Effects & Dangers of Mixing Alcohol and Heroin

Misusing two or more substances simultaneously or within a short period of time of one another is known as polysubstance use.¹

In this article, we will take a closer look at polysubstance use involving alcohol and heroin. This will include learning more about the possible health effects of each and this combination, dangerous interactions, addiction potential, and how to get professional treatment if you or a loved one are experiencing an addiction to these or other substances.

Combining Alcohol and Heroin

Alcohol and heroin are among the most addictive substances in the country.² According to the National Survey on Drug Use and Health, approximately 28.9 million Americans had an alcohol use disorder (AUD) in 2023, while nearly 600,000 Americans had a heroin use disorder.² Research suggests that having a substance use disorder involving one substance increases a person’s likelihood of becoming addicted to another substance.³

Studies have shown that a significant percentage of people with opioid use disorder (OUD) also meet the criteria for AUD. For example, some studies have found that around 20-40% of individuals in treatment for OUD also have AUD. Similarly, individuals with AUD are at an increased risk of developing OUD compared to the general population.^4,5

Dangers of Mixing Alcohol and Heroin

Alcohol and heroin can both depress the central nervous system.^1,6 Combining these substances, or using either with other depressants, significantly increases the risk of serious health consequences and even death.¹

Effects of Alcohol

Depending on how much alcohol was consumed, the immediate, short-term effects that a person may experience can vary.

Short-term effects of alcohol can include:⁷

• Slurred speech.
• Unstable gait.
• Impaired coordination.
• Difficulty with memory and/or attention.
• Confusion.
• Stupor.
• Coma.

When under the influence of alcohol, additional risks exist, including engaging in risky behavior, such as unprotected sex (which can result in the transmission of sexually transmitted infections (STI’s) or unplanned pregnancy), suffering injuries from a fall or a motor vehicle accident, or engaging in/being a victim of violence.⁸

The continued misuse of alcohol over longer periods of time can result in a greater risk of long-term and potentially irreversible health problems, many of which can persist even after drinking has stopped entirely.

Long-term effects of alcohol can include:^8,9,10

• Cardiovascular effects such as stroke, high blood pressure, irregular heart beat, and damage to heart muscle.
• Liver problems, including fatty liver, alcoholic hepatitis, cirrhosis of the liver, and fibrosis.
• Pancreatic complications, such as pancreatitis.
• Increased risk of certain types of cancers, including head and neck, esophageal, liver, breast, and colorectal cancers.
• Neurological effects, such as cognitive impairment, memory problems, and dementia (e.g., Wernicke-Korsakoff syndrome).
• Increased risk of developing or exacerbating existing mental health issues, including depression and anxiety.
• Increased risk of dependence and/or addiction.

Effects of Heroin

Heroin use can also negatively impact a person’s health and wellbeing. The immediate effects someone may experience from heroin use may fluctuate and can depend on factors such as how the heroin was administered and in what amount.¹¹

Short-term effects of heroin can include:¹²

• Euphoria.
• Flushed skin.
• Dry mouth.
• Heaviness in the arms and legs.
• Nausea.
• Vomiting.
• Itching.
• Slowed breathing.
• Slowed heart rate.

Chronic, long-term use of heroin can also cause significant effects on one’s health. In addition to the ongoing risk of overdose and addiction, these effects range in severity but can all seriously impact health and wellbeing.

Long-term effects of heroin can include:^13,14

• Insomnia.
• Constipation.
• Lung problems, including pneumonia and tuberculosis.
• Increased risk of mental health disorders, including depression and antisocial personality disorder.
• Deterioration of white matter in the brain, leading to poor decision-making, difficulty regulating behavior, and changes in stress response.
• Mucosal damage in nasal tissue and perforation of the nasal septum in people who repeatedly snort heroin.
• Scarred or collapsed veins, bacterial infections in blood vessels and heart valves, abscesses ,soft tissue infections and bloodborne diseases, including HIV and hepatitis B and C, for those who intravenously use heroin.

Interactions Between Alcohol & Heroin

Mixing alcohol with other substances is never safe, and there is no safe amount of heroin.¹ Combining alcohol and heroin significantly increases the risk of overdose due to the intensification of their depressant effects.^6,12 This combination severely impacts respiratory and cardiovascular function, leading to dangerously slowed breathing and heart rate. The consequences can include permanent brain damage, coma, and death.¹²

Alcohol and Heroin Addiction Treatment

Each person who seeks treatment will have unique needs, which is why there are many options for care. This allows individuals to begin their treatment at a level appropriate for their specific circumstances—considering factors like the severity of their addiction, any co-occurring mental health conditions, and their support system—and then step up to more intensive care or step down to less intensive care as needed.

These levels of care include the following:

• Medical detox: During drug and alcohol detox, a person receives medically supervised care while they rid their body of addictive substances.¹⁶ They may be prescribed medications to help ease withdrawal symptoms and prevent complications.¹⁶
• : Inpatient treatment requires patients to reside at a facility for the duration of their care.¹⁷ Patients receive 24/7 supervision and these programs are often best suited for those with severe substance use disorders.¹⁷
• Partial hospitalization programs (PHPs): Also known as high intensity outpatient programs (HIOPs), PHPs require patients to visit the facility for several hours a day.¹⁷ Patients can continue to live at home during this time.¹⁷
• Intensive outpatient programs: Intensive outpatient programs, or IOPs, are similar to PHPs in that patients can still live at home while receiving therapy, however they are not required to spend as much time at the facility.¹⁷ Instead, patients spend about 9 to 20 hours of time per week receiving treatment.¹⁷
• : Standard outpatient programs allow patients to attend treatment after work or on weekends, therefore allowing them to maintain their daily lives.¹⁷They spend less time here than in a PHP or IOP.¹⁷
• : Ongoing support and aftercare planning (sober living programs, mutual help groups like those offered through AA, NA, or SMART Recovery) are also crucial parts of the treatment process to help individuals maintain long-term recovery.¹⁷

Getting Help for Alcohol and Heroin Addiction

If you or a loved one is ready to seek rehab for a substance use disorder, explore your options and reach out to a rehab center using our rehab directory tool today!