or sex. Addiction is a disease that’s caused when your reward system confuses drugs with a life-sustaining task, creating powerful compulsions to repeat them.
Opioid misuse and addiction can increase your chance of experiencing a dangerous overdose. Opioids work as inhibitory chemicals in the brain and body. They block the pain response, but they also cause sedation, slowing down nervous system activity. In high doses, they can start to slow down some other important functions of the nervous system. Your heart rate may slow down, you could pass out, and your breathing may slow down. In fatal opioid overdoses, respiratory depression leads to oxygen deprivation and death.
The misuse of opioids like hydrocodone can lead to the later use of illicit opioids. An addiction to pain pills can be expensive and difficult to manage. According to the National Institute on Drug Abuse (NIDA), the misuse of prescription opioids is a risk factor for the use of illicit heroin. Illicit drugs are unpredictable and can increase your risk of an opioid overdose.
Alcohol is a central nervous system depressant that interacts with a chemical in your brain called gamma-Aminobutyric acid (GABA). GABA can activate its receptors to create relaxing feelings, anti-anxiety, sedation, and hypnosis. As a depressant, alcohol slows down the central nervous system, and it can impair some functions if you drink too much. Side effects include fatigue, impaired judgment, impaired motor function, and slurred speech.
Like opioids, high doses and frequent drinking can lead to chemical dependency and addiction. The euphoric effects of alcohol can trick your reward system into treating drinking like an important activity that should be repeated. It can also cause your brain to rely on it, which can lead to tolerance and dependence. Unlike opioids, if you quit drinking abruptly after developing a chemical dependence, the withdrawal symptoms can be potentially life-threatening.
Alcohol use disorder can increase your risk of alcohol poisoning and uncomfortable alcohol withdrawal symptoms. Since alcohol can suppress the nervous system, it can start to slow down important functions like breathing and your heart rate, similar to opioids. These automatic functions aren’t usually significantly affected with moderate use, but binge drinking and overdose can be. Someone who is experiencing alcohol poisoning may lose consciousness. Their heart rate may slow down, their breathing may become slow and shallow, and their body temperature may drop.
Alcohol is one of the most commonly used recreational substances in the United States, so much so that the majority of Americans had alcohol at least once. For many people, it’s a common part of everyday life. However, alcohol can be potentially dangerous when it’s mixed with several prescription medications. In many cases, it’s a matter of giving your system too much to process at once. For instance, drinking alcohol with antibiotics can put too much stress on your liver, which can damage it. That’s true for opioids, but they can also interact with alcohol in other ways.
It’s common for people to mix alcohol and their medications by accident. They may be used to drinking on a weekly basis, and then, they forget a new prescription may necessitate changing their typical habits. However, some people mix drugs intentionally for added or unique effects.
Mixing opioids like hydrocodone with alcohol can be life-threatening because of a phenomenon called potentiation. Potentiation literally means to empower or to make something more powerful. When it comes to drugs, potentiation refers to when two or more drugs work together to create more powerful effects than they would individually. This happens because opioids and alcohol can cause some of the same effects on the nervous system.
Though opioids aren’t necessarily central nervous system depressants, they share some common features with depressants. Both alcohol and opioids slow down the nervous system and cause symptoms like sedation, slowed heart rates, and slowed breathing.
When the two are mixed, relatively moderate doses of each can come together to cause severe side effects and overdose. Using multiple drugs at the same time is called polydrug use, and it’s common in overdose cases. It’s also dangerous to mix alcohol and opioids with other depressants like benzodiazepines and other sleep aids.
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National Institute on Drug Abuse. (n.d.). Opioids. from https://www.drugabuse.gov/drugs-abuse/opioids
National Institute on Drug Abuse. (2018, March 6). Prescription CNS Depressants. from https://www.drugabuse.gov/publications/drugfacts/prescription-cns-depressants
RxList. (2019, September 17). Gamma-aminobutyric Acid: Health Benefits, Uses, Side Effects, Dosage & Interactions. from https://www.rxlist.com/gamma-aminobutyric_acid/supplements.htm
Scheve, T. (2019, July 25). What are endorphins? from https://science.howstuffworks.com/life/inside-the-mind/emotions/endorphins.htm