Dangers of Mixing Vicodin (Hydrocodone) and Alcohol

Mixing Vicodin with alcohol is an unsafe practice that can lead to dangerous physical and psychological consequences. The combination of the two substances alters a person’s judgment and ability to think clearly. It also impacts motor functions, including the ability to drive, write, walk and other tasks that require motor coordination. In addition, using Vicodin and alcohol together can accelerate an individual’s risk of developing a substance use disorder.

Vicodin is the brand name for a medication that contains two active ingredients: hydrocodone and acetaminophen (Tylenol). Vicodin is an opioid medication and central nervous depressant that is used to relieve moderate to severe pain. The medication works by blocking pain signaling in the brain and spinal cord, and it can also produce feelings of euphoria and sedation. Sometimes, people abuse this drug because tolerance develops, which means that larger amounts of the drug are required to produce the same effect. An individual may misuse Vicodin and take higher doses to capture the positive feelings it generates and to reduce pain.

Alcohol is a substance that is commonly abused to numb feelings of physical or emotional pain. Like Vicodin, it is a central nervous system depressant, so it also causes sedation and can slow respiration. Individuals may combine the two substances to strengthen their effects, but the results can be fatal.

How Are Vicodin and Alcohol Similar?

Vicodin works similarly to other opioids, such as Percocet and morphine. It has a powerful influence on dopamine, a neurotransmitter found in the brain. Dopamine is part of the reward system in the brain that generates euphoria or feelings of happiness. When a person consumes Vicodin, a surge of dopamine flows into the brain, producing those positive feelings and lowering anxiety. This can make someone want to experience that rewarding and pleasant feeling again. 

Alcohol lowers inhibitions and also triggers a rise of dopamine in the brain, which allows an individual to feel good. A person will want these pleasurable feelings to continue, so they will drink more. Over time, this effect will wear off. Unfortunately, at this point, that person has usually become dependent on alcohol or even addicted to it. Mixing Vicodin and alcohol will accelerate the time it takes for the positive effects of dopamine to be almost non-existent. 

MIXING VICODIN AND ALCOHOL CAN IMPAIR COGNITIVE FUNCTION AND MOTOR SKILLS AND CAN EVEN LEAD TO SEVERE RESPIRATORY ISSUES.

What Happens When You Mix Alcohol With Vicodin?

Mixing alcohol with Vicodin causes extreme sedation, impairs a person’s judgment and triggers uncoordinated movement. In addition to lowering psychomotor skills, the combination of these two substances can increase the risk of overdose and death. Because both Vicodin and alcohol are central nervous system depressants, they can lead to respiratory arrest when taken together. This is a common culprit for fatalities when mixing these substances.

Additionally, “dose dumping” will likely occur. Combining alcohol with Vicodin will result in a rapid release of Vicodin in a short period of time, which increases the likelihood of side effects and overdose. It is important to keep in mind that alcohol is found in many over-the-counter medicines, like cough syrups. Although the content of alcohol is not high in these medicines, if you are taking large amounts of Vicodin, the risk for an interaction exists. 

Other side effects of Vicodin and alcohol include: 

• Slow heartbeat
• Shallow breathing
• Cold, clammy skin
• Confusion
• Dizziness
• Weakness
• Feeling faint
• Seizures

Another dangerous interaction actually involves the acetaminophen (Tylenol) component of Vicodin. Like alcohol, acetaminophen is metabolized by the liver. If someone is abusing Vicodin, they are probably taking large doses of it, meaning they are ingesting a lot of acetaminophen. If taken in large doses by itself, acetaminophen can lead to liver toxicity. When combined with alcohol, this side effect is increased dramatically. 

Side effects of combining acetaminophen with alcohol include: 

• Abdominal discomfort
• Rapid heartbeat
• Ulcers
• Gastrointestinal bleeding
• Liver damage

Vicodin and Alcohol Overdose

Overdoses related to combining opioids like Vicodin with alcohol are on the rise. Opioid deaths involving alcohol increased from 12.4% in 1999 to 14.7% in 2017. Because both Vicodin and alcohol are central nervous system depressants, the risk of overdose — particularly from respiratory depression — is increased. Signs and symptoms associated with mixing depressants like alcohol and Vicodin include: 

• Slowed breathing
• Weak pulse
• Confusion/altered mental status
• Fainting or passing out
• Inability to be woken up
• Bluish color in lips or nails

If you suspect an overdose, contact 911 immediately. If naltrexone (Narcan) is available, administer it to the individual as soon as you notice signs of an overdose. 

How Long Should I Wait To Drink After Taking Vicodin?

The half-life of Vicodin after a single dose, or the time it takes for half of the drug to be eliminated by the body, is four to six hours. According to its half-life, Vicodin would be out of your system after 30 hours. However, it is important to keep in mind that this is only after one dose. There are certain factors that can lengthen the time for how long Vicodin stays in the body. These factors include: 

• The amount of Vicodin an individual takes and how soon they take another dose
• How long a person has been using or misusing Vicodin 
• A person’s unique metabolism — some people naturally metabolize certain drugs more quickly or more slowly than others
• Age — elderly individuals tend to eliminate drugs more slowly
• Weight — increased weight generally leads to slower elimination of a drug from the body
• Gender — females typically eliminate drugs more slowly
• Kidney impairment
• Liver impairment

If you are prescribed Vicodin for pain and want to have a drink, the safest time frame to wait before having one would be the following day. More specifically, you should wait at least 30 hours from the last dose and have a full night’s sleep in between. For example, if you took a dose of Vicodin at 3:00 p.m. on Thursday, then you shouldn’t have an alcoholic beverage until 9:00 p.m. on Friday at the earliest. This is assuming you are taking the medication as prescribed and you don’t have any liver or kidney problems. 

Long-Term Effects of Mixing Alcohol and Opioids

Because of the acetaminophen in Vicodin, using Vicodin with alcohol long-term can lead to liver damage. Combining these two drugs can also cause damage to other major organs in the body, such as the heart and brain. In regard to the brain, cognition is impacted dramatically with long-term use of Vicodin and alcohol. A person’s memory may become impaired, the ability to make decisions diminishes and speech is negatively affected. 

Many people who take Vicodin and alcohol long-term are likely to develop a substance use disorder (SUD). An addiction to these substances can drastically alter a person’s life, affecting their ability to maintain a job, stay in school and keep healthy relationships with friends and family.

Get Treatment for Polysubstance Abuse in Ohio

Misusing Vicodin or alcohol over time can lead to addiction, but it is important to know that recovery is possible. The Recovery Village Columbus is an addiction rehabilitation center that utilizes evidence-based care to treat those with substance use disorders and co-occurring mental health conditions. If you or someone you love is struggling with an addiction, contact The Recovery Village Columbus today to speak with a knowledgeable professional about treatment options that can work well for your situation. 

Editor – Jonathan Strum

Jonathan Strum graduated from the University of Nebraska Omaha with a Bachelor's in Communication in 2017 and has been writing professionally ever since. Read more

Medically Reviewed By – Michelle Giordano

Michelle Giordano has been a licensed pharmacist in New York State for nearly two decades. She received her doctorate in pharmacology from St. John’s University, where she earned an academic merit scholarship throughout the course of her studies. Read more