The Dangers of Mixing Hydrocodone and Alcohol
Record numbers of people are dying from the use and abuse of drugs and alcohol (Center for Disease Control, 2015). Opioid medication, the category including hydrocodone, has reached epidemic levels, seeing the largest increases in death by overdose (Center for Disease Control, 2015) with interactions between multiple substances, sending more and more people to the emergency room.
Whether it is an intended overdose or not, it is a deadly reality, and more people now need to be aware of the potential dangers and risks of mixing hydrocodone and alcohol.
Is It Safe to Combine Alcohol and Hydrocodone?
Opioids come with many warnings with them, some on the bottle itself, others in the paperwork given, but clearly something is amiss if there are so many heading to the emergency room or worse from combining alcohol and hydrocodone.
To understand this better, first let's look at what the statistics say on the combination of these two substances, and then look at them individually to see how they work alone, before looking at the mixing of hydrocodone and alcohol and how it is potentially dangerous and deadly.
People experiencing addiction or misuse drugs and other substance, including hydrocodone and alcohol, remain a significant portion of the country. In the nation approximately 130 million people commonly use alcohol, with an estimated 15 million being diagnosed as having a dependence on it (Center for Behavioral Health Statistics and Quality, 2016).
According to the National Insititute on Drug Abuse (2014), an estimated 2.1 million people struggle with an addiction to opioids, and scarily, almost 80 people will die every day from overdose or interactions between substances, like mixing alcohol and hydrocodone.
Everyone likely knows what alcohol is, and has had some to drink at some point in their lives. It’s used to celebrate something, to be a tradition, to cool down on a hot summer night, or to bond over after work, but let’s look at its effects on the body, to see why it is so dangerous to pair with benzodiazepine.
Alcohol is in the category of psychoactive substances referred to commonly as depressants. This means they impact the central nervous system by slowing it down, dampening it, lessening the impact of it, and in general, depressing it. Drinking slows both the thought process and most major cognitive functions, but also slows the breathing as well, making respiration harder for the body to make happen when the blood alcohol level is high. It enters the system quickly, and can start to impact a person within 10 minutes of drinking (National Institute on Alcohol Abuse and Alcoholism, n.d.).
Hydrocodone is part of the opioid category of medication, a pain reliever that works by changing how the brain and the body respond to pain. Hydrocodone is the generic for brand name medications, like Vicodin, Norco, and Lortab. In prescription form, it is also mixed acetaminophen to help with pain relief, inflammation, and the reduction of fevers (WebMD, n.d.). It is available only by prescription, is a controlled substance, and due to the current crisis with opioid pain relievers, especially when mixed with alcohol, is becoming increasingly more difficult to get from a prescribing physician.
Hydrocodone and alcohol both work by depressing or slowing the central nervous system, and often times include pain relief, numbness, and a feeling of euphoria or a lack of negative emotions.
By combining depressant medication, it is essentially doubling or tripling the effect of the drink, so taking a hydrocodone with a drink will become like drinking two or three drinks, to put it in clear terms. All the effects get doubled or tripled in intensity, both the pain relieving properties, and all the side effects, positive and negative.
Mixing alcohol with hydrocodone becomes problematic quickly, and should be done sparingly, if at all. The main danger is that since it intensifies the effects of the substances, and that can happen quickly without a person feeling the effects of it immediately, that a dangerous amount of depressants can enter the system without realizing it, or even meaning it. It becomes easy to see how taking too many pills or drinking too much can happen quickly, and without a person noticing until it is too late.
Combining hydrocodone and alcohol can seem very tempting to some; it is a quick and efficient way to relieve pain and suffering. While that is true, it also has potentially deadly results. Taking both substances, alcohol and hydrocodone, puts a person at increasing risk of many dangerous side effects, combined effects, and tragic outcomes.
Signs and Symptoms of Alcohol with Hydrocodone
These two substances, while different, have fairly similar side effect profiles. That makes it simple to understand, but makes it more dangerous to combine, since it intensifies the impact of both the hydrocodone and alcohol. In order to understand this, let's look first at the individual side effect profiles of each substance.
The immediate effects of drinking include (National Institute on Alcohol Abuse and Alcoholism, n.d.):
- Reduced inhibitions
- Muscle relaxation
- Slurred speech
- Motor impairment
- Memory problem/Concentration problems
- Nausea and vomitting
- Breathing problems
Hydrocodone side effects include (WebMd, 2016):
- Constipation/bowel blockage
- Difficulty with memory and concentration
- Slowed breathing and heart rate
- Difficulty waking up or rousing
- Muscle relaxation
It has been made abundantly clear that these are similar substances, and that the side effects are similar as a result. However, it must be made clear that it makes these substances more deadly as a result, not safer, as some may think. When mixing hydrocodone side effects with alcohol, it creates, as we will see, and increased likelihood of damaging consequences.
The mixing of alcohol and hydrocodone adds to the risk of loss of consciousness or being in a blackout, or passed out state. By slowing the central nervous system, and restricting or limiting the respiratory system, and slowing the heart rate, it exponentially increases the chance that a person will be in a blackout state at best, or more likely, pass out and lose consciousness (WebMD, 2016).
Both alcohol and hydrocodone have potential side effects that upset or harm the digestive system. When combined, a person using both hydrocodone and alcohol can experience sever vomiting, constipation, and dehydration as a result of that, and as a result of how these substances work on the digestive tract, upsetting the lining of the stomach, and removing fluids that would normally be there to soften stool.
A major risk of taking hydrocodone and drinking comes from the fact that both substances being depressants slow the breathing as a matter of course for how they work. Depressants slow the respiratory system and dampen the central nervous system. When combined they take the breathing down to dangerously slow levels, and with a lack of oxygen, that can lead to other, much worse outcomes.
Another symptom of mixing these two substances comes from the cardiovascular system. Depressing the nervous system will also impact the heart, and cause a dangerously weak heart rate, slowing it down to a damagingly low heartbeat. By interfering with the signals that the nervous system sends to the heart, disrupting that vital communication, hydrocodone side effects combined with alcohol put the life of the person at risk (WebMD, 2016).
Seizures are another possibility when people combine these drugs. It cannot be stressed enough how much hydrocodone and alcohol disrupt and upset the way the brain and the nervous system normally function. While both present the possibility of seizure activity by themselves, alcohol and hydrocodone mixed together have a greater chance of producing seizures, even in people that have never experienced them before.
While these have all been dangerous, hydrocodone side effects when combined with alcohol become deadly as they start to build off of each other. The difficult breathing, potential for seizure activity, and damage they can do to the brain and nervous system can potentially lead to a coma as well, where the person is unconscious and non-responsive for an unknown period of time, possibly for the rest of their lives.
This leads to the worst possible outcome for mixing substances: death. Although when taking drugs together death is always a possibility, when looking at the symptoms of alcohol and hydrocodone usage, the myriad ways that death can happen are staggering. They impact the nervous, respiratory, cardiovascular, and digestive systems, and after a certain point, they will simply start shutting those systems down.
Combined Effects of Hydrocodone and Alcohol
The combined effects of alcohol and hydrocodone have been made fairly clear: they double or triple the effects, including the negative side effects, putting anyone that drinks and takes hydrocodone at greater risk for damage to one's health and well-being (Mayo Clinic, 2017). Risk of damage to the liver or brain, for example, increases two to three times when one drinks and uses. While there is almost no risk that is an absolute certainty, who would want the risk of brain damage, liver damage, seizure or death, to double or triple just to take hydrocodone with a drink?
The effects do not just limit themselves to the health of the person mixing alcohol and hydrocodone. A person drinking while on this medication is also at increased risk of death by suicide, violence, and accident. One study in the New England Journal of Medicine (1994) showed that drinking and driving increases the odds of a fatal car accident by seven times.
There are also the social consequences of using these substances. Some of these consequences can include being jailed or otherwise involved in the legal system, loss of job, financial ruin, loss of friends and family, and the mental anguish and grief that comes with these losses. And then there is the quite possibly the largest danger to face when mixing these drugs: addiction.
When Abuse Becomes Addiction
Substance Use Disorder (SUD) is the clinical term for an addiction (Substance Abuse and Mental Health Services Administration, 2015). This definition provides an understanding that the more symptoms a person presents, the worse the addiction is. The possible symptoms include: spending more time thinking about, or trying to get the substances; ignoring other, important areas of life to use; craving or desiring the substance more and more; an inability to quit even when attempts are made to do so; or using despite potentially dangerous consequences, for some examples.
While it is possible to abuse a substance without becoming addicted to it, the risk for both physical and psychological addiction increases the longer a substance is abused. The longer a substance is used, the more a body becomes used to it and the tolerance increases, meaning that over time, more of the substance is needed to get the same feeling. This should serve as another warning sign that using alcohol and hydrocodone is becoming an addiction, and not just pain relief or recreational use.
Concurrent Alcohol and Hydrocodone Abuse
The risk with using two substances, especially two such as hydrocodone and alcohol, is the risk of overdose. Reviewing the impact of both on the body, overdose is likely to happen quickly, and without the individual realizing that it is happening. One drink has the impact of three, two becomes six, and within minutes a person may be overdosing (National Institute on Alcohol Abuse and Alcoholism, 2014). The rates of concurrent abuse have been increasing over the years, as have the rates of overdosing on hydrocodone and alcohol, and it is a problem that needs a solution.
Alcohol and Hydrocodone Addiction Treatment
There has been a lot of discussion here about the possible consequences and damage done by the abuse and dependency of alcohol and hydrocodone. But it is important to know that there is help out there. The very first step is to understand that this is a problem and to make that first call for help, to a substance abuse treatment professional or a health care provider.
Treatment may consist of many different things. It may be done inpatient, where the person lives for a brief period of time at the treatment facility and work on themselves. Here there will be a variety of ways the addiction will be treated, including a detox process, individual and group therapy, family therapy, and education on the nature of addiction, recovery, and healthy living. Or it can be done on an outpatient basis, working with a counselor as an individual or in a group setting, to focus on recovery and the reasons why the addiction started.
The focus of recovery is finding support, and ways to live healthy, and cope with stress and problems when they arise. This can include a twelve-step support group, like Alcoholics Anonymous, or other forms of recovery support groups, as well as an in-depth understanding of what causes addiction, what triggers the individual to use, and ways to combat it. The person's strengths and skills take the forefront here, so that they learn how to succeed and overcome addiction.
Hydrocodone and alcohol are two substances that have a long history and many uses, some being very positive and beneficial. It is also important to remember that used properly, they can be helpful to any one of us. The problem is when they are abused, when people become dependent on them, and especially when they are used together, that they become problematic at best, and deadly at worst. If you see yourself or a loved one in the descriptions above please reach out for professional help; help and hope are out there.