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Is it Safe to Mix Hydrocodone and Alcohol?

Written by Brennan Valeski

& 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.
If you or a loved one is struggling with addiction, help is available. Speak with a Recovery Advocate by calling (855) 602-7202 now.

Hydrocodone and Alcohol at a Glance

  • Mixing hydrocodone, a common opioid painkiller, and alcohol can be dangerous due to their combined effects as central nervous system depressants.
  • The combination of hydrocodone and alcohol can lead to slowed breathing, extreme drowsiness, coma, and even fatal overdose.
  • Long-term use of hydrocodone and alcohol can result in tolerance, abuse, and dependence, increasing the risks of life-threatening side effects.
  • Many hydrocodone medications contain acetaminophen, which, when combined with alcohol, can lead to liver toxicity, stomach ulcers, and internal bleeding.
  • Treatment options for hydrocodone and alcohol addiction include inpatient and outpatient rehabilitation, counseling, and behavioral therapy.

What Is Hydrocodone?

Hydrocodone is one of the most commonly prescribed opioids for managing pain. Many people may be more familiar with the brand names of drugs that contain hydrocodone, such as Vicodin, Lortab, Lorcet or Norco.

Hydrocodone is a partially synthetic opioid that closely resembles codeine. All opioids act on the same opioid receptors in the brain, the central nervous system (CNS) and the digestive system. Once ingested, opioids like hydrocodone bind to opioid receptors in these regions and act as a CNS depressant. In other words, opioids decrease the activity of the CNS, including breathing functions.

Alcohol is also a CNS depressant, but it works in a completely different way than opioids like hydrocodone. Using multiple CNS depressants at the same time can cause many adverse side effects, so it’s risky for someone to take hydrocodone and drink alcohol simultaneously. Many medicines also contain alcohol, which can cause someone to mix hydrocodone with alcohol unknowingly. When a person combines alcohol with hydrocodone — whether purposely or unintentionally — they may be putting themselves in danger.

Can You Mix Hydrocodone and Alcohol?

Hydrocodone and alcohol can be a dangerous combination. When taken alone, opioids like hydrocodone can cause slowed breathing, shortness of breath, extreme drowsiness and coma. Mixing even moderate amounts of alcohol with hydrocodone increases the risk of severe side effects like trouble breathing and overdose, which can be fatal.

What Happens When You Mix Hydrocodone and Alcohol?

Hydrocodone and alcohol carry a risk of tolerance, abuse and dependence, especially with long-term use. Over time, a person may need higher and higher doses to get the same effect as before. Sometimes, people look for ways to enhance the effects of a medication like hydrocodone and begin to take other substances, such as alcohol. Combining more than one substance (also known as polysubstance use) can put a person at risk for life-threatening side effects.

When hydrocodone and alcohol are taken together, the side effects of each are magnified. Both of these substances are CNS depressants that slow your breathing and heart rate and reduce your cough reflex. You may experience slowed, difficult breathing and also be at risk of getting foods, fluids and objects stuck in your airway.

Side Effects of Mixing Hydrocodone and Alcohol

Drinking alcohol with hydrocodone in your system can cause a variety of negative side effects when used on their own. When these substances are combined, however, the side effects can quickly intensify and become severe or even fatal. There are various physical side effects that a person may encounter when mixing alcohol and hydrocodone, including:

  • Irregular heartbeat
  • Irregular or slowed breathing
  • Excessive tiredness or inability to stay awake
  • Muscle weakness
  • Potential to overdose
  • Organ damage
  • Shaking or trembling
  • Seizures
  • Decreased control of movements
  • Unconsciousness
  • Death

Risks of Mixing Hydrocodone and Alcohol

Upon mixing hydrocodone and alcohol, a person may feel peaceful or relaxed. However, some unseen risks or events may occur after the initial euphoria wears off. Using both drugs together intensifies each of their effects. Using both drugs together not only causes a person to be more drowsy and dizzy but also increases their risk of overdosing from either drug.

Besides physical side effects associated with consuming hydrocodone and alcohol, there are negative consequences on cognitive processes, including:

  • Increased confusion
  • Lapses in memory
  • Increased aggression or hostility
  • Decreased decision-making ability

Further, not many people realize that hydrocodone is commonly prescribed in a form that is mixed with acetaminophen (Tylenol). For many years, it has been known that acetaminophen can lead to liver toxicity when used in high quantities or with alcohol. As a result, mixing hydrocodone and alcohol is associated with liver toxicity due to the presence of acetaminophen when used long-term. Mixing alcohol and hydrocodone formulations can also lead to stomach ulcers and internal bleeding.

Can You Overdose on Hydrocodone and Alcohol?

Individuals who consume alcohol and hydrocodone significantly increase their risk of an overdose. Effects of an overdose include respiratory depression, meaning their breathing stops or slows to a dangerous level. Further, a person may lose their ability to control their body and can end up choking, falling or severely injuring themselves. Typical symptoms associated with a hydrocodone overdose include:

  • Bluish fingernails or lips
  • Unresponsiveness
  • Coma
  • Sweaty or clammy skin
  • Decreased heart rate
  • Decreased or stopped breathing
  • Vomiting
  • Decreased pupil size

Nowadays, there are opioid reversal drugs that directly counteract opioids and can be administered relatively easily. Unfortunately, there are no such drugs that counteract alcohol. Even if naloxone or a similar drug is given to reverse opioid activity, a person may still experience the negative repercussions of alcohol poisoning. A person with alcohol poisoning may be given fluids or have their stomach pumped to remove as much alcohol as possible before it is absorbed into the bloodstream.

Insurance May Cover the Cost of Rehab

Cost should not stop you from getting the help you need. See if your insurance is accepted at The Recovery Village.

Getting Help for Hydrocodone and Alcohol Addiction

There are many ways that individuals can begin on their road to recovery. Hydrocodone treatment may include getting concurrent help for alcohol addiction and attending opioid and alcohol support groups. It may also involve receiving treatment at an inpatient or outpatient rehabilitation facility and attending counseling or behavioral therapy sessions. There are also many other approaches that may be included in treatment.

Located in the Pacific Northwest, The Recovery Village Ridgefield provides various treatment levels designed to meet your specific needs. We offer residential treatment programs with around-the-clock medical support and outpatient treatment programs for those needing less intense care. We also connect you with long-term aftercare designed to aid in your transition back to everyday life. Our addiction specialists will assess your unique situation and recommend the appropriate level of care for you.

The Recovery Village Ridgefield offers scenic views and comfortable living accommodations to help promote a relaxing environment that fosters your addiction recovery journey. In addition to receiving the highest standard of addiction treatment, you can also enjoy art and music therapy, exercise gyms, a basketball court and many other amenities during your stay.

If you or someone you love is struggling with hydrocodone or alcohol addiction, The Recovery Village Ridgefield is here to help. Contact us today to speak with a representative and learn more about addiction treatment programs that can work well for your situation.

We are here when you are ready.

Speak with a Recovery Advocate today to talk about your treatment options.


Centers for Disease Control and Prevention. “Polysubstance Use Facts.” February 23, 2022. Accessed June 28, 2022. National Institute on Alcohol Abuse and Alcoholism. “Mixing Alcohol With Medicines.” 2014. Accessed June 28, 2022. National Institute on Alcohol Abuse and Alcoholism. “Understanding the Dangers of Alcohol Overdose.” May 2021. Accessed June 28, 2022. U.S. National Library of Medicine. “Acetaminophen.” MedlinePlus, January 15, 2022. Accessed June 28, 2022. U.S. National Library of Medicine. “Hydrocodone.” MedlinePlus, January 15, 2022. Accessed June 28, 2022.  U.S. National Library of Medicine. “Hydrocodone/oxycodone overdose.” MedlinePlus, February 12, 2021. Accessed June 28, 2022.  PubChem. “Hydrocodone.” Accessed June 28, 2022. Scholastic. “Dangerous Liaisons: Mixing Hydrocodone with Alcohol and Other Drugs.” 2007. Accessed June 28, 2022. Weathermon, Ron; et al. “Alcohol and Medication Interactions.” Alcohol Research & Health, 1999. Accessed June 28, 2022.

View Sources

Centers for Disease Control and Prevention. “Polysubstance Use Facts.” February 23, 2022. Accessed November 20, 2023.

National Institute on Alcohol Abuse and Alcoholism. “Mixing Alcohol With Medicines.” 2014. Accessed November 20, 2023.

National Institute on Alcohol Abuse and Alcoholism. “Understanding the Dangers of Alcohol Overdose.” January 2023. Accessed November 20, 2023.

Weathermon, Ron; et al. “Alcohol and Medication Interactions.” Alcohol Research & Health, 1999. Accessed November 20, 2023.

Drug Enforcement Administration. “Hydrocodone.” October 2019. Accessed November 20, 2023. “HYDROcodone Monograph for Professionals.” April 19, 2023. Accessed November 20, 2023.

ClinCalc. “Acetaminophen; Hydrocodone – Drug Usage Statistics.” Accessed November 20, 2023.

Agrawal, Suneil; Khazaeni, Babak. “Acetaminophen Toxicity.” StatPearls, June 9, 2023. Accessed November 20, 2023.