Alcohol and Opiates

The combination of alcohol and opiates is complicating the already serious problems of alcoholism and opiate addiction. Using both creates a synergistic effect where the combination is greater than the sum of its parts — one drug increases the other’s effectiveness. But this increased effect is dangerous and can cause overdose and death.

I don’t know if there are good statistics regarding the consequences of the combined use of alcohol and opiates – I haven’t seen any – but here are a few statistics regarding each:

According to recent statistics , 16.6 million adults in the US had an alcohol use disorder in 2013 and almost 88,000 people die every year from causes involving alcohol use and abuse.

The American Society of Addiction Medicine’s 2016 Facts & Figures shows that nearly 2 million people in the nation are suffering from an addiction to prescription painkillers.  The study also reports that 4 of 5 new heroin users first abused prescription opiates.

So, several problems are developing — prescription opiate use is leading to the use of heroin, and more people are mixing alcohol and opiates. Not that heroin is necessarily any worse than prescription opiate addiction, but buying heroin on the street can be very risky when you can’t know the potency.  I suspect we’ll find going forward that the combination of alcohol and opiates will be identified as a major cause of drug-related death. In the past, the separate statistics showing deaths from alcohol use or opiate use have likely missed the fact that both opiates and alcohol were used in combination to cause many of these deaths. Also, the use of drugs like Xanax and opiates have had the synergistic effect leading to overdose and death.

Now that the 60s drug explosion seems like ancient history, we’re seeing people come to treatment who use a combination of drugs. It’s not just an alcohol problem or an opiate problem, it’s a problem with multiple drugs. I would like to see better research showing the consequences of polydrug addiction or abuse, especially related to alcohol and opiates.

The challenge for treatment professionals is dealing with clients who want to give up one drug but keep the one they perceive as less dangerous, like pot or Xanax. Substituting, or “just smoking pot” doesn’t work for the addict. It doesn’t take high intelligence and great emotional stability to recover from addiction, but it takes all the intelligence and emotional stability a person can muster — altering the mood with any substance affects judgment, and when judgment is affected, then the addict makes poor decisions, and these decisions are often deadly. The exception to this is medication that has a medical purpose. Usually medication that treats a co-existing disorder doesn’t trigger relapse — it’s used for conditions that would surely lead to relapse, such as anxiety medication, depression medication, or drugs like Suboxone that remove the craving for opiates in early recovery for the opiate addict. Such medication doesn’t alter the mind in the same ways as alcohol, pot, cocaine, heroin, etc. These medication are basically regulating brain chemicals to address a dysregulation of brain chemicals.