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Complete Sobriety during Treatment

A grandma walking with her young granddaughter on a sidewalk

It is not uncommon for people with opioid use disorder to also misuse alcohol during the depths of their addiction. Still, many argue that drinking socially or moderately during treatment and recovery is possible for those who can regulate their intake. However, the interactions between methadone and alcohol can be severe, and the risk of alcohol misuse for those overcoming opioid addiction is too high to ignore. Most addiction experts agree that complete abstinence during treatment is vital to enduring the road to long-lasting recovery, especially when considering the dangers of mixing methadone and alcohol, even in sporadic or small amounts.

Methadone and Alcohol Interactions

While methadone is a prescription medication, it’s still considered a Schedule II substance and an opioid agonist, meaning it interacts with opioid receptors in the brain to reduce pain and withdrawal symptoms similarly to illicit opioids. Even when the dosage is medically-supervised, mixing methadone and alcohol can lead to deadly depressed breathing and reduced heart rate. Mirroring the symptoms of an opioid overdose, mixing methadone and alcohol can lead to fainting, seizures, unconsciousness, dizziness, and vomiting.

Because both methadone and alcohol are central nervous system depressants, their ability to slow down the body’s breathing and heart rate can easily lead to coma or death. The level of intoxication a person will experience when mixing the two is quick and dangerous, impairing both judgment and coordination, potentially leading to a heightened risk of injury or accidental death.

Co-Occurring Methadone and Alcohol Misuse 

About 20-50% of methadone users also have symptoms of alcohol use disorder in the United States. Although methadone is a very safe treatment for opioid use disorder, its misuse can give way to a separate addiction of its own if a patient is not monitored correctly or if the medication is obtained through illegal means. The prevalence of methadone and alcohol misuse signifies that comprehensive treatment is necessary for the patient to address the comorbidity most effectively. This can be done in inpatient or outpatient treatment as long as there is a heavy emphasis on sobriety, relapse prevention and substance use counseling.

Adjusting back to life upon entering opioid use disorder treatment can be challenging, especially when navigating social situations with casual drinking. However, the interaction between methadone and alcohol not only poses a risk to a patient’s immediate safety and health but also their prospects of achieving their goals of long-lasting recovery free from the strain of addiction. It’s best for those in recovery to maintain complete sobriety during their medication-assisted treatment and to avoid mixing methadone and alcohol at all costs.

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