Alcohol is one of the most common intoxicating substances in the United States, in large part because it is legal for people ages 21 and older to consume. While many people ingest alcohol in moderation, often at social events or celebrations, some people may abuse this substance. Binge drinking is a large problem in the US, and increasingly, it is not just a problem among college students or young adults. Other people may become addicted to alcohol and feel like they need to consume several beverages a day to feel “normal.”
Similarly, hydrocodone can be both a problematic drug and a useful tool in medical treatment. This drug is Schedule II per the Drug Enforcement Administration (DEA). Hydrocodone is a powerful opioid medication related to oxycodone and morphine, and it is prescribed to treat moderate or severe pain. The most common version of hydrocodone, Vicodin, is often prescribed for short-term use after surgery, such as wisdom tooth removal, with the intention of reducing the dose over a few days as the person’s pain goes away. However, some people may find that they crave hydrocodone, continue to take this drug after it should no longer be needed, or even take more to get the original sensations experienced with use. Opioid drugs, like alcohol, can lead to addiction.
Prescription hydrocodone drugs should not be taken with alcohol, because alcohol can interfere with the pharmokinetics of the drug. This means that euphoric effects could be enhanced even though palliative aspects of the drug could be dampened.
Dangers of Combining Alcohol and Hydrocodone
Both alcohol and hydrocodone are central nervous system (CNS) depressants. This means that they induce a feeling of euphoria at high doses, as well as a feeling of relaxation and happiness. Opioids specifically relieve pain, although alcohol can also have a similar pain-relieving sensation by relaxing muscles and relieving anxiety or stress. These sensations can be addictive for some people.
The Substance Abuse and Mental Health Services Administration (SAMHSA) noted that, in 2012, there were 20,406 people sent to the emergency room due to ingesting the dangerous combination of alcohol and opiates, including hydrocodone. This represented about 1.2 percent of all hospital admissions.
People who struggle with addiction to one of these substances are at risk of developing an addiction to the other; in many cases, a person could develop a problem with polydrug abuse or abusing multiple substances at the same time. Taking CNS depressants together enhances the effects of the drugs, so a person who struggles with addiction to one substance, like hydrocodone, may try to enhance the euphoric effects of that drug by taking another CNS depressant like alcohol. According to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), alcohol abuse is present in most incidents of polydrug abuse, including those involving prescription painkillers.
Some hydrocodone medications, like Vicodin, contain other substances to enhance the painkilling effects of the opioid. Vicodin specifically also has acetaminophen, a common over-the-counter painkiller. When Vicodin is combined with alcohol, the person can suffer side effects from the opioid and ethanol combined, as well as liver damage due to high doses of acetaminophen and alcohol. This can cause cirrhosis, jaundice, and liver failure.
Alcohol and Hydrocodone Lead to Overdose Faster
When two CNS depressants enhance each other’s effects, this can lead to overdose much faster. This means that symptoms of alcohol poisoning and opioid overdose can be present. Signs of both conditions include:
- Slow or irregular breathing
- Rapid heart rate or changes to heartbeat
- Changes to body temperature, typically feeling cold or clammy
- Pinpoint pupils
- Stumbling or falling into a stupor (awake but unresponsive)
- Falling asleep and not able to wake up
If a person combines alcohol and opioid abuse, overdose symptoms are harder to treat. The first step is to call 911. A second step for a suspected opioid overdose may be to administer naloxone, an opioid antagonist that temporarily stops an opioid overdose. This drug can help save lives, because emergency responders have more time to help the person survive overdose symptoms. However, when opioids are combined with alcohol, naloxone will not function to reverse the effects of the alcohol overdose.