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Oxycodone and Alcohol: Is There a Safe Way to Mix Them?

Oxycodone is a highly potent opiate medication that is processed from the opium in the Asian poppy plant. Opiates are drugs that have long been identified as significant drugs of abuse worldwide.

Technically, oxycodone and other similar drugs are classified as endogenous opiate agonists, indicating that these drugs act on specific receptor sites in the brain that are involved in the subjective experience of pain.

Although the exact mechanism of how oxycodone works is not entirely understood, it attaches to receptors in the brain that are specialized for neurotransmitters like endorphins and enkephalins. Oxycodone is a very potent drug that produces significant reductions in one’s experience of acute and chronic pain, a reduction in stress, and reductions in the other actions that occur within the brain and the spinal cord (the central nervous system or CNS).

According to Acute Pain Management: A Practical Guide, the drug is a CNS depressant, meaning that it depresses or suppresses the actions of the neurons (nerves) in the CNS.

A widespread side effect of oxycodone and other narcotic drugs is a feeling of euphoria or extreme well-being that accompanies the CNS depressant effects. Some of the other results of using a CNS depressant like oxycodone include decreases in:

  • Life-sustaining bodily functions. Taking these substances results in a decline in one’s breathing rate, heart rate, and blood pressure.
  • Motor actions and reflex actions. People using CNS depressants will move more slowly, have poorer motor coordination, and decreased reflexes as a result of the actions of these substances.
  • Mental faculties. The use of these substances results in a slower rate of thought, decreased ability to pay attention to stimuli and to remember new information, and poorer judgment and rational thinking.
  • Emotional control. These drugs can lead to a decrease in the ability to control emotions and inhibit impulsive behaviors.

The effects of using a CNS depressant are dose-dependent, such that the more of the drug that is used, the stronger the effects become.

According to the United States Drug Enforcement Administration (DEA), substances containing oxycodone are classified as Schedule II controlled substances, indicating that these products can be used for medical purposes, but they can only be obtained with a prescription from a physician. It also indicates oxycodone can only be used for specific purposes and according to a physician’s instructions.

Anyone who obtains, sells, or possesses such a product without a written prescription from a physician violates state and federal laws. Oxycodone is the primary active ingredient in several medications, including Percocet and OxyContin. It is primarily prescribed in pill form, and it is most often prescribed to treat chronic or postoperative pain.

Alcohol is also a CNS depressant substance; however, alcohol can be legally purchased by individuals who are of legal age (21 years and up) in the United States. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), alcohol is one of the most commonly abused substances in the United States. Millions of people would very likely qualify for a formal diagnosis of an alcohol use disorder, the clinical term for a person who abuses or is addicted to alcohol.

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Combining Oxycodone and Alcohol

Individuals who are prescribed medications containing oxycodone will notice the instructions for the medication very explicitly state that it should not be taken in conjunction with alcoholic beverages.  Nonetheless, according to SAMHSA, people who abuse opiate drugs recreationally very commonly mix them with other CNS depressant drugs like alcohol.

Professional sources that describe the actions and misuse of different types of drugs, such as the books Drug Interactions: Analysis and Management 2014 and Alcohol and Opiates: Neurochemical and Behavioral Mechanisms, describe numerous potential dangers of combining any amount of oxycodone with any amount of alcohol.

alcohol and pills
  • Enhanced effects: When two CNS depressant drugs are combined, the effects of both drugs are enhanced in a manner that can be potentially dangerous. This includes the effects mentioned previously. Significantly decreased breathing and decreased heart rate can be potentially fatal.
  • Increased absorption of the opiate: In some cases, it has been found that using alcohol in conjunction with an opiate drug increases the absorption rate of the opiate, which can be potentially dangerous and lead to enhanced effects of the opiate.
  • Bigger risk of side effects or unpredictable effects: Many medications, as well as alcohol, can produce side effects in people who use them. In addition, some people may experience unpredictable or unusual effects of these substances. Combining two CNS depressants can increase the potential for these effects.
  • Increased burden on the tissues and organs of the body: Most readers are probably aware that chronic alcohol abuse can seriously damage organs such as the heart and liver. Likewise, chronic abuse of opiate drugs may increase the potential for organ damage. When an individual chronically abuses both drugs, the potential for these drugs to have detrimental effects on other organ systems in the body, besides the CNS, is significantly enhanced. Moreover, other potentially dangerous activities that may result from a decline in judgment while a person is under the effects of these drugs, such as engaging in unsafe sex or needle sharing, can increase the risk for disease or organ damage.
  • Increased risk for the development of physical dependence: Both oxycodone and alcohol can produce physical dependence when used chronically. Physical dependence on alcohol can produce potentially fatal seizures during alcohol withdrawal. Chronically combining oxycodone and alcohol can lead to more rapid development of physical dependence.

Obviously, if combining two drugs enhances their effects, the potential for overdosing on either drug is enhanced, even if one uses relatively small amounts of both drugs in combinations. In addition, because even small amounts of both drugs can significantly affect mental capacities and judgment, the potential for an individual to make poor decisions, engage in impulsive behaviors, or engage in potentially dangerous behaviors is increased when one combines these drugs.

Individuals often can’t conceptualize the ramifications of their behavior when they are under the influence of these drugs. Combining them can lead to an increased risk for self-harm or harm to others due to the behaviors individuals may engage in under the influence.

The potential for harm is not limited to the direct effects of the drugs themselves. Combining them on a regular basis may lead to an individual being more apt to commit a crime, become the victim of a crime, or have potentially serious accidents. It could also lead to the loss of one’s career, important relationships, or freedom due to incarceration.

While individuals from all age groups are at risk of developing problems associated with the chronic use of the combination of oxycodone and alcohol, older individuals are more likely to experience the physical effects of this combination more quickly than younger individuals.

“That being said, younger individuals are much more likely to be hospitalized because of overdoses that happen as a result of this combination of drugs. Toxic effects or potential overdose effects as a result of combining alcohol and oxycodone products can occur with the ingestion of relatively small amounts of these drugs”

Finally, the National Institute on Drug Abuse reports that the majority of people who are prescribed to take opiate medications such as oxycodone do not abuse them; only a minority of people prescribed opiates develop an opiate use disorder. However, the majority (about 80 percent) of heroin users first abused prescription opiates like oxycodone.

Using an opiate with alcohol would formally qualify as misuse of the drug due to the instructions on the label prohibiting the use of it in conjunction with alcohol. Therefore, some people may transition on to more prolonged or significant forms of substance abuse.

Is There a Safe Way to Combine These Substances?

The key to understanding the seriousness of combining alcohol and oxycodone is to remember that even on the instructions of prescription medications containing oxycodone, there is a warning that the drug should not be combined with alcohol.

This means that even when the drug is taken in relatively small amounts and for medical reasons, it is not deemed to be safe to take products containing oxycodone with any amount of alcohol. Thus, there is no safe way for any individual to combine a product containing oxycodone with alcohol. This practice should be avoided at all costs.

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