Mixing Vicodin with Alcohol

Mixing Vicodin and alcohol can intensify a Vicodin high. But it can also cause your heart and breathing rates to slow down. Enough to lose consciousness, overdose, or die. More here on harms and warnings for mixing Vicodin with alcohol.

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Reviewed by: Dr. Manish Mishra, MBBS

ARTICLE SUMMARY: Mixing an opioid painkiller such as Vicodin with alcohol can result in overdose or death. Read more on the possible dangers of mixing Vicodin with alcohol here.


Why Mix the Two?

Are you considering mixing Vicodin with alcohol?

You need to evaluate the risks and dangers of mixing Vicodin with alcohol first. Used alone, alcohol and Vicodin can do harm to your health. But the combo of these two is a deadly cocktail. The amount and dosage of Vicodin that is safe varies by person, but most prescription painkillers go funky when mixed with alcohol. Why?

On the one hand, Vicodin is a prescription opioid containing hydrocodone and acetaminophen. It can elicit feelings of pain relief, euphoria, and relaxation via depressant effects on the nervous system. On the other hand, alcohol is also a depressant. It slows down brain activity, causing relaxation feelings. Because both substances produce similar effects, when they are combined together… they cause drug synergy.

Drug Synergism =  An interaction between two or more drugs that causes the total effect of the drugs to be greater than the sum of the individual effects of each drug.

When you drink and take Vicodin, the negative effects of this combo can build upon each other, bringing you closer to overdose or even death. So, why do people do it…especially if the effects can be more intensified and can lead to death?

There are two main reasons:

1. Ignorance. Most often people do not read prescription labels or do not follow doctor’s instruction. So, they may accidentally start mixing these two substances not knowing the consequences.

2. To get high. People who want to intensify a high drink on Vicodin.

Effects on the Brain

Taken together, Vicodin and alcohol can cause serious imbalance in the brain. The FDA Vicodin label says:

Alcohol and other CNS depressants may produce an additive CNS depression, when taken with this combination product, and should be avoided.

CNS depression is physiological depression of the central nervous system that can result in:

  • Decreased rate of breathing
  • Decreased heart rate
  • Loss of consciousness
  • Coma or even death

Alcohol enhances GABA neurotransmitters in the brain causing sedation, reducing stress and anxiety. In fact, it slows down the brain activity. Vicodin also acts like a depressant. Moreover, both substances increase dopamine levels in the brain.

However, getting high on Vicodin becomes more intense when you mix the two. Vicodin reacts chemically with alcohol, and has an additive depressant effect in the body and brain when combined. That means that the effects of the alcohol and Vicodin are both stronger and more dangerous when taken together. In other words, this combo is a quick way to accidentally overdose and die from Vicodin.


Vicodin is a narcotic painkiller that contains the opioid hydrocodone, which can cause feelings of euphoria when taken in large amounts. Alcohol can intensify the euphoric effect of Vicodin, which many people find pleasant. In self-reports, people who drink while taking Vicodin have reported some of these effects:

  • drowsiness
  • euphoria
  • relaxation
  • numbness

And more people may be combining drugs that you think. For example, the National Institute On Drug Abuse reported that 7 out of 10 nonmedical teen users reported combining prescription opioids with at least one other substance (over 50% alcohol) in the past year.

Side Effects

Drinking and taking Vicodin can cause serious side effects that include:

  • abnormal behavior
  • coordination problems
  • concentration problems
  • changes in blood pressure
  • dizziness
  • dehydration
  • irregular heart rate
  • passing out
  • nausea and vomiting

Mixing alcohol with Vicodin can cause depressed breathing.

Another major effect of mixing Vicodin with alcohol is ” liver toxicity”. The acetaminophen in vicodin is directly metabolized in the liver and so is the alcohol. There are plenty of people who have abused Vicodin for a long time who coming to the hospital with cases of liver toxicity and hepatocellular carcinoma. This drug cocktail can cause death. Even if a person uses Vicodin as prescribed, and drinks a glass of alcohol, the substances can enhance each other effects leading to intoxication and accidental overdose.


Taking alcohol and Vicodin together can cause dangerous side effects. The dangers of mixing are mainly due to the addictive effects of hydrocodone and alcohol. So, the nervous system effects of Vicodin are intensified by the addition of alcohol (a depressant) in the bloodstream. Some potentially dangerous effects of mixing Vicodin with alcohol include:

  • dizziness
  • drowsiness
  • coma
  • loss of consciousness
  • shallow breathing
  • impaired coordination
  • overdose
  • slowed heart rate

However, Vicodin isn’t the only drug that becomes more dangerous when mixed. The effects of the alcohol are intensified, as well. Your alcohol tolerance will be lower than normal, which can lead to drinking too much and potential alcohol poisoning. Plus, you can experience a greater intoxication from alcohol when mixing it with narcotics, which can be potentially deadly.

Further, alcohol also makes you sleepy, drowsy, and lightheaded as it takes a sedative effect on the body. Drinking and using Vicodin can cause trouble concentrating, difficulty with coordination, slowed reaction time, and other issues which can cause accidents.


The 2011 DAWN Report on National Estimates of Drug-Related Emergency Department Visits reported that in 2011, there were around 25,000 Emergency Department visits that involved combination of hydrocodone products (including Vicodin) with alcohol.

Your risk of overdose on Vicodin goes up when you take drugs that contain hydrocodone with alcohol. The effects of both drugs are much stronger together than they are on their own. The practice of mixing alcohol and Vicodin can be dangerous even if you take them a few hours apart, because some of the Vicodin will still be in your system and could cause a bad reaction.


It’s very common for people to drink while taking narcotics like Vicodin, despite the dangers. But even normal doses of Vicodin combined with alcohol can cause breathing trouble or serious health issues. And if you abuse painkiller or take more than a normal prescription dose, you might overdose and die. The only way to avoid these risks is to decide not to drink at all while on Vicodin.

According to the 2016 CDC National Vital Statistics Report on drugs most frequently involved in OD deaths, 12-22% of all overdoses on opioids involved mixture with alcohol. Moreover, it is estimated that more than 45 people died from overdose that involved prescription opoid every day in 2016.

Safety Guidelines

It is not safe to take any painkiller when you are drinking alcohol. In fact, doctors do not recommend drinking while taking Vicodin…even when use is at different times of the day. This combination just enhances the most dangerous effects of both drugs.

If you’re not sure how far apart to space a prescribed dose of Vicodin and social drinking, you should ask your doctor for more information on taking painkillers and drinking safely. But the FDA warns against mixing the two at all.

Signs You Need Help

Vicodin is an addictive drug and you risk addiction when you are not using it as prescribed by a doctor. Some of the most common signs of addiction include:

  • Taking more pills than you should.
  • Taking more pills than prescribed, so you run out before the refill date.
  • Taking pills to get high, and/or to escape from your emotions.
  • Combining pills with other substances such as alcohol, benzodiazepines, or other opioids.

Moreover, there are four check points for any addiction, known as the 4Cs:

  • CRAVING for the drug.
  • COMPULSION to use the drug.
  • Losing CONTROL of amount and frequency of drug use.
  • Use the drug despite the negative CONSEQUENCES.

How can you know for sure if you have a drug problem? Seek a diagnosis. Addiction experts are those who can diagnose addiction. So, if you are not sure whether you have a problem or not, seek help from a counselor, rehab clinic, psychotherapist, or your physician.

Got Questions?

Do you still have questions? Please leave your questions here. Your experiences are also welcome. We try our best to answer all questions personally, and promptly. And if we don’t know the answer, we will refer you to someone who can help.

Reference Sources: Facing Addiction: The Surgeon General’s Report
NIAAA pamphlet: Harmful Interactions, Mixing Alcohol with Medicines
DEA: Hydrocodone
Medline Plus: Hydrocodone
NCBI: Alcohol and opioids: possible interactions of clinical importance
About the author
Lee Weber is a published author, medical writer, and woman in long-term recovery from addiction. Her latest book, The Definitive Guide to Addiction Interventions is set to reach university bookstores in early 2019.
Medical Reviewers
Dr. Manish Mishra, MBBS serves as the Chief Medical Officer of the Texas Healt...

All of the information on this page has been reviewed and verified by a licensed medical professional.

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