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Fentanyl and Alcohol: Why Mixing the Two Is Dangerous and Deadly

Written by Heather Lomax

& Medically Reviewed by Dr. Jessica Pyhtila, PharmD

Medically Reviewed

Up to Date

This article was reviewed by a medical professional to guarantee the delivery of accurate and up-to- date information. View our research policy.
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Fentanyl and alcohol are both substances that can be abused. While both substances individually can be dangerous and lead to an overdose, mixing them carries additional dangers. Because both fentanyl and alcohol are central nervous system depressants, they can have an additive impact on the brain and body.

What Is Fentanyl?

Fentanyl is a type of opioid that can be used to treat severe pain and is up to 100 times stronger than morphine. When used as prescribed, fentanyl can be a helpful medication but may come with some side effects. These side effects and risks can be worsened if fentanyl is mixed with alcohol.

Fentanyl is misused recreationally for its relaxing “high.” Some people use fentanyl accidentally when using other drugs that are unknowingly cut with fentanyl. Using fentanyl recreationally is particularly dangerous, and combining it with alcohol is risky and even deadly. Learning the dangers of using fentanyl and alcohol together can prevent dangerous use or help you find help if you need it.

Dangers of Mixing Fentanyl and Alcohol

Mixing alcohol and fentanyl can lead to an overdose, which is potentially fatal. An overdose can occur because both fentanyl and alcohol are central nervous system depressants, and combining them can increase their effects.

Fentanyl is a powerful painkiller that acts on the central nervous system by binding to specific opioid receptors. Fentanyl is known as a central nervous system depressant because it slows or reduces some of the functions of the body and brain. This can include slurred speech, low blood pressure or a dangerously low breathing rate.

Alcohol is also a central nervous system depressant, and interactions between fentanyl and alcohol can cause serious damage or even death. Because they act on the same systems, alcohol can heighten the risks or side effects of fentanyl use. This combination can be dangerous regardless of whether fentanyl is taken as a pill or used in the fentanyl patch form along with alcohol.

Can You Drink Alcohol After Fentanyl?

You should avoid drinking alcohol after fentanyl. This is because fentanyl can linger in your body for hours or even days after the last use, and mixing it with alcohol during that period can lead to deadly consequences. The half-life of a drug refers to how long it takes for half of a single dose to leave your body, and it generally takes five half-lives for your body to completely clear a drug. Depending on the dosage form, fentanyl’s half-life can vary significantly. For example, the skin patch form of fentanyl can have a half-life of up to 27 hours, while the lozenge form has a half-life of only 3.2 hours. This means that it is dangerous to drink within around five days of using a fentanyl skin patch and within about 15 hours of using a fentanyl lozenge.

Side Effects of Mixing Fentanyl and Alcohol

A danger of using fentanyl and alcohol together is that the combination can make risky side effects more severe. Even when used as prescribed, fentanyl side effects can include:

  • Nausea or vomiting
  • Weakness
  • Drowsiness or confusion
  • Slurred speech
  • Slowed breathing rate
  • Lower blood pressure

Side effects while using fentanyl can be fairly common, particularly when a person is just starting to take the drug. Using alcohol has its own group of side effects, and the combination of the two can make it hard for the body to perform basic functions. Combining fentanyl and alcohol can increase the severity of side effects to a dangerous or even fatal level.

Risks of Mixing Fentanyl and Alcohol

Because combining alcohol and fentanyl can worsen potential side effects, using the two together — even if using fentanyl as prescribed — can be a very high-risk combination. The effects of fentanyl and alcohol can depend on the person and can be impacted by factors like gender, height, size and tolerance for the drug. Because of this, it is difficult to predict how you will react to a combination of fentanyl and alcohol.

One of the main risks of mixing fentanyl and alcohol is the slowing of important functions — like heart rate or rate of breathing — to the point that the body does not get the oxygen it needs. Without oxygen, the body begins to shut down, which can result in loss of consciousness or death. As a result, it is important to avoid alcohol when using the drug.

Fentanyl and Alcohol Overdose

As a result of the combined effects of the drugs, fentanyl and alcohol overdose can happen even after using relatively small doses. A fentanyl overdose can be amplified by alcohol, and the signs and symptoms can include:

  • Clammy skin
  • Limp muscles
  • Purple or blue fingernails or lips
  • Vomiting
  • Gurgling noises
  • Inability to wake up
  • Slowed or stopped breathing and heartbeat

Combining these substances can have long-term effects on physical and mental health and can be fatal.

Recognizing Fentanyl and Alcohol Abuse

When a person starts to misuse a substance, different signs and symptoms can emerge. These can manifest as physical symptoms and behavioral changes, and may be the first clue a friend or loved one has that a person is spiraling into addiction. It is important to address a potential fentanyl or alcohol addiction as soon as possible, in part because of the ever-present risk of a potentially fatal overdose, especially when the substances are taken together.

Physical Signs of Abuse

Signs of misuse can often show up in a person’s appearance. Physical signs of fentanyl or alcohol misuse are similar to those of other substances and include:

  • Bloodshot eyes 
  • Small pupils 
  • Sudden changes in weight 
  • A disheveled physical appearance
  • Unpleasant breath
  • Poor-smelling body or clothing
  • Tremors, slurred speech or coordination problems

Psychological Signs of Abuse

A person’s behavior often starts to change as they misuse a substance like alcohol or fentanyl. Psychological signs of misuse can show up in many different ways and include:

  • Uncharacteristically poor performance at work or school
  • Frequently getting into trouble with other people
  • Acting secretive or suspicious
  • Changes in appetite or sleep
  • Changes in personality
  • Sudden mood swings
  • Unusual hyperactivity or agitation
  • Low motivation
  • Increased anxiety with no reason

Getting Help for Fentanyl and Alcohol Addiction

As an opioid, fentanyl belongs to an addictive class of drugs and is a high-risk substance for abuse. Some people may regularly combine fentanyl and alcohol to increase their “high” and can become addicted to both fentanyl and alcohol.

Fentanyl addiction treatment can help to address the body’s physical dependence on the drug, and also help a person develop skills and strategies to cope without substances. If you or someone you know is abusing both fentanyl and alcohol, then alcohol addiction treatment may be necessary as well. Treatment may include medical detox, inpatient or outpatient rehab to address underlying thoughts, behaviors and mental health conditions that may contribute to substance use.

Getting help for a fentanyl and alcohol addiction can seem intimidating, but can reduce the risk of serious consequences from mixing drugs. If you or someone you love is struggling with a substance use disorder, The Recovery Village Ridgefield Drug and Alcohol Rehab can help. Call today to discuss the treatment options that are available to you.


Alcohol and Drug Foundation. “Fentanyl.” August 15, 2019. Accessed August 15, 2019.

Jones, Christopher M; et al. “Alcohol involvement in opioid pain reliever and benzodiazepine drug abuse-related emergency department visits and drug-related deaths – United States, 2010.” Morbidity and Mortality Weekly Report, 2014. Accessed August 15, 2019.

Kandel, Denise B; et al. “Increases from 2002 to 2015 in prescription opioid overdose deaths in combination with other substances.” Drug and Alcohol Dependence, September 1 2017. Accessed August 15, 2019.

National Institute on Drug Abuse. “Fentanyl.” February 2019. Accessed August 15, 2019.

New Zealand Government. “Data Sheet (Fentanyl Injection).” May 8, 2017. Accessed August 16, 2019.

View Sources “FentaNYL Monograph for Professionals.” April 19, 2023. Accessed January 13, 2024.

National Institute on Drug Abuse. “Fentanyl DrugFacts.” June 2021. Accessed January 13, 2024.

Jones, Christopher M.; Paulozzi, Leonard J.; Mack, Karin A. “Alcohol Involvement in Opioid Pain Reliever and Benzodiazepine Drug Abuse–Related Emergency Department Visits and Drug-Related Deaths — United States, 2010.” Morbidity and Mortality Weekly Report, Centers for Disease Control and Prevention, October 10, 2014. Accessed January 13, 2024.

Substance Abuse and Mental Health Services Administration. “Preventing, Recognizing, and Treating Opioid Overdose.” December 8, 2023. Accessed January 13, 2024.

Hallare, Jericho; Gerriets, Valerie. “Half Life.” StatPearls, June 20, 2023. Accessed January 13, 2024. “Drug Interaction Report: ethanol, fentanyl.” Accessed January 13, 2024.

Substance Abuse and Mental Health Services Administration. “Mental Health and Substance Use Co-Occurring Disorders.” April 24, 2023. Accessed January 13, 2024.