Mixing Methadone and Alcohol

man on methadone holding an alcoholic drink

Methadone and alcohol should never be taken together because mixing these two substances can lead to dangerous health consequences. Methadone is a prescription medication used in opioid treatment programs, also known as medication-assisted treatment (MAT). Methadone is a drug that helps reduce opioid cravings of people recovering from addictions to drugs like oxycodone, hydrocodone and heroin.

Abusing methadone without a prescription or tolerance to opioids is especially dangerous and can lead to extreme drowsiness, trouble breathing, coma or death. Mixing methadone and alcohol together can further increase the chances of overdose or addiction.

People using methadone in an opioid treatment program should never combine alcohol and methadone, as it may cause them to be discharged from their treatment program. For those not already in a treatment program, polysubstance abuse can be treated in most addiction treatment centers.

Why Do People Mix Methadone and Alcohol?

Methadone and alcohol may be ingested together by accident or intentionally. Sometimes methadone is prescribed for pain, and in these cases, the recipient may not be adequately aware of the risks of drinking alcohol while on the medication. They may have a few drinks and quickly discover they are more impaired than they thought. Each drink of alcohol is intensified when ingested with methadone, and the combined effects of both substances are often unpredictable.

People in an opioid treatment program should have received extensive education about the dangers of mixing alcohol and methadone. This combination should never be taken together because it is dangerous and can lead to relapse. Alcohol is an addictive substance that may trigger cravings for opioids and other drugs.

In people with a history of opioid abuse, methadone’s abuse potential is low. However, for people with no history of opioid use, it can be a very potent and intoxicating opioid. They may abuse methadone and alcohol together to increase feelings of pleasure and euphoria, which can lead to overdose.

Effects of Combining Alcohol and Methadone

Methadone and alcohol are both central nervous system (CNS) depressants. They slow down processes in the body like breathing, thinking and moving.

Combining more than one CNS depressants carries a high risk of the following side effects:

  • Coma
  • Dizziness
  • Drowsiness
  • Impaired motor control
  • Increased risk for overdose
  • Liver damage
  • Loss of consciousness
  • Memory problems
  • Slowed breathing
  • Slurred speech
  • Unusual behavior
  • Death

Risks of Mixing Methadone and Alcohol

The most imminent risk of mixing central nervous system depressants is an overdose.

If you witness signs of an overdose, call 911 immediately. Signs may include:

  • Slowed breathing or heart rate
  • Fingernails or lips that turn blue or purple
  • Skin that feels cold and clammy to the touch
  • Pale or white skin
  • Inability to be woken up or speak
  • Vomiting

Upon arrival at the hospital, someone overdosing will receive support for their breathing and circulation. Stoppage of the lungs or heart are the primary killers in an overdose.

The person may also receive reversal agents like naloxone to reverse the effects of methadone or other opioids. They may stay in the hospital for a few days during recovery.

Another risk of polysubstance abuse is the increased risk of addiction. Methadone and alcohol by themselves carry a high risk of addiction. When used together, that risk is heightened.

Impact of Mixing Alcohol and Methadone During Opioid Addiction Treatment

People in opioid treatment should never drink alcohol. Mixing opioids and alcohol is dangerous because of additive CNS depression that results in drowsiness, slowed breathing, unusual behavior, coma and death.

Alcohol can slow the metabolism of methadone, prolonging how long it stays in the body. The reverse is also true.

Another primary risk of mixing methadone and alcohol is that alcohol is addictive and may trigger other addictive urges, triggering a relapse.

Treatment for Methadone and Alcohol Addiction

Those enrolled in an opioid treatment program should speak to their treatment clinic about their alcohol consumption. The clinic staff can provide resources and advice to help prevent polysubstance abuse.

For those not currently enrolled in a program, treatment typically involves medical detox, treatment and maintenance. A rehab center can provide both methadone and alcohol addiction help.

Once treatment is complete, someone in remission will enter aftercare and maintenance programs to ensure they can continue living a happy and substance-free life.

Treatment for polysubstance abuse can occur in treatment programs like those found at The Recovery Village Ridgefield. Reach out to a representative today for more information.

Food and Drug Administration. “Methadone Package Insert.” Accessed Aug 24, 2019.

National Institute on Alcohol Abuse and Alcoholism (NIAAA). “Harmful Interactions.” 2019.  Accessed Aug 24, 2019.

MedlinePlus. “Opioid Overdose.” 2015. Accessed Aug 24, 2019.

Ryder, Niamh, et al. “Prevalence of Problem Alcohol Use among Patients Attending Primary Care for Methadone Treatment.” BMC Family Practice, 2009. Accessed Aug 24, 2019.