What Happens When You Mix Methadone and Alcohol?

Updated January 10, 2025

Authored By:

Joe Gilmore

Edited By

Amy Leifeste

Medically Reviewed By

Javier Rodriguez-Winter

Authored By:

Joe Gilmore

Edited By

Amy Leifeste

Medically Reviewed By

Javier Rodriguez-Winter

Table of Contents

What Happens When You Mix Methadone and Alcohol?

Mixing methadone and alcohol can trigger dangerous and potentially life-threatening consequences. Methadone is a medication commonly used to help people overcome opioid addiction, while alcohol is a CNS depressant that affects the brain and body in powerful ways. Although both substances may seem manageable on their own, combining alcohol and methadone can have severe effects on the heart, lungs, and brain.

Understanding these dangers is essential for anyone taking methadone or supporting someone in recovery from opioid addiction. This page explores the many risks of using methadone and alcohol together, highlights the side effects of methadone and alcohol, and shows you how to get compassionate and effective addiction treatment.

What Is Methadone?

Methadone is a prescription medication often used to manage opioid addiction [1]. Developed in the 1940s, methadone helps people manage cravings and withdrawal symptoms from opioids like heroin, morphine, and prescription painkillers. Ironically, it is an opioid itself, but it doesn’t produce the same intense high as drugs like heroin. This makes it a safer alternative when used correctly under medical supervision. 

Methadone works by attaching the same parts of the brain affected by opioids, helping to ease withdrawal symptoms without causing severe drowsiness or euphoria [2]. 

Methadone is commonly provided as part of MAT (medication-assisted treatment) programs. MAT blends medications like methadone with therapy and counseling, giving people tools to manage physical dependence and the factors underpinning addiction. This approach has proven effective, allowing many people to reduce their reliance on opioids gradually in a controlled and supportive way. 

Trained professionals administer methadone in clinics. Individuals visit the clinic regularly to receive their doses, especially during the early stages of treatment, to ensure they respond well to the medication and avoid misuse. Methadone is usually liquid, but it can also come as a tablet or powder mixed with water. Controlled dosing and medical oversight reduce the risk of misuse and overdose, which are prevalent with other opioids. 

Although methadone is effective, it still carries risks, especially if not taken as directed. As a long-acting opioid, it stays in the body longer than other drugs, so taking extra doses or mixing it with other substances can trigger severe complications. One of the greatest risks comes from combining methadone with other CNS depressants like alcohol [3]. Both substances affect the central nervous system, which controls core functions like breathing and heart rate. Mixing methadone and alcohol can slow these processes to dangerous levels, putting people at risk of life-threatening overdose.

Methadone can be a safe and effective recovery tool, but it requires responsibility and support.

What Are the Side Effects of Methadone and Alcohol?

The methadone and alcohol combination can provoke severe physical and psychological symptoms. Each substance can cause drowsiness, slowed breathing, and mood changes. 

Combined methadone and alcohol use can make these effects much stronger and potentially dangerous. Alcohol and methadone both depress the central nervous system, impacting heart rate, breathing, and coordination. Together, they can suppress these functions too much, which may provoke severe and sometimes deadly outcomes.

The immediate side effects of the methadone and alcohol interaction can vary depending on the amount of each substance taken and the person’s tolerance level. Even in small amounts, taking the substances together can cause:

  • Dizziness
  • Lightheadedness
  • Drowsiness
  • Sedation
  • Nausea and vomiting
  • Confusion
  • Disorientation
  • Impaired motor skills 

In addition to the short-term effects of mixing methadone and alcohol, there are serious and life-threatening risks, especially with prolonged use or high doses. 

Life Threatening side effects include: 

  • Respiratory depression: This is one of the most severe risks. Both methadone and alcohol slow breathing. Together, they can cause breathing to slow dangerously or even stop altogether. This condition—respiratory depression—can be fatal if not treated immediately [4].
  • Loss of consciousness: Methadone and alcohol can cause someone to faint or go into a coma, especially when used in large amounts. This can be particularly dangerous if they’re alone and unable to get help.
  • Lowered heart rate and blood pressure: Both substances reduce heart rate and blood pressure. When combined, these can cause vital signs to drop too low, leading to fainting, shock, or cardiac arrest.
  • Seizures: Although rare, combining CNS depressants may trigger seizures—episodes of uncontrolled shaking and muscle stiffness that require emergency care.
  • Overdose risk: Both methadone and alcohol stay in the body for a long time, so using them together increases the chance of an overdose. Signs of overdose include extreme confusion, inability to stay awake, and slowed breathing. Methadone and alcohol overdose can be fatal. 

There are also long-term risks associated with mixing methadone and alcohol. 

Long-term side effects include:

  • Liver damage: Alcohol is taxing on the liver, and methadone can also strain this organ, especially when taken over time. Together, methadone and alcohol can increase the risk of liver inflammation, liver cirrhosis, and liver failure.
  • Brain damage: Prolonged use of both substances can affect brain function, leading to memory loss, impaired cognitive skills, and permanent brain damage. Alcohol, in particular, can weaken brain health over time, and the depressant effects of methadone can worsen this risk.
  • Heart complications: Combining methadone and alcohol can prompt long-term issues with blood pressure and heart health. This increases the risk of heart attack, stroke, and other cardiovascular issues.
  • Increased risk of cancer: Long-term alcohol use is known to raise the risk of liver, mouth, and throat cancer [5]. Methadone use, when combined with alcohol, may further contribute to a weakened immune system, making the body more prone to illness. 

If you or someone you know takes methadone for opioid addiction treatment, avoid alcohol and comply with dosage guidelines.

Dangers of Mixing Methadone and Alcohol

Mixing methadone and alcohol is extremely risky because both substances suppress the CNS. When methadone and alcohol are taken together, the combined effect can trigger dangerously slowed breathing or respiratory failure, a leading cause of overdose deaths. 

Many people don’t realize that the depressant effects of methadone can last much longer than alcohol due to its extended half-life [6]. This increases the risk of severe complications even hours after drinking. 

Beyond this, combining methadone and alcohol heightens the likelihood of life-threatening symptoms like seizures, coma, or sudden heart failure. 

Avoid alcohol when taking methadone to stay safe and prevent these severe and potentially life-threatening risks.

Treatment for Methadone and Alcohol

Treating a combination of methadone and alcohol misuse requires a specialized approach, as both substances create physical dependence and can lead to withdrawal symptoms upon discontinuation. When someone struggles with methadone and alcohol, a treatment plan should address each issue individually while also focusing on the factors underpinning polysubstance use. 

  • Medical detox: For those dependent on methadone and alcohol, treatment begins with supervised medical detox. During this process, healthcare professionals help manage withdrawal symptoms to keep the person safe and comfortable. Both methadone and alcohol can cause severe withdrawal effects like nausea, anxiety, tremors, and seizures. Detoxing under medical supervision reduces the risk of complications and provides a safe, controlled environment to begin recovery.
  • MAT (medication-assisted treatment): MAT can be invaluable during ongoing treatment. Medications like naltrexone and buprenorphine can be used to manage cravings and reduce the risk of relapse. Medication-assisted treatment helps people focus on counseling and recovery skills without being overwhelmed by physical cravings. These medications are prescribed by doctors and monitored to ensure they are working effectively without risking further dependence.
  • Counseling and therapy: Counseling is central to treatment for methadone and alcohol misuse. Therapy helps people identify triggers, manage cravings, and develop healthier coping strategies. CBT (cognitive behavioral therapy) and motivational interviewing are common techniques used to address the psychological side of addiction. Counseling also explores any underlying mental health issues that may have contributed to substance use—depression or anxiety, for instance.
    Support groups and aftercare: Support groups like AA (Alcoholics Anonymous) and NA (Narcotics Anonymous) provide a community of people who share similar experiences, helping people feel less alone in their recovery journey. Effective treatment also includes tailored aftercare. This may involve ongoing counseling, group meetings, or sober living arrangements to support long-term recovery.
  • Dual diagnosis treatment: Those dealing with methadone and alcohol addiction at the same time as mental health conditions benefit from integrated dual diagnosis treatment. This approach tackles both issues simultaneously and is proven more successful than treating each condition separately [7]. 

For those misusing methadone and alcohol, targeted treatment and ongoing support can lead to successful long-term recovery.

Get Effective Treatment for Alcohol or Opioid Addiction at California Detox 

If you need help getting back on track from alcohol or opioid addiction, we offer effective MAT programs at our luxury rehab in Laguna Beach, California.

When you choose medical detox at our beachside facility, you can access medications and continuous clinical care as you withdraw from drugs or alcohol under close supervision. After addressing dependence on alcohol or opioids, you can move into ongoing inpatient treatment. 

All treatment plans are personalized at California Detox to reflect the unique aspects of all alcohol and opioid addictions. Therapies include: 

  • MAT (medication-assisted treatment)
  • Motivational therapies
  • Counseling
  • Talk therapies
  • Group therapy
  • Holistic treatment
  • Family therapy
  • Aftercare 

Start your recovery by calling California Detox at 888-995-4208. 

Sources 

[1] https://www.ncbi.nlm.nih.gov/books/NBK310658/ 

[2] https://www.painphysicianjournal.com/current/pdf?article=OTg3&journal=42 

[3] https://www.ncbi.nlm.nih.gov/books/NBK143211 

[4] https://www.sciencedirect.com/topics/medicine-and-dentistry/respiration-depression 

[5] https://www.cancer.gov/about-cancer/causes-prevention/risk/alcohol/alcohol-fact-sheet

[6] https://www.ncbi.nlm.nih.gov/books/NBK574918

[7] https://pubmed.ncbi.nlm.nih.gov/30352668/

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