Heroin and Alcohol
Heroin is a dangerous drug on its own, that comes with many risks and adverse consequences. The dangers of combining it with alcohol may be better understood by looking at heroin’s properties and addiction potential.
What Is Heroin?
Heroin is an illicit opioid drug. It is made from morphine, which is made from the sap of the opium poppy plant. It is a depressant drug, meaning that it slows down functions of the brain and the central nervous system. As an opioid, it interacts with the brain’s opioid receptors and causes responses in the body that include pain relief, pleasure, relaxation, or contentment.
Heroin can come in different forms. It can come as a fine white powder, more coarse, off-white granules, or as small light brown ‘rocks’. The drug is smoked, snorted, or injected intravenously. Often, drug dealers mix or ‘cut’ heroin with other substances, such as caffeine, paracetamol, or sugar, to increase their profits. This places a user at great risk as they can not determine how strong or weak a dose is.
Heroin is a highly addictive substance. As with other drugs, regular heroin use can cause a person to develop tolerance. This is when the body gets used to the presence of a drug, and will need larger doses for the person to experience the same effect.
Not only will the body need the drug to function ‘normally’ – known as heroin dependence – but it can develop tolerance even after very short-term use. This places a person at risk for addiction even after a single use.
Signs of Heroin Addiction
The most common symptoms include depression, anxiety, and mood swings between these and euphoria. A person may have periods of extreme hyperactivity followed by exhaustion. They may act hostile toward others while experiencing agitation and irritability. They may lose a lot of weight or have scabs and bruises on their skin from picking it as heroin use causes skin itching while paying less attention to personal hygiene. Warm, flushed skin and constricted pupils as well as forced or pressured speech often occur. Lying about drug abuse and avoiding seeing loved ones is common, as well as delusions, hallucinations, disorientation, and paranoia.
Other signs include:
- Apathy and a lack of motivation
- A decline in school or work performance
- Inability to fulfill responsibilities
- Continuing the use of heroin despite negative consequences
- Spending a lot of time obtaining, consuming, or recovering from it
Attempting to stop using the drug can be challenging, and people may relapse. This is partly due to withdrawal symptoms, which are the body’s reaction to the absence of a substance it has become used to. These symptoms can start anywhere within six hours to one day after the last dose and can last for a week to ten days. Especially when substance abuse has been prolonged, giving up the drug often requires the help of a treatment provider or addiction treatment centers.
symptoms of withdrawal
Common symptoms include anxiety and depression, irritability, and restlessness. Other symptoms a person may experience could be:
- Muscle spasms
- Intense cravings for the substance
- Bone and joint pain
Effects of Heroin
A person’s weight, size, health, the strength of heroin, as well as the use of other drugs play a role in how heroin affects them.
Once the substance enters the brain, it binds to opioid receptors rapidly, and these receptors are responsible primarily for regulating pleasurable feelings, as well as controlling sleeping, breathing, and heart rate. A person will therefore experience an immediate ‘rush’, which will come with intense feelings. Pleasure and relaxation, feelings of detachment, and pain relief can last for three to five hours.
But after these initial effects, a person may be drowsy for many hours, their mental function will be clouded and their heart and breathing rate will be severely slowed down. This could be to the extent of becoming life-threatening and could lead to permanent brain damage or coma. They may also experience other effects, such as a dry mouth or shortness of breath.
Long-term Effects of Heroin
When used long term, heroin can cause problems to health and lifestyle. These include:
- Frequent respiratory infections
- Dental issues
- Heart, lung liver, and brain damage
- Damage to veins and skin, with abscesses (swollen tissue filled with pus)
- Irregular menstrual cycles for women
- Erectile dysfunction and infertility in men
- Intense sadness
- Financial, occupational and social problems
Dangers of Mixing Heroin and Alcohol
While the drug comes with its own dangers, taking heroin with other drugs can lead to an increased risk of harm. That includes over-the-counter and prescription drugs and alcohol.
According to the Centers for Disease Control and Prevention, nearly all people who use heroin also use at least one other drug. By 2009 it was estimated that 20 to 30% of heroin addicts have a past or current drinking problem.
Other studies point to heroin users increasing alcohol use after or during treatment, possibly as a short-term substitute. One study showed that 55% of heroin users who abstained from alcohol use before rehab were using alcohol three months after.
The systems that are altered by the use of narcotics like heroin are usually normalized when treatment providers treat it long-term with methadone. But factors such as liver disease and the abuse of alcohol can alter this stability, as the interaction between ethanol and methadone, as well as ethanol and heroin, contribute to further addiction to both. The presence of alcohol can therefore negatively affect someone who is receiving methadone treatment for heroin addiction.
Cognitive, Physical, and Emotional Dangers
Apart from more challenges in treatment, being addicted to either one of the substances prompts a person to combine it with the other, to increase the sedative effects of each and reach a more intense high. But both substances are addictive drugs, and both affect behavior, mood, and cognitive function. While they can both produce several negative consequences individually, combining them increases these dangerous effects.
The increase in cognitive effects from both drugs includes significantly slow rates of thinking, a loss of rational thinking ability, inhibition and attention, and concentration. Problem-solving and developing new memories may also be impaired. Due to the effects of heroin and alcohol on cognitive thinking, a person is more likely to engage in risky behaviors. This includes operating machinery, needle sharing, engaging in criminal activity, or developing suicidal ideations.
An increase in the physical effects of both drugs will occur, such as a significant decrease in the firing of the neurons in the brain, a significant decrease in breathing rate, a significant decrease in heart rate and blood pressure, and substantial issues with balance and motor coordination. This will lead to extreme lethargy.
Emotional effects too increase, including a loss of emotional inhibition, and at high doses, an increase in negative states. This includes sadness, depression, anxiety, and potential psychosis.
Higher Overdose Risk
Combining the two substances is an even more dangerous mix due to the fact that the majority of heroin overdoses happen by combining the drug with alcohol or other drugs. Mixing heroin with alcohol means a significantly higher risk of overdose in either drug. The traditional symptoms of heroin use are further agitated by alcohol, meaning that shallow breathing, low heart and breathing rate, and deep sedation are enhanced. It can be to the extent of not being able to call 911. Just as with heroin, alcohol also depresses the central nervous system, and so a coma, brain damage, and even death are possible when combining the two.
Those who use both substances may take more alcohol than heroin, and high levels of alcohol use are associated with alcohol poisoning and alcohol overdose.
As heroin is unregulated, it is difficult to determine the purity and strength of a batch. When heroin is present, the body absorbs alcohol faster, meaning that alcohol poisoning is possible even after only consuming some beer, wine, or liquor. A resulting lower threshold at which an individual can overdose on either drug makes the mix very dangerous.
Other Negative Effects of Combining Alcohol and Heroin
When a person has combined these two drugs, they may experience the following:
- Impaired coordination
- Loss of consciousness
- Respiratory depression
The National Institute on Drug Abuse reports that drug overdose deaths involving heroin reached 13,165 by 2020.
Luckily, if caught in time, naloxone can temporarily reverse the effects of heroin and other opioids. It can block opioid drugs from attaching to opioid receptors, and often ambulance officers and treatment centers use it. It can easily be administered by family and friends, too.
Related: How long does heroin stay in your system
Signs of an Overdose
In case of an overdose, it is best to call for help. The following are signs to watch out for:
- Small, pinpoint pupils
- Low blood pressure
- Cold, clammy skin
- Slow or irregular breathing
- Irregular heartbeat
- Blue lips and fingertips
- Wanting to urinate but finding it difficult
- Extreme drowsiness
- Passing out
Treatment Options for Heroin Abuse
Alcohol abuse or alcohol addiction alters a person’s brain chemistry, so symptoms of withdrawal will also occur when its use is stopped. Combining this with heroin withdrawal, which includes heavy flu-like symptoms, can be overwhelmingly dangerous. It could require hospitalization, and that is why attempting to stop alcohol use and heroin use is best done at a treatment facility.
Quitting either of these addictive substances alone or without treatment providers is not advised, especially as heroin detox can come with intense symptoms such as a rapid heartbeat, paranoia, and vomiting. Without professional treatment advice or a treatment center, a person is most likely to relapse.
Undergoing detox at a treatment facility provides a person with a safe and supervised environment. Medical staff is at hand 24/7 to help manage withdrawal symptoms.
Before the heroin detox, treatment providers will assess a person, to evaluate their medical and family history, history of drug abuse, the duration and amount of drug(s) that were used, as well as any co-occurring mental health disorders.
By including all these factors, a treatment provider can determine which treatment options are necessary for someone to fully recover. In the case of alcohol and heroin, a dual diagnosis can be made, and treatment for both substances can be planned. A certified addiction professional at a treatment center can design a plan that covers physical, emotional, and social health needs.
While heroin dependence is often treated with methadone, naltrexone, and buprenorphine, addiction treatment in the form of therapy is also required. The recovery journey includes therapies whereby a person identifies underlying causes for their drug use, as well as triggers that may make them use drugs again. A therapist also teaches a person skills and tools to respond to these triggers healthily, instead of relapsing.
Where Can I Find a Treatment Center?
If you or a loved one is struggling with drug or alcohol abuse, Brookdale is the specific treatment center that can help you. Caring and experienced staff at our world-class facility can design a treatment plan that best suits your needs, while the serene mountain setting will provide the best environment for you to embark on your road to recovery.