Dangers of Mixing Alcohol & Fentanyl

Mixing alcohol and fentanyl (a practice known as polysubstance misuse) can lead to unpredictable and dangerous health consequences.^1(abstract) On their own alcohol and fentanyl can cause a variety of negative effects, but when taken together the two drugs can amplify the effects, increasing the risk of serious complications.¹ Despite the danger of addiction and risks of polysubstance use, there are evidence-based treatments that can help you build a healthy future.

Understanding Fentanyl and Alcohol

Fentanyl is a powerful, synthetic opioid, commonly used in various forms of treatment for severe pain. However, while fentanyl can be effective for pain management when taken under medical supervision, many may seek to misuse fentanyl for its ability to induce effects like sedation, relaxation, and euphoria (a general sensation of being “high”). While many may willingly opt to mix fentanyl with other substances to amplify its effects, others may end up taking substances that are contaminated with fentanyl, thereby misusing fentanyl unintentionally as fentanyl is commonly laced in illicit substances such as cocaine, ketamine and other opioids. . Like most opioids, fentanyl usage presents a risk of slowing down a person’s breathing causing respiratory depression which can be life threatening. Due to fentanyl’s potency, even a small dose can cause serious effects, including deadly overdose.

Alcohol is one of the most misused substances in the world. A central nervous system depressant, alcohol can have a variety of effects on the body.¹⁰  While many may consume alcohol for pleasurable short-term effects, alcohol can have serious effects on the brain and the body. Alcohol consumptions can increase the risk of:¹⁰

• Neurological problems such as dementia, slowed reaction time, etc., as alcohol can interfere with brain functionality.
• Cardiovascular concerns, such as high blood pressure, cardiomyopathy, irregular heartbeat, and stroke.
• Liver diseases, such as fatty liver disease, alcoholic hepatitis, fibrosis, and liver cirrhosis.
• Pancreatitis.
• Various types of cancers.
• A weakened immune system.
• Addiction.

Dangers & Risks of Mixing Fentanyl and Alcohol

The consequences associated with mixing alcohol and fentanyl can be significant.² Fentanyl is a potent opioid (nearly 50 to 100 times more powerful than morphine) that can cause life-threatening effects on its own.^{3, 5} When mixed together, alcohol can amplify the effects of fentanyl, and vice versa.¹ Most noteworthy is that both alcohol and fentanyl can act as central nervous system depressants.¹ As a result, when taken in tandem, alcohol and fentanyl can cause respiratory depression, which can result in a lethal overdose. ¹

Studies indicate that alcohol commonly plays a role in opioid overdose deaths.⁸ For overdose deaths involving fentanyl specifically, a study found that a blood alcohol concentration (BAC) of .08% was associated with lowering the threshold of a fentanyl overdose, meaning that even the tiniest amount of fentanyl with this BAC can be deadly.⁹ This suggests that alcohol consumption can make it easier to overdose on fentanyl.⁹

Furthermore, those who use alcohol with other drugs (like cocaine, heroin, or MDMA) may also be at risk for mixing it with fentanyl. ¹¹ Fentanyl is often mixed in with other illicit drugs as a way for drug dealers to amplify their product’s effects and increase profits. As a result, if one uses a fentanyl-contaminated drug in tandem with alcohol they may unintentionally be exposed to fentanyl. ¹¹ Due to fentanyl’s potency, this could cause dangerous side effects, especially in those with low opioid tolerance. Fentanyl test strips can be an effective for determining if a substance is laced or contaminated with fentanyl, and as a result could increase safety for those using illicit drugs.¹²

Additionally, while both fentanyl and alcohol can cause a variety of health effects, both carry a high potential for misuse and addiction.

Fentanyl and Alcohol Overdose

The risk of a severe or fatal overdose increases significantly when alcohol and fentanyl are taken together.^4,9 This is due to the increased risk of respiratory depression from both alcohol and opioids like fentanyl.⁴ Furthermore, symptoms associated with an alcohol overdose, such as difficulty maintaining consciousness, a slowed heart rate, and seizures, can present further complications, necessitating the need for emergency medical services in the event of a fentanyl and alcohol overdose.² If you or a loved one are experiencing an overdose, call 911 immediately.

Fentanyl and Alcohol Overdose Symptoms

Due to the potency of fentanyl, many overdoses involving alcohol and fentanyl may present as an opioid overdose. One of the main concerns in the event of a fentanyl and alcohol overdose will be slowed or shallow breathing (respiratory depression).⁵ Common signs of a fentanyl (opioid) overdose may include:^{6, 7}

• Difficulty or an absence of breathing.
• Pinpoint pupils.
• Bluish lips, nose, or fingernails.
• A lack of responsiveness.
• Vomiting.

How to Stop a Fentanyl and Alcohol Overdose

If you or a loved one may have overdosed on alcohol, fentanyl, or a combination of both, call 911 immediately. Other steps you can take in the event of an alcohol and fentanyl overdose include:^{2, 5}

• Administer naloxone if it is available.
• Have a conscious person lean forward or roll the unconscious person on their side to prevent choking.
• Stay with the person.
• Be prepared to provide information to the emergency responders if you know the amount or extent of substances that were taken by the person that day and about any other health conditions.

Naloxone (Narcan) is a fast-acting medication that can reverse the effects of an opioid overdose including fentanyl, potentially avoiding lethal effects.⁶ Naloxone is often available over the counter at pharmacies and can be administered easily. However, an overdose constitutes a medical emergency, and while Naloxone can provide relief, emergency medical treatment is often required.⁶

Finding Treatment for Fentanyl and Alcohol Addiction

Alcohol and opioid use disorders are serious conditions that require help to overcome. However, evidence-based treatment options are available. Many people with severe addictions have recovered after getting help. If you are concerned about controlling your alcohol and fentanyl use, consult your doctor about options for rehab near you.

In addition to speaking with your healthcare provider for addiction recovery resources, the fentanyl support treatment directory is available to help you search through thousands of available addiction treatment centers online.

Using this resource and contacting the American Addiction Centers (AAC) addiction helpline may provide the assistance you need to start your journey. AAC helpline staff can answer questions about insurance coverage and assist you in finding an appropriate treatment program for your needs. Call today. A new start is just a phone call away.