Alcohol and Opiates: Similarities

alcohol and heroin

Drugs are drugs

There are similarities between alcohol and opiates. The research is beyond my full understanding, but the research results show that the two drugs act on the same parts of the brain in similar ways. I have a hunch that one day science will discover there are more similarities than differences. The biggest difference today is that opiates are associated with heroin, and heroin is the bad child who no one discusses.

However, in the 60s, young people (and even some older people), started asking why alcohol is socially acceptable, yet marijuana is not. The acceptance of alcohol as the “good” drug was/is a social construct. Heroin was once associated solely with the back alleys, poverty, minorities, musician-types, crime, needles, disease, and so on. Heroin/opiates have a long history of going between popularity/vilification. Heroin was out of favor with most people until recently, about a decade ago, when heroin use started to rise and young people started to find it acceptable to use. Young people discovered they can smoke heroin or snort it – they don’t have to use a needle. Plus, opiates are purchased with a prescription, and opioids are opioids are opioids.

The basics of the heroin epidemic are rather simple – opioid-type drugs make a person feel extremely euphoric, it’s relatively cheap in the form of heroin, it lasts a good while, and it’s addictive. One day we’ll discover better ways to feel euphoric and to manage artificial brain changes, or we’ll find natural ways to feel good enough so we don’t want to take a drug to feel even better, because it’s not worth the risks involved. Right now, though, alcohol, opiates and pot appear to represent the most favored drugs. Cocaine use is going down. There are many people using prescribed, mood altering drugs for anxiety and depression, but the most regularly used social drugs that are ostensibly recreational drugs appear to be the three mentioned.

At our treatment facility we see some combination of these three, and sometimes all three in combination. Opiate addicts usually drink alcohol on a regular basis. We still see alcoholics who don’t use any other drugs, but they’re becoming rare. We also see pot smokers, but not many, who drink very little and don’t use any opiates. I expect to see a continued rise in clients who use opiates and drink alcohol. There appears to be a symbiotic relationship between alcohol (ethanol) and opiates, and as I wrote above, science will likely find even more connections between the two drugs.

The answer to the opiate epidemic is not to double down on the War on Drugs. Propaganda to vilify drugs and drug dealers will not work. Prison doesn’t work. It’s too late. This is the Information Age and drug users talk to one another online. I shouldn’t have to say it, but alcohol is a drug, and although older adults perceive the use of alcohol as morally superior to opiates, the brain doesn’t make such moral or social distinctions between alcohol and opiates, and many people who use drugs have moved past artificial distinctions. Heavy alcohol drinkers can’t even win the argument on a health basis, because alcohol does more damage to health than all other drugs put together. There’s still the legal distinction, but many people think that distinction should be eradicated also. Trying to stigmatize something that many people perceive as a viable escape will only increase the desire to try it. The only way to deal with the problem of drug addiction is to understand it, talk about it without fear or prejudice and treat it.

In order to do the topic justice, we need to discuss substance abuse, addiction, and the effects of alcohol and opiates outside the confines of social constructs. Don’t worry — I’m not saying that heroin use and alcohol use are relatively the same thing. There are important differences, but understanding heroin or all opiates without fear is, I think, necessary to problem solving.

I will write part 2 in a few days.


  1. […] is an extension of the previous post. As I wrote previously, addiction has been in the news lately due to the heroin epidemic, […]

  2. […] and opiate addiction are similar in many ways. The reason alcoholism and opiate addiction have been so difficult to treat is that both forms of […]

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