Hydrocodone and Alcohol

Last Updated: May 30, 2023

Editorial Policy | Research Policy

Article 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.

Hydrocodone is one of the most commonly prescribed opioids for managing pain. Many people may be more familiar with one of hydrocodone’s brand names, 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 negative 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 unknowingly mix hydrocodone with alcohol. When a person mixes 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.

Alcohol and Acetaminophen

Many prescription medications that contain hydrocodone also contain acetaminophen (APAP). You may see this printed on your prescription label as hydrocodone/APAP. Acetaminophen is an over-the-counter (OTC) medication commonly used as a pain reliever and fever reducer. It is added to hydrocodone to enhance the pain-relieving effects of the medicine.

Even though acetaminophen is available OTC, it is not without risks. High doses of acetaminophen can cause your body to produce a toxic acetaminophen product that can result in life-threatening liver damage. Drinking alcohol with acetaminophen increases the amount of toxic product that is made. The risk of acetaminophen-related liver injury is not associated with a specific alcohol level, so people should avoid mixing any amount of alcohol with acetaminophen.

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, there are unseen risks or events that 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 refversal 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.

Getting Help for Hydrocodone and Alcohol Addiction

Currently, 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.


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    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.