Opioids are some of the most commonly abused prescription drugs. They include oxycodone, hydrocodone, meperidine (Demerol), and many others. The demographics of those who abuse painkillers transcend the stereotypes of typical drug addicts.
Opioid painkillers are prescribed to manage moderate to severe pain. Taken as prescribed, they are an effective and relatively safe part of many pain management plans. However, the risk of negative consequences increases when the medication is misused or abused—as in cases of accidentally taking more than prescribed or simply taking them for other than indicated use. Prescription painkillers and heroin share a similar chemical make-up and, as a result, their effects are similar. They both can elicit euphoria by influencing pleasure/reward circuitry in the brain, which in turn, reinforces problematic opioid use. Though not everyone who uses them becomes addicted, many people find themselves craving pills they were initially prescribed. Slowly, a dependence may develop, even in the presence of a legitimate medical need for the drug. This can open a door to addiction, which negatively impacts physical and mental health, relationships, and work.
Prescription opioids produce a number of harmful effects when abused or misused; this potential is worsened when opioids are combined with alcohol. Combining the opioid effects of painkillers with alcohol’s depressant properties is very dangerous and can potentially be life-threatening.
Alcohol and Painkiller Facts
- Painkillers and heroin share extremely similar chemical structures and effects.
- Alcohol is a central nervous system depressant, which means that it slows down brain activity.
- Painkillers cause respiratory depression. When combined with alcohol, this effect may be amplified, and can lead to coma or death.-
- Both alcohol and prescription opioids have a high potential for abuse.
- Opioid painkiller abuse has become a gateway to heroin use, in part due to the rising cost of prescriptions and tightened controls on prescription opioid access.
- Per the Centers for Disease Control (CDC), in nearly 19% of opioid painkiller emergency room visits, alcohol had been consumed concurrently. In just over 22% of prescription painkiller deaths, alcohol was involved as well.
Signs and Symptoms of Using Alcohol with Painkillers
Alcohol and opioid painkillers depress the central nervous and respiratory systems, with potential catastrophic interplay. Concurrent use can hasten an overdose due to a synergy in respiratory depression. There are many different signs and symptoms that someone is abusing alcohol and opioid painkillers that include:
- Periods of euphoria followed by apathy.
- Impaired judgment.
- Slurred speech.
- Loss of fine motor control; incoordination.
- Severe itching.
- Unsteady gait.
- Impaired memory.
- Decreased appetite.
- Problems with attention or concentration.
- Sexual dysfunction.
Combined Effects of Painkiller and Alcohol Abuse
With prolonged use, both alcohol and painkillers build tolerance and have addictive potential.
Additionally, the risk of liver damage is severe, as many painkillers contain acetaminophen, a drug that damages the liver when taken in excess. Alcohol alone can have a number of harmful effects on the liver as well, so when it is combined with prescription opioids, the risk of liver damage increases greatly. The liver isn’t the only organ that is negatively impacted by excessive alcohol and painkiller abuse, however; the National Institute on Alcohol Abuse and Alcoholism lists the brain, heart, and pancreas as additional organs affected by excessive alcohol consumption. Harmful effects that may stem from co-occurring alcohol and painkiller use include:
- Respiratory depression.
- Clotting disorders and bleeding.
- Liver damage (especially high risk for painkillers including acetaminophen).
- Alcoholic hepatitis.
- Fatty liver.
- Liver cancer.
- Fulminant hepatic necrosis.
- Irregular heartbeat.
- High blood pressure.
- Mouth and throat cancer.
- Breast cancer.
- Weakened immune system.
- Tolerance (needing higher doses or potency to achieve the desired effects).
- Impaired decision-making and behavioral regulation.
Treatment for Co-Occurring Alcohol and Painkiller Addiction
Regardless of whether you begin taking painkillers legitimately or illegally, you still have the potential to become addicted. Abusing painkillers alone produces wide-ranging negative effects; adding alcohol to the mix only serves to worsen them. Those struggling with a co-occurring addiction to prescription drugs and alcohol should seek addiction treatment immediately.
Withdrawal from opioid painkillers can be very uncomfortable. However, alcohol withdrawal can actually result in life-threatening symptoms, so medically-supervised detoxification is essential. Detoxing in a supportive environment where your symptoms can be managed is an important early step in recovery and relapse prevention.
The next step after supervised detox is addiction treatment. This may take place in an inpatient or an outpatient environment. Many people struggling with addiction to multiple substances prefer to get help in a residential treatment environment that treats co-occurring addictions, because it provides a safe place away from daily temptations and compulsions to use, along with 24/7 care. Inpatient treatment centers provide a patient with the ability to focus solely on his or her recovery without having to cope with outside triggers and stressors.
Outpatient treatment may work for you, however, if you have a supportive home environment and are able to attend therapy on a regular basis. This option is often sought by those who have responsibilities at home, work, or school that they are reluctant or unable to place aside for the treatment duration.
Twelve-step programs—like Alcoholics Anonymous and Pills Anonymous—have also shown an enormous amount of success in the recovery of those suffering from alcohol and drug abuse. These programs are free to join and provide members with a supportive and encouraging environment in which they can share experiences associated with addiction.
Statistics for Alcohol and Painkillers
According to the Substance Abuse and Mental Health Services Administration (SAMHSA):
- In 2015, 138.3 million Americans aged 12 or older reported current alcohol use, with 66.7 million people 12 years old or older reporting binge drinking in the past 30 days.
- More than 17 million people reported heavily using alcohol in the past month.
- An estimated 1 in 4 people age 12 or older are current binge drinkers.
SAMHSA also found that:
- In 2015, there was an estimated 3.8 million people aged 12 or older who were current misusers of pain relievers, which represents 1.4% of the population.
Painkiller and Alcohol Use Statistics
A national study of 43,093 individuals aged 18 years or older found that:
- Nonmedical use of prescription drugs was more prevalent among individuals who had alcohol use disorders than those without alcohol use disorders.
- People with alcohol use disorders accounted for more than 1 in 3 users of prescription drugs.
- More than 1 in 4 young adults aged 18 to 24 who met the criteria for past-year alcohol dependence also reported past year nonmedical use of prescription drugs.
Teen Drinking and Painkiller Abuse
Teens and young adults as more susceptible to painkiller addiction. Prescription drugs are very popular amongst adolescents, and they are the second most popular abused illicit substance behind marijuana. Per the National Institute on Drug Abuse (NIDA), in 2015, 18.3% of high school seniors reported having ever used prescription drugs.
SAMHSA states that:
- In 2015, roughly 276,000 adolescents aged 12 to 17 were current misusers of pain relievers, which corresponds to 1.1% of adolescents.
- Approximately 829,000 young adults between the ages of 18 and 25 misused pain relievers in the month prior to the survey. This equates to 2.4% of all young adults.
The Harvard Mental Health Letter cites teens and young adults as more susceptible to painkiller addiction. Most teenagers do not believe painkillers are a serious danger. This may be due to the fact that they are prescribed by doctors and that they are not illegal. Education is an important factor in preventing painkiller abuse in teens and young adults.
Resources, Articles and More Information
- The National Institute on Drug Abuse provides a scientific overview of many controlled substances, including painkillers.
- Alcoholics Anonymous
- Narcotics Anonymous
- Effects of Painkiller Use
- How to Help a Painkiller Addict
- Saunders, K., Korff, M., Campbell, C., Banta-Green, C., Sullivan, M., Merrill, J., & Weisner, C. (2012). Concurrent Use of Alcohol and Sedatives Among Persons Prescribed Chronic Opioid Therapy: Prevalence and Risk Factors. The Journal of Pain, 13(3), 266-275. doi:10.1016/j.jpain.2011.11.004.
- National Institute on Drug Abuse. (2014). America’s Addiction to Opioids: Heroin and Prescription Drug Abuse.
- State Government of Victoria. (n.d.). Alcohol and the Brain.
- Meier, B. (2013, October 24). F.D.A. Urging a Tighter Rein on Painkillers. The New York Times.
- Centers for Disease Control and Prevention. (2014). Alcohol Involvement in Opioid Pain Reliever and Benzodiazepine Drug Abuse–Related Emergency Department Visits and Drug-Related Deaths — United States, 2010.
- Diagnostic and statistical manual of mental disorders: DSM-5. (5th ed.). (2013). Washington, D.C.: American Psychiatric Association.
- Baldini, A., Korff, M., & Lin, E. (2012). A Review of Potential Adverse Effects of Long-Term Opioid Therapy. The Primary Care Companion For CNS Disorders Prim. Care Companion CNS Disord., 14(3).
- National Institute on Alcohol Abuse and Alcoholism.(n.d.). Alcohol’s Effects on the Body.
- National Institute on Drug Abuse. (2014). What Are the Possible Consequences of Opioid Use and Abuse?
- National Council on Alcoholism and Drug Dependence. (2015). Facts About Alcohol.
- Connor JP, Haber PS, Hall WD. Alcohol use disorders. Lancet 2015 [Epub ahead of print].
- National Institute on Alcohol Abuse and Alcoholism. (2016). Alcohol Facts and Statistics.
- National Institute on Drug Abuse for Teens. (n.d.). Prescription Drugs.
- National Institute on Drug Abuse for Teens. (n.d.). Prescription Pain Medications (Opioids).
- Center for Behavioral Health Statistics and Quality. (2016). Key Substance Use and Mental Health Indicators in the United States: Results from the 2015 National Survey on Drug Use and Health. Substance Abuse and Mental Health Services Administration, Rockville, MD.
- McCabe, S. E., Cranford, J. A., & Boyd, C. J. (2006). The relationship between past-year drinking behaviors and nonmedical use of prescription drugs: prevalence of co-occurrence in a national sample. Drug and alcohol dependence, 84(3), 281-288.
- National Institute on Drug Abuse. (n.d.). Monitoring the Future Study: Trends in Prevalence of Various Drugs.