Mixing Hydrocodone and Alcohol

Depressed Alcoholic

Hydrocodone is a prescription opioid medication that’s prescribed to treat relatively minor pain, such as experienced as a result of oral/dental procedures or osteoarthritis.1 Hydrocodone is the most frequently prescribed opioid in the United States with more than 83.6 million dispensed in 2017.2 There are many different brand name and generic hydrocodone medications, and most are combination products—the most frequently prescribed combination is hydrocodone and acetaminophen (Vicodin, Lorcet).1,2

Hydrocodone binds to opioid receptors in the body resulting in depression of activity in the central nervous system (CNS) producing analgesia, euphoria, respiratory depression, and a slowdown of the body’s digestive system.2 As with all opioids, hydrocodone is associated with tolerance, dependence, and addiction.1,2 In fact, hydrocodone is the most common opioid used for nonmedical purposes.2

Like other opioid medications, hydrocodone carries with it a risk of overdose. Someone who takes too much hydrocodone will display the opioid overdose triad of loss of consciousness, pinpoint pupils, and respiratory depression.3 When combined with acetaminophen, there’s an additional risk of liver toxicity due to acetaminophen toxicity.3 Symptoms include sweating, general malaise, nausea, and vomiting.3

Mixing hydrocodone with other substances that also depress the central nervous system—such as alcohol, antihistamines, barbiturates, or benzodiazepines—can be potentially life-threatening.1,4 Drinking alcohol while taking hydrocodone intensifies many of drug’s effects resulting in:4

  • Drowsiness and/or dizziness.
  • Slowed or difficulty breathing.
  • Impaired motor control.
  • Unusual behavior.
  • Memory problems.
  • Increased risk for potentially deadly overdose.

A person who overdoses on hydrocodone in combination with alcohol requires immediate medical attention.5 Bystanders should administer naloxone, if available, in an effort to reverse the opioid overdose. In cases of alcohol poisoning in combination with administration of hydrocodone, naloxone will not have the desired effect.5

More on Mixing with Alcohol


  1. Miller, S. C., Fiellin, D. A., Rosenthal, R. N., & Saitz, R. (2019). The ASAM Principles of Addiction Medicine, Sixth Edition. Philadelphia: Wolters Kluwer.
  2. U.S. Drug Enforcement Agency. (2019). Hydrocodone.
  3. Food and Drug Administration. (2019). Drug Label: Norco (Hydrocodone Bitartrate and Acetaminophen).
  4. National Institute on Alcohol Abuse and Alcoholism. (2014). Harmful Combinations: Mixing Alcohol with Medicines.
  5. Schiller, E. Y., & Mechanic, O. J. (2019). StatPearls: Opioid Overdose.

About The Contributor

Ryan Kelley, NREMT
Ryan Kelley, NREMT

Medical Editor, American Addiction Centers

Ryan Kelley is a nationally registered Emergency Medical Technician and the former managing editor of the Journal of Emergency Medical Services (JEMS). During his time at JEMS, Ryan developed Mobile Integrated Healthcare in Action, a series... Read More

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