Combining Oxycodone and Alcohol: What Are the Dangers?

Oxycodone and alcohol are both central nervous system (CNS) depressants, which means they slow the brain and body’s activity, including breathing and heart rate. 

Mixing alcohol and oxycodone (OxyContin) can increase the risk of dangerous respiratory depression and life-threatening overdose. In fact, polysubstance use of prescription opioids like oxycodone and alcohol is common among overdose deaths—by some estimates, over 30% of opioid overdose deaths also involved alcohol.[1]

In addition to increasing overdose risk, combining oxycodone and alcohol can severely harm your liver, heart, brain and more.

Is It Safe to Mix Oxycodone and Alcohol?

Risks of Mixing Oxycodone and Alcohol

Mixing OxyContin and alcohol is referred to as polysubstance use. Some people may misuse both substances in order to enhance their high; however, this is even more dangerous than using either substance on its own.

Using alcohol and oxycodone can cause many serious effects on your mental and physical health and greatly increase the likelihood of a fatal overdose. 

Increased Chance of Overdose

Because both alcohol and oxycodone cause sedation and respiratory depression, using them together can cause your heart and breathing to slow or stop—this is known as an overdose.

If you suspect you or someone else has overdosed, call 911 immediately. Perform CPR in the event the person stops breathing. And if you have it on you, administer naloxone (Narcan) to reverse the effects of the oxycodone overdose. Narcan won’t work on the alcohol, but it will reverse some of the respiratory depression caused by the opioid and buy the person some time while waiting for first responders.[3]

Other Health Risks and Effects

Mixing alcohol and oxycodone increases the risk of experiencing side effects from oxycodone, such as:[4]

• Drowsiness
• Mood changes
• Headache
• Flushing
• Nausea and vomiting
• Dizziness
• Difficulty breathing 
• Lightheadedness
• Chest pain

Moreover, other risks of combining these sedatives include:[5],[6]

• Impaired motor control
• Increased risk of injury and accidents
• Increased risk of violence
• Risky sexual behavior
• Chronic disease
• Opioid use disorder and alcohol use disorder
• Organ damage
• Increased risk of suicidality
• Increased risk of arrests and incarceration

Liver Damage

Chronic alcohol misuse on its own can cause severe liver disease and damage. Mixing alcohol and oxycodone, either alone or with acetaminophen, can greatly increase the risk of liver injury, such as:[7],[8]

• Alcoholic hepatitis
• Fibrosis
• Cirrhosis
• Fatty liver disease (steatosis)
• Liver cancer

In the case of an overdose on oxycodone with acetaminophen, someone can experience acute liver damage since acetaminophen is particularly toxic in large doses. Additionally, liver damage can occur due to anoxia, or dangerously low oxygen, caused by an overdose.[8]

Brain Damage

Heavy and long-term drinking can cause brain damage, such as hippocampus shrinkage, leading to memory and reasoning problems.[9] Alcohol can also cause Wernicke-Korsakoff syndrome, a severe condition affecting many areas of the brain and impairing functions like motivation, memory, sleep, language, movement and vision.[10]

Some consequences of Wernicke-Korsakoff syndrome include:[10]

• Tremors
• Lack of muscle coordination
• Double vision
• Abnormal eye movements
• Confusion
• Irreversible memory problems
• Inventing inaccurate stories
• Apathy
• Inability to plan, organize, and complete tasks
• Hallucinations

The main cause of brain damage in people misusing oxycodone occurs in the event of non-fatal opioid overdose. Non-fatal opioid overdoses can cause brain injuries caused by lack of oxygen. These brain injuries can cause:[11]

• Short-term memory loss
• Disorientation
• Incontinence
• Cognitive decline
• Lack of coordination
• Slower reaction time

Research has shown that multiple non-fatal opioid overdoses severely increase the risk for hypoxia (low oxygen levels) and related brain damage.[11]

Heart Disease and Damage

On their own, heavy drinking and oxycodone misuse can cause severe heart damage and complications, and mixing these two depressants can greatly increase the likelihood of adverse cardiovascular effects, such as:[12],[13]

• Peripheral arterial disease
• Stroke
• Coronary heart disease
• Hypertension
• Cardiomyopathy (heart muscle grows and weakens)
• Heart failure
• Heart attack

Also, injecting oxycodone or other drugs increases your risk of developing endocarditis, a bacterial infection of the heart lining, which can be life-threatening.[14]

Oxycodone and Alcohol Addiction

Mixing oxycodone and alcohol in the long term can lead to physiological dependence and addiction—also known as substance use disorder. An addiction to OxyContin and alcohol is characterized by compulsive use regardless of negative consequences. 

Signs of a polysubstance addiction include:[14]

• Experiencing a strong desire to use these drugs
• Taking larger amounts than intended
• Experiencing a desire to quit or cut down but being unable to do so
• Spending a considerable amount of time obtaining and using these substances as well as recovering from the effects
• Failing to fulfill obligations at home, school, or work due to use
• Continuing to use drugs despite interpersonal or social issues caused by use
• Neglecting important activities or hobbies in favor of oxycodone and alcohol use
• Using these substances in dangerous situations, such as while driving
• Continuing to use alcohol and oxycodone despite the knowledge that use is causing or worsening physical or mental health conditions
• Experiencing tolerance, or a need to use higher doses to experience the desired effects
• Dependence, or withdrawal symptoms when you abruptly stop use

Two or more of these symptoms may indicate a polysubstance addiction to OxyContin and alcohol—and the more symptoms present, the more severe the addiction.[14]

Opioid and Alcohol Withdrawal Symptoms

When you use oxycodone and alcohol chronically, you may develop a physiological dependence on them, which means your body and brain have adapted to the presence of these sedatives and require them to function properly. If you suddenly stop taking one or both of these substances, you’ll experience distressing and even dangerous alcohol and opioid withdrawal symptoms, such as:[14]

• Nausea, vomiting and diarrhea
• Fever and sweating
• Dilated pupils
• Depressed mood
• Anxiety
• Muscle and joint pain
• Insomnia
• Runny nose and tearing eyes
• Rapid pulse
• Tremors
• Hallucinations
• Seizures

Seizures, which are associated with alcohol withdrawal specifically, can be fatal, which is why it’s important to seek out medical detox services. Medical detox services can keep you safe and prevent and address any medical complications that occur during withdrawal.

Treatment for Alcohol and Oxycodone Addiction

Treatment for alcohol and oxycodone addiction requires a comprehensive, integrated and individualized approach to care. Polysubstance addiction is typically best treated in an inpatient setting due to its complications and severity. 

Inpatient rehab involves living at the facility for the duration of the treatment program, which may last from 30 to 90 days, sometimes longer. In this highly-structured environment, away from your everyday using environment, you are able to focus solely on your recovery. This is especially helpful in the early stages of recovery when you are first beginning to abstain from oxycodone and alcohol. 

During an inpatient treatment program, your treatment plan will be tailored to meet your unique needs and may include therapeutic interventions, such as:[15],[16]

• Medications for Addiction Treatment (MAT): You may be prescribed MAT, such as Suboxone, methadone, or naltrexone, to treat your opioid use disorder and alcohol use disorder. Naltrexone is FDA-approved to treat both conditions, so that may be particularly beneficial.
• Cognitive behavioral therapy (CBT): You learn to understand the connection between your thoughts, feelings and behaviors in order to abstain from drugs and learn coping and relapse prevention skills.
• Motivational enhancement therapy (MET): You work with a therapist to resolve ambivalence you may have related to quitting OxyContin and alcohol in order to become more engaged in treatment and commit to long-term change.
• Contingency management (CM): You receive tangible rewards for abstinent behaviors, such as drug-free urine tests.
• 12-step facilitation therapy: This type of therapy helps to encourage you to join 12-step meetings and commit to positive change through these support groups.
• Group counseling: These groups are facilitated by a professional and can help you to build sober social skills, receive and give advice to others, benefit from sharing experiences and role-play various skills in a safe space.
• Family therapy: A therapist can help you and your loved ones heal from substance addiction, improve communication skills, build conflict-resolution skills and improve boundary-setting.
• Holistic treatment methods: Some treatment programs may integrate holistic treatment modalities into treatment plans. These may include meditation, yoga, creative arts therapy and more.

If you are unable to attend an inpatient program due to commitments, responsibilities, or costs, other options are available. You could attend a partial hospitalization or intensive outpatient program, both of which allow you to return home in the evenings and during non-treatment hours. And if you have a high motivation to change and quit drugs, you could also try out a virtual treatment program, such as Bicycle Health, where you receive a high frequency of care from the comfort of your own home.