Mixing Pain Pills and Alcohol

Generic pain pills spilling out of a bottle on a pink counter

Pain medications, both over-the-counter and prescription, are generally considered safe when used as recommended. However, it is important to know that while these medications are safe, they can have harmful interactions with other substances, especially alcohol. Because pain medications are commonly used by many people, it is important to understand the possible risks of mixing different types of pain pills and alcohol, and to ask your doctor or pharmacist about any questions you have.

Risks of Alcohol Use with Over-the-Counter Pain Medication

Over-the-counter medications are available without a prescription and are commonly used to self-treat minor aches, pains or injuries.

Common over-the-counter pain medications include:

  • Tylenol (acetaminophen)
  • Non-steroidal anti-inflammatories (NSAIDs) such as Advil (ibuprofen), Motrin (ibuprofen), Aleve (naproxen)
  • Headache medications such as Excedrin (aspirin/acetaminophen)

There are some significant interactions to consider when mixing over-the-counter pain relief pills and alcohol, including:

  • Liver damage (high risk interaction for acetaminophen)
  • Stomach upset
  • Bleeding and ulcers
  • Rapid heartbeat

It is always helpful to talk to your doctor or pharmacist about any specific medications you are taking and the possible interactions with other substances, such as alcohol.

Dangers of Combining Alcohol With Prescription Pain Pills

Prescription pain medications require prescription orders from your doctor and are used to treat severe pain from injuries, surgery, migraines or arthritis.

Types and examples of prescription pain medications include:

  • Prescription opioids such as Percocet (oxycodone/acetaminophen), Vicodin (hydrocodone/acetaminophen), Ultram (tramadol) and Tylenol #3 (acetaminophen/codeine)
  • Prescription NSAIDs such as Celebrex (celecoxib), Naprosyn (naproxen), Indocin (indomethacin), Mobic (meloxicam), Voltaren (diclofenac), Relafen (nabumetone), Motrin (ibuprofen) and ketoprofen
  • Migraine medications such as Fioricet (aspirin/acetaminophen/butalbital)
  • Muscle spasm relievers such as Flexeril (cyclobenzaprine), Soma (carisoprodol) and Zanaflex (tizanidine)
  • Nerve pain relievers such as Lyrica (pregabalin)

Taking these medications with alcohol can cause a range of side effects, including:

  • Drowsiness
  • Dizziness
  • Ulcers
  • Stomach bleeding
  • Liver damage
  • Impaired coordination
  • Impaired cognition
  • Memory problems
  • Difficulty breathing

If you have specific questions about the medications you are taking and their interaction with alcohol, you should speak with your doctor or pharmacist.

The effects of combined alcohol and opioid use can be severe. The CDC reports that alcohol is involved in approximately 22% of deaths caused by prescription opioids and 18% of emergency room visits related to the misuse of prescription opioids. One of the most concerning side effects of mixing opioids and alcohol is respiratory depression.

Respiratory Depression

Respiratory depression is the term used when a person’s breathing rate has become slower. Respiratory depression is a very serious side effect of combined opioid and alcohol use and can cause death from overdose. When alcohol and opioids are taken together, the central nervous system depression that is caused by both alcohol and opioids individually compounds. This additive effect could result in the body not maintaining the necessary levels of oxygen for organs to survive, resulting in coma or death.

One person’s reaction to certain doses of an opioid and alcohol may vary greatly in comparison to that of another person. Therefore, what may be considered a safe dose for one person can be fatal for another.

If you or someone you know is experiencing respiratory depression or has become unconscious after using alcohol and prescription pain medications, call 9-1-1 and seek immediate medical attention. If the person was using opioids, administer Narcan (naloxone) if it is available.

Respiratory depression and alcohol overdose treatment should be handled by healthcare professionals in order to ensure the best possible outcome and prevent death. Seek immediate emergency medical attention.

Guidelines for Alcohol Use While on Pain Pills

Before using alcohol while taking pain medications, you should talk to your doctor or pharmacist about the possible side effects and alcohol consumption guidelines specific to your medications. Generally, it is recommended to avoid alcohol use while taking pain medications due to the potential side effects. Alcohol intake can also increase inflammation and pain related to injuries, arthritis or swelling.

Unfortunately, alcohol is used many times by people to self-medicate for pain. Proper treatment of pain can help prevent alcoholism. It is important to speak with your doctor about any problems you are having in order to ensure that you are receiving the most optimal care.

If you or a loved one is struggling with alcohol or opioid dependence, help is available. The Recovery Village Ridgefield offers individualized and comprehensive treatment plans that can lead you to a path of recovery. Contact us today to learn more about personalized treatment plans.

Centers for Disease Control and Prevention. “Alcohol Screening and brief intervention for people who consume alcohol and use opioids.” July 11, 2018. Accessed September 1, 2019.

National Institute on Alcohol Abuse and Alcoholism. “Harmful Interactions: Mixing Alcohol with Medications.” Updated 2014. Accessed September 1, 2019.

National Institute on Alcohol Abuse and Alcoholism. “Understanding the Dangers of Alcohol Overdose.” Updated October 2018. Accessed September 1, 2019.

Wang, Joe H; Zakhari, Samir; Jung, M Katherine. “Alcohol, inflammation, and gut-liver-brain interactions in tissue damage and disease development.” World Journal of Gastroenterology, March 21, 2010. Accessed September 1, 2019.

Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.