Oxycodone Interactions With Alcohol and Other Drugs

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Oxycodone is a prescription pain reliever that’s used in hospital settings and prescribed for home use. While it’s a useful medication for treating pain, it can also be misused for recreational purposes. In 2019, 14,139 overdose deaths involved prescription opioids like oxycodone. In many of these cases, more than one drug is used at the same time. Opioids may be mixed with other substances for potentially dangerous effects. Alcohol is often mixed with other drugs, especially during recreational use. Learn more about the dangers of mixing oxycodone with alcohol and other drugs.

Oxycodone and Drug Interactions

When you take a prescription drug like oxycodone, you may be warned about potential drug interactions. If your doctor or pharmacist doesn’t give you a warning, you’ll find some on the label. Drug interactions fall under the broad category of contraindications, which are factors that should make you think twice about taking a drug. Oxycodone is a substance that can change your brain chemistry and affect systems all over your body. When you’re taking an opioid, such as oxycodone, it’s important to know how it might affect or be affected by other substances. Introducing other drugs alongside oxycodone can cause interactions that create uncomfortable symptoms or dangerous side effects. 

Many drug interactions can tax the organs that process them in the body. For instance, if you’ve ever taken certain antibiotics, your doctor may have told you to avoid alcohol. Since antibiotics can be hard on your liver, adding alcohol to the mix could lead to liver damage. Other drug interactions could be dangerous to your nervous system. Oxycodone may potentiate with depressants and synergize with stimulants. Both of those scenarios can lead to severe complications.

Whenever you’re given a new prescription drug, it’s important to become familiar with its potential interactions with other drugs. Oxycodone is a potent opioid. If you mix it with the wrong substance, it’s not just going to cause an upset stomach; it may lead to life-threatening complications. 

oxycodone-and-alcohol

What if You Mix Oxycodone with Alcohol?

Alcohol is the most commonly misused substance in the United States. The vast majority of adults over the age of 18 have tried it at least once in their lives. In 2019, a national survey found that more than 25% of adults reported binge drinking within the last month before the survey. Alcohol use is so common; it may sometimes overlap with the use of other drugs, including prescription opioids. Whether you mix the drugs because you accidentally drank while taking the prescription or if you intentionally misuse both substances, the practice can be extremely dangerous. 

Alcohol is a central nervous system depressant. It slows down activity in your central nervous system by interacting with a chemical messenger called gamma-aminobutyric acid (GABA). GABA is your main neurotransmitter that’s responsible for sleep and relaxation. Alcohol increases its effectiveness and causes more pronounced feelings of sedation and sleepiness. Alcohol can also create other effects that are caused by your depressed nervous system. Your judgment, motor functions, and decision-making skills may be impaired. Heavy drinking can start to affect your autonomic nervous system, which controls unconscious things like your heart rate, blood pressure, and breathing. Severe alcohol intoxication can cause your breathing and heart rate to slow down.

Opioids are not exactly in the same category as other central nervous system depressants because they work in the brain in different ways. But they can also lead to feelings of sedation and relaxation. Opioids work by binding to your body’s natural opioid receptors and activating them. This causes pain signals to be blocked and creates feelings of warmth and relaxation. Opioids also influence feel-good chemicals like dopamine. High doses of an opioid can also cause some automatic functions to slow down, including your heart rate and breathing.

Together, opioids and alcohol can potentiate, which means they can work together to create powerful effects. Both can cause some of the same side effects, like sedation. Even in relatively moderate doses of each individual drug, combining the two can lead to severe overdose symptoms.

The Danger of Respiratory Depression

One of the most dangerous effects that come from combining oxycodone with depressants like alcohol is respiratory depression. Respiratory depression is when your breathing stops or slows down to a dangerous degree. It’s one of the most concerning side effects of opioids for doctors. Respiratory depression can happen with very high doses of an opioid, but it can also occur when opioids are mixed with other substances. Central nervous system depressants and opioids slow down the nervous system to the point in which breathing is slowed or stopped. People that experience this deadly symptom during an overdose may also pass out, and they may be difficult to wake. 

If you notice someone pass out after drinking or using an opioid, check their breathing and their pulse. If their breathing is slow or if they can’t be woken up, call emergency services immediately. Respiratory depression can lead to oxygen deprivation, brain damage, coma, and death if it’s not addressed as soon as possible. If an opioid is involved in causing respiratory depression, the drug naloxone, which is sold under the brand name Narcan, can reverse the effects of an opioid overdose. But that only works if it’s administered in time. 

What Other Drugs Are Dangerous to Mix with Oxycodone?

Alcohol is just one of the commonly used and misused substances that can be dangerous when mixed with opioids like oxycodone. But opioids can also interact with some other drugs to create some potentially deadly effects.

Other Opioids

Mixing oxycodone with other opioids like hydrocodone, morphine, or heroin, can lead to respiratory depression and overdose. Just like alcohol, opioids can potentiate one another, causing dangerous overdose symptoms.

Prescription Depressants

Prescription depressants can include benzodiazepines, like Xanax, Ativan, and Valium. It also includes non-benzodiazepine sleep aids, like Ambien and Zoloft. All of these drugs work in a way that’s similar to alcohol, influencing GABA and its receptors. They’re typically used to treat issues that cause overactivity in the nervous system like insomnia, anxiety, and panic disorders. They may cause some of the same dangerous effects as alcohol when they’re combined with oxycodone.

Stimulants

Cocaine and methamphetamine are powerful stimulants that are often used recreationally. Recreational cocaine use is often combined with opioids like heroin or even prescriptions. A mixture of opioids and cocaine is commonly called a speedball, which can lead to deadly overdose symptoms. Opioids don’t potentiate with cocaine as they can with alcohol. Instead, they synergize, creating opposite effects. This can mask some of the symptoms that might tell your brain when you’ve had enough of one of the drugs. Mixing uppers and downers can lead you to believe you can handle higher doses than you actually can.

Why Do People Mix Drugs?

Polydrug use is a significant problem that frequently leads to serious issues like overdose. There seem to be several potential dangers when it comes to mixing drugs and taking different substances at the same time. Why do people do it? There are several potential reasons someone might have for mixing oxycodone with other substances. The first and most obvious is mixing them accidentally. When you’re taking a prescription drug, you may go about your normal routine without thinking about how certain substances can interact with your prescriptions. If you’re used to drinking on the weekend, you may not realize it could have damaging effects when you’re taking an opioid. Though doctors and pharmacists usually remind you of the potentially dangerous mixtures when you take a prescription, it’s easy to forget if you’re not thinking about it. 

Any time you take a new prescription, it’s important to do your homework and ask questions about how you can use it responsibly. Opioids are a particularly potent prescription drug, so you should be all the more careful. Even in settings where recreational drug use occurs, you may take multiple substances without knowing they can interact poorly. Another reason for polydrug use is mixing them intentionally for unique effects. Polydrug users may take more than one substance at the same time to increase the quality of the high they experience. They may also take two or more drugs in order to avoid certain side effects that one or both of the drugs can cause. 

The first reason is the most common when it comes to mixing alcohol and opioids. The two can cause similar effects that amplify one another for a more intense high. Mixing opioids and stimulants is mixing drugs with some opposing effects, which is thought to cut down on side effects. For instance, cocaine may prevent the drowsiness that’s usually caused by heroin. However, mixing uppers and downers may cause a host of side effects despite the fact that you’re attempting to cancel them out.

In many cases of extreme drug use and polydrug use, users are self-medicating or masking other issues like anxiety and depression. According to the National Institute on Drug Abuse, people with substance use disorders are around twice as likely to have a mental health problem when compared to the general population. However, self-medicating with drugs usually leads to more problems and worsens mental health issues.

Sources

American Psychiatric Association. (2017, January). What Is Addiction? from https://www.psychiatry.org/patients-families/addiction/what-is-addiction

National Institute on Drug Abuse. (2021, February 25). Overdose death rates. from https://www.drugabuse.gov/drug-topics/trends-statistics/overdose-death-rates

National Institute on Alcohol Abuse and Alcoholism. (n.d.). Alcohol facts and statistics. from https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/alcohol-facts-and-statistics

National Institute on Drug Abuse. (2021, February 16). Mental health effects. from https://www.drugabuse.gov/drug-topics/health-consequences-drug-misuse/mental-health-effects

National Institute on Drug Abuse. (n.d.). Opioids. from https://www.drugabuse.gov/drugs-abuse/opioids

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