The Dangers of Mixing Oxycodone and Alcohol

By Carmen Cook, LMFT | August 29th, 2025

What Is Oxycodone?

Oxycodone is a prescription opioid commonly used to treat moderate to severe pain. It belongs to the same drug class as morphine, hydrocodone, and fentanyl, and it works by binding to opioid receptors in the brain and spinal cord to block pain signals. Doctors often prescribe oxycodone after surgeries, for chronic pain conditions, or for injuries that require more than over-the-counter pain relief.

While effective, oxycodone also has a high potential for misuse and addiction. People who take it for long periods of time may build tolerance, meaning they need higher doses to feel the same relief. Dependence can develop quickly, and withdrawal symptoms—such as nausea, insomnia, anxiety, and muscle aches—can make it difficult to stop without medical support.

When taken as directed, oxycodone can be safe under medical supervision. However, when misused or mixed with other substances like alcohol, the risks increase dramatically. The combination can depress vital bodily functions, leading to dangerous and sometimes fatal consequences.

How Alcohol Affects the Central Nervous System

Alcohol is classified as a central nervous system (CNS) depressant, which means it slows down brain activity and impacts communication between the brain and body. At low doses, alcohol may make people feel relaxed, lower inhibitions, and create a sense of euphoria. At higher doses, it can cause slurred speech, impaired motor skills, slowed reaction times, and memory blackouts.

The primary way alcohol affects the CNS is by enhancing the effects of gamma-aminobutyric acid (GABA), a neurotransmitter that reduces brain activity, while inhibiting glutamate, which normally excites the brain. This “double impact” slows thinking, decreases coordination, and lowers overall brain function.

When alcohol is combined with oxycodone—another CNS depressant—the effects don’t just add up, they multiply. The brain and body become overwhelmed, leading to extreme drowsiness, suppressed breathing, lowered heart rate, and in severe cases, coma or death.

Why Mixing Oxycodone and Alcohol Is So Dangerous

Both oxycodone and alcohol suppress the central nervous system. On their own, they can already cause slowed breathing, impaired thinking, and drowsiness. Together, they magnify each other’s sedative effects.

This interaction is known as synergistic toxicity. Rather than feeling “double the effect,” users may experience a sudden and overwhelming shutdown of vital functions. Breathing can slow to dangerously low levels, oxygen supply to the brain may be cut off, and the heart may struggle to pump effectively.

Another danger lies in impaired judgment. Someone who mixes alcohol and oxycodone may underestimate how intoxicated they are, continue consuming both substances, and unknowingly push themselves closer to overdose.

Even small amounts of alcohol with a therapeutic dose of oxycodone can cause problems, which is why doctors and pharmacists strongly warn against drinking while taking prescription opioids.

The Short-Term Effects of Combining Oxycodone and Alcohol

Mixing these substances produces immediate effects that can range from mild to life-threatening. Short-term risks include:

• Extreme drowsiness and sedation
• Dizziness and loss of coordination
• Blurred vision
• Confusion or difficulty concentrating
• Slowed or irregular breathing
• Nausea and vomiting
• Risk of choking due to a suppressed gag reflex

In some cases, people may experience a sudden drop in blood pressure, fainting, or a dangerously slowed heart rate. Even if a person survives the initial effects, accidents and injuries are far more likely due to impaired motor skills and judgment.

Long-Term Health Risks of Using Alcohol and Oxycodone Together

Chronic use of alcohol and oxycodone together takes a severe toll on the body. Over time, people who mix these substances face:

• Liver damage: Both alcohol and oxycodone strain the liver, leading to fatty liver disease, hepatitis, or cirrhosis.
• Cardiovascular issues: Long-term use raises the risk of arrhythmias, heart disease, and stroke.
• Digestive problems: Stomach ulcers, pancreatitis, and gastrointestinal bleeding can occur.
• Neurological decline: Memory problems, poor concentration, and permanent brain changes are possible.
• Weakened immune system: Making it harder for the body to fight off illness and infection.

Over the years, the combination can significantly shorten life expectancy and contribute to chronic disability, even if an overdose never occurs.

Increased Risk of Overdose and Death

Perhaps the greatest danger of mixing oxycodone and alcohol is the high risk of overdose. Both substances depress breathing, which can cause hypoxia (lack of oxygen to the brain). Just a few minutes without adequate oxygen can result in permanent brain damage or death.

Signs of an overdose may appear suddenly and progress quickly, especially when alcohol and oxycodone are combined. Many overdoses occur when someone misjudges their tolerance or consumes more alcohol than expected while taking prescribed opioids. Tragically, many individuals never intend to overdose—it often happens unexpectedly.

How Mixing Substances Impacts Judgment and Behavior

Alcohol and oxycodone not only affect the body but also the mind. When combined, they significantly impair decision-making, risk assessment, and self-control. This can lead to:

• Reckless driving or accidents
• Engaging in unsafe sexual behaviors
• Increased likelihood of violence or aggression
• Poor judgment about continuing substance use
• Higher risk of suicidal thoughts or actions

Because both substances can produce feelings of relaxation or euphoria, people may continue using them despite obvious warning signs. This impaired judgment increases the likelihood of dangerous situations and long-term consequences.

Signs and Symptoms of an Oxycodone and Alcohol Overdose

Recognizing the signs of overdose can be the difference between life and death. Warning symptoms include:

• Shallow or stopped breathing
• Slow or irregular heartbeat
• Blue or pale skin, lips, or fingertips
• Extreme drowsiness or unresponsiveness
• Inability to wake the person
• Seizures
• Cold or clammy skin

If you suspect someone is overdosing, call 911 immediately. Quick action is critical to survival.

Emergency Steps to Take If You Suspect an Overdose

If you believe someone has overdosed on oxycodone and alcohol:

1. Call 911 right away. Provide details about the substances taken and the person’s condition.
2. Administer naloxone (Narcan) if available. This medication can reverse opioid overdose effects, but may need multiple doses if alcohol is also involved.
3. Keep the person awake and breathing if possible.
4. Lay them on their side. This prevents choking if they vomit.
5. Stay with them until help arrives.
   

Acting quickly saves lives. Even if the person seems to recover, emergency care is still needed.

The Impact on the Liver, Heart, and Brain

Mixing alcohol and oxycodone puts enormous stress on major organs:

• Liver: Both substances are metabolized in the liver, increasing the risk of liver damage, hepatitis, and cirrhosis.
• Heart: Oxycodone and alcohol can both slow the heart rate. Long-term use raises risks of arrhythmias, high blood pressure, and heart failure.
• Brain: Chronic use impacts brain chemistry, leading to memory issues, cognitive decline, and heightened risk of depression and anxiety.

These health effects can develop gradually, but once damage occurs, it is often irreversible.

Mental Health Consequences of Polysubstance Use

Using multiple substances doesn’t just harm physical health—it deeply disrupts mental and emotional well-being. When drugs like oxycodone and alcohol are combined, they alter brain chemistry in ways that significantly increase the risk of psychiatric disorders. These effects often overlap and intensify each other, creating a cycle that is extremely difficult to break without treatment.

Some of the most common mental health consequences include:

• Depression and hopelessness: Polysubstance use suppresses the brain’s natural reward system, leading to a lack of motivation, feelings of emptiness, and prolonged sadness. For many, this depression persists even during periods of abstinence.
• Anxiety and panic attacks: The nervous system is destabilized by the opposing effects of alcohol (a depressant) and oxycodone (an opioid). This imbalance can create constant worry, heightened stress responses, and episodes of overwhelming panic.
• Mood swings and irritability: As the brain becomes dependent on external substances to regulate emotions, people often experience sudden shifts in mood—from euphoria to anger or despair—in a matter of minutes or hours.
• Sleep disturbances: Both oxycodone and alcohol interfere with restorative sleep cycles. Insomnia, vivid nightmares, and poor sleep quality contribute to fatigue and worsen mental health symptoms.
• Increased risk of suicidal ideation: The combination of impaired judgment, emotional instability, and feelings of hopelessness significantly raises the risk of self-harm and suicidal thoughts.

Beyond these direct effects, polysubstance use often contributes to co-occurring disorders. Individuals may develop or worsen conditions such as bipolar disorder, post-traumatic stress disorder (PTSD), or generalized anxiety disorder. The emotional toll of strained relationships, job loss, financial struggles, and legal issues further compounds the psychological burden.

The cycle of substance use and mental health decline reinforces itself: people may turn to substances to cope with emotional pain, but those substances ultimately intensify the very symptoms they’re trying to escape. This self-perpetuating loop can feel impossible to break without professional intervention, which is why integrated treatment—addressing both addiction and mental health simultaneously—is essential for lasting recovery.

Who Is Most at Risk for Mixing Oxycodone and Alcohol?

Certain groups face higher risks when it comes to combining substances:

• Young adults experimenting with recreational use
• Individuals with chronic pain who self-medicate with alcohol while prescribed opioids
• People with a history of substance use disorder
• Those with untreated mental health conditions
• Older adults, whose bodies metabolize substances more slowly

Even people without these risk factors can face serious consequences, underscoring the importance of avoiding this dangerous combination altogether.

Treatment Options for Oxycodone and Alcohol Addiction

Recovery is possible, but it requires the right support. Common treatment options include:

• Medical detox: Safely managing withdrawal symptoms under supervision.
• Inpatient rehab: Structured programs with 24/7 support.
• Outpatient treatment: Flexible care while living at home.
• Therapies: Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT), and trauma-informed care.
• Medication-assisted treatment (MAT): Medications like buprenorphine or naltrexone to reduce cravings and relapse risk.

Each treatment plan is tailored to the individual’s needs, addressing both the physical and psychological aspects of addiction.

How Detox and Recovery Programs Address Dual Substance Abuse

Detoxing from oxycodone and alcohol can be complex because both substances cause significant withdrawal symptoms. Recovery programs often use a dual approach that includes:

• Gradual tapering of opioids under medical supervision
• Medications to reduce alcohol cravings and withdrawal risks
• Mental health counseling to address underlying conditions
• Group support to provide accountability and encouragement
• Education about relapse prevention strategies

Comprehensive programs don’t just focus on stopping substance use—they help individuals rebuild healthy lifestyles and coping skills.

Preventing Relapse: Support and Aftercare Resources

Recovery doesn’t end after detox. Preventing relapse requires ongoing support, which may include:

• 12-step programs such as Alcoholics Anonymous (AA) or Narcotics Anonymous (NA)
• Outpatient counseling for continued therapy
• Sober living homes for structured environments
• Family therapy to rebuild trust and support systems
• Holistic approaches like mindfulness, yoga, or exercise to manage stress

Long-term recovery is most successful when people stay connected to supportive resources.

Getting Help for Substance Abuse: Your Next Steps

If you or a loved one is struggling with mixing oxycodone and alcohol, it’s important to reach out for help. Treatment is available and recovery is possible.

At Mana Recovery, we provide compassionate, evidence-based care for individuals facing addiction. Our programs are designed to address the emotional healing needed for long-term recovery.

You don’t have to face this alone. With the right support, healing, and a brighter future are within reach. Contact Mana Recovery today!