Mixing alcohol with any drug can have unintended consequences. Interactions can occur between alcohol and many classes of drugs. This includes both prescription and street drugs.
When it comes to opiates and opioids, alcohol can be a particularly dangerous element to add to the mix. The combination of alcohol with opiates can have a number of serious unintended consequences, up to and including death. Read on to learn what these drugs do and what happens when they combine in the body.
Opiates, Opioids and Their Effects
Opiates and opioids are painkillers that are ultimately derived from the opium poppy. Opiates consist of naturally occurring drugs like morphine and codeine. Although heroin is partly synthetic, it too is usually considered an opiate.
Opioid is the word used to refer to synthetic and partly synthetic drugs. Examples of opioids are fentanyl, Imodium, demerol and oxycontin. Recently, some people have begun to use the term opioid to refer to both of these classes of drugs. While not strictly correct, it is becoming more accepted.
Opioids are very effective at helping people manage pain. They work by binding to receptors in the brain that are designed for naturally occurring neurotransmitters. The neurotransmitters and opioids both produce positive feelings and relief from physical pain.
These types of drugs are classed as narcotics, meaning they cause feelings like numbness and sleepiness. They act as downers, or depressants. In fact, opiates and opioids literally depress the central nervous system. Using these drugs can dramatically impact essential bodily functions, including breathing. Opioids can also lead to physical effects like constipation.
Opiates like heroin can also cause breathing and the heartbeat to slow down. When heroin was first developed in the late 1800s, its effects on breathing were seen as a good thing. Pharmaceutical companies like Bayer hoped it would be useful in treating diseases like tuberculosis, which was much more common at the time.
For a short time, it was even believed that heroin was a safer, non-habit-forming alternative to morphine. The simple truth is that it turns into morphine in the body. Fairly quickly, many people began using heroin recreationally in large numbers. Doctors learned that it was not the hoped-for miracle drug. It ceased to be produced and marketed for legitimate medical use by the mid-1910s in many places.
Alcohol Use and Effects
The alcohol that people commonly drink is known as ethanol or ethyl alcohol. Like opioids, it is a depressant that works on the central nervous system.
It is possible that human beings have been using alcohol throughout our history as a species. There is some suggestion that even the primate ancestors of humans consumed alcohol. Originally, this came in the form of fermented fruit.
Not every species has the ability to break down alcohol in the body the way humans do. Being able to consume less-than-fresh fruit was an important advantage that helped the species to succeed. Later, humans in China and Mesopotamia began to brew beer. Egyptian honey wine has also been found at a number of archaeological dig sites.
However it is consumed, alcohol has a number of effects on the human body. After entering the body, it is absorbed in the stomach and small intestine. Eating before and while drinking helps slow down the absorption of this drug. Women experience greater intoxication from alcohol than men do, even when adjusted for weight. This is partly because women tend to have a higher percentage of body fat, and alcohol is water-soluble, not fat-soluble.
Alcohol is ultimately processed by the liver, which can handle about one standard drink per hour. Consuming more than that can lead to feelings of intoxication and high levels of blood alcohol. Some people, especially those of Asian descent, lack an enzyme that assists with the processing of alcohol. They may experience additional unpleasant effects from using this drug, including nausea and headache.
The way alcohol makes people feel depends in part on how much has been consumed. At first, people may feel a little warm and happy. Drinking more can lead to exaggerated displays of emotion and increased feelings of happiness. Alcohol affects reflexes and reaction times in people, but it also leads to disinhibition. People tend to feel more confident when they are drinking. Some people will do things they would normally be afraid or intimidated to do while they are drinking. These may be small things, like approaching attractive people to talk to them, or they may be willing to attempt dangerous physical stunts.
Alcohol is used and liked by many people because of its reputation as a social lubricant. It can make interacting with others feel more natural and easy for those who are normally anxious or inhibited. The pleasant effects of alcohol can influence a growing psychological or physical dependency on the drug.
Consuming more than four alcoholic drinks in two hours is known as binge drinking. This kind of drinking can increase risky behavior. In turn, this behavior can increase the risk of contracting an STD, participating in a fight or driving impaired. The toxins in alcohol also increase the risk of developing certain cancers. Binge drinking can result in alcohol poisoning, coma and even death in some cases.
Mixing Alcohol and Opioids
Some people drink habitually. This does not mean that they have a substance use disorder. In fact, it can be appropriate or even healthy to have a glass or two of wine daily. Red wine, for example, contains antioxidants and may lower the risk of heart disease.
However, when people are using prescription drugs, alcohol can interact with them negatively. It is always important to use prescription drugs according to the instructions of a physician or pharmacist. Drug interactions between opioids and alcohol can actually be deadly.
One reason for this is that both drugs depress the central nervous system. If someone has been prescribed an opioid-like oxycodone and they consume alcohol with it, that can depress their breathing. Doctors in emergency rooms are beginning to see this more commonly, especially in senior citizens.
A study conducted at Leiden University in the Netherlands compared the effects of alcohol and opiates on young adults and senior citizens. Both age groups saw respiratory depression after drinking a moderate amount. However, senior citizens were more likely to stop breathing briefly, multiple times. The researchers have emphasized that it is not safe to have any level of alcohol while taking an opioid painkiller.
Combining Alcohol, Opioids and Other Drugs
Opioids are not just prescribed for people who have an acute medical problem. In addition to giving them to patients post-surgery, physicians prescribe opioids to individuals who live with chronic pain. Sometimes, doctors even need to prescribe other classes of drugs alongside opioids for effective pain management.
Benzodiazepines, or sedatives, are sometimes used in this way. Valium, Xanax and Klonopin are examples of commonly prescribed benzodiazepines. Benzodiazepines are yet another class of drug that can depress breathing function.
Using alcohol while taking opioids and benzodiazepines increases the risk of overdose. Even when people are taking medications as prescribed, adding alcohol to the mix increases the likelihood of problems. This can include strange behavior, non-fatal overdose and even death.
According to the National Institute on Drug Abuse at the National Institutes of Health, 16% of opioid overdose deaths in 2019 also involved benzodiazepines. In North Carolina, one study showed that the risk of overdose death was 10 times as great for people prescribed both kinds of drugs as opposed to just opioids.
Luckily, since 2016, the CDC has been working to reduce the prescription of benzodiazepines and opioids in the same patients. They have included black box warnings on both of these types of medications explaining the risks of combining them. However, benzodiazepines can also be taken by recreational users.
Sometimes, they are trying to come down after taking an upper like cocaine. At other times, they have become dependent on the drug after it was prescribed by a doctor. Valium is a very common prescription, and it was even known as a “mother’s little helper” at one point because of its ubiquity.
Other Concerns with Recreational Use
Another issue when considering the recreational use of drugs like opioids and Valium is that users are not always getting what they think they are. In Scotland, several people died in 2018 after buying what they thought was Valium on the streets.
For opioid users, drugs like heroin are often cut with other substances. It’s hard for users to know how pure the drug they have purchased is, and what it is they are actually getting.
One particularly troubling issue is the rise of fentanyl. Fentanyl was designed to be used in patients with intractable pain from diseases like cancer. However, it is turning up in other street drugs now. For example, Fentanyl was found in cocaine in New York in 2019, a troubling sign since it is very easy to overdose on even a small amount.
If people are using opioids during a night when they have also been drinking, they may face very serious consequences. It is crucial that users of street drugs understand that in many ways, the stakes have been raised in recent years.
Detoxing From Alcohol and Opiates
Alcohol and opiates are both drugs that can be habit-forming. Sometimes, people who use them develop substance use disorder and need help to stop.
Withdrawal from opiates like heroin can be extremely uncomfortable. The process can include physical aches and pains, fever and diarrhea. Withdrawal can also produce flu-like symptoms and mood swings.
Alcohol withdrawal is even more physically dangerous than heroin withdrawal. Detoxing from alcohol can lead to seizures, and they can be fatal. This is why it is crucial that anyone who needs to come off alcohol seeks assistance from medical professionals. Alcohol detox can be fatal if attempted cold turkey.
At Granite Recovery Centers, we are able to help people at every stage of recovery. We offer medical detox from drugs and alcohol in addition to traditional rehab. We are also open to medication-assisted treatment, which can include the use of methadone or suboxone therapy.
Our treatment program includes option for long-term care. We offer outpatient therapy, which is usually most successful in people who have completed inpatient and sober-living options.
If you or a loved one are struggling with substance use disorder, reach out to us today. We take great pride in helping people recover fully from the use of drugs and alcohol. Obstacles can include not just substances, but also stress on the job and other medical or psychiatric diagnoses. At Granite Recovery Centers, we would love to be a part of the healing and rebuilding processes for you and your family.