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Mixing Dilaudid and Alcohol: What Are the Dangers & Risks?

Peter Manza, PhD profile image
Reviewed By Peter Manza, PhD • Updated Oct 3, 2023 • 4 cited sources

Dilaudid (hydromorphone) is an opioid painkiller that has its own risks, side effects, and dangers. Combining Dilaudid and alcohol is even more dangerous because both substances are central nervous system (CNS) depressants—mixing them can lead to severe respiratory depression, overdose, coma and even death.

Experts say excessive drinking is associated with plenty of health problems. And alcohol misuse is a common issue among people who report high rates of misusing prescription drugs like Dilaudid.[1]

What Do Dilaudid & Alcohol Do?

Learning about Dilaudid and alcohol can help you understand why mixing them is so dangerous and can lead to life-threatening consequences.

What Is Dilaudid?

Dilaudid is the brand name of hydromorphone, an opioid painkiller. Doctors prescribe this drug to patients with severe pain that can’t be managed with other prescription opioids. Much like alcohol, hydromorphone is a depressant, which means that it slows a person’s breathing and heart rate.

Dilaudid comes in pills, tablets and injections. It’s also available from street dealers, but you can’t be sure that the drugs you buy actually contain hydromorphone or some other drug, such as fentanyl. When Dilaudid pills purchased on the street contain fentanyl, the risk of overdose increases significantly—this is because fentanyl is extremely potent and even a small amount can have potentially fatal effects.

Some people misuse Dilaudid because it causes euphoria, even when used at therapeutic levels. Some people start using this drug due to pain but keep using it because of tolerance and dependence. Once someone develops a dependence, it can be really difficult to stop due to withdrawal symptoms. This can lead to an addiction to Dilaudid, which is characterized by compulsive use.

What Is Alcohol?

Alcohol is a central nervous system depressant that causes euphoria, relaxation and inhibition. As your inhibitions drop, you may be likely to make poor decisions, including taking opioid painkillers. 

Alcohol, like Dilaudid, is very addictive and can be difficult to stop using once dependence develops.

Can You Mix Dilaudid and Alcohol?

You should never mix Dilaudid and alcohol—combining these two depressants is very dangerous.

Mixing Dilaudid with alcohol can greatly increase your overdose risk. A dose of Dilaudid you might take that seems safe could be far too much when combined with even a small amount of alcohol. This is because both substances are depressants and can cause your breathing to slow or stop altogether. [2]

Plus, chronic misuse of Dilaudid and alcohol can lead to tolerance, dependence, and substance use disorder. If you are dependent on both alcohol and Dilaudid, you’ll experience withdrawal symptoms if you suddenly stop. These symptoms may be severe and distressing because alcohol and opioid withdrawal are already very uncomfortable on their own, let alone together.

Dilaudid and Alcohol Withdrawal Symptoms

Suddenly quitting Dilaudid and alcohol can lead to painful and dangerous withdrawal symptoms, such as: [3]

  • Sweating
  • Rapid pulse
  • Tremors
  • Nausea and vomiting
  • Diarrhea
  • Anxiety
  • Depression
  • Insomnia
  • Rapid, purposeless movements like fidgeting or pacing
  • Hallucinations
  • Seizures
  • Muscle aches and joint pain
  • Runny nose and tearing eyes
  • Yawning
  • Fever

The most concerning withdrawal symptoms, such as seizures and hallucinations, are associated with alcohol withdrawal and can be life-threatening.[3] If you are addicted to alcohol and Dilaudid, you should quit taking them in a medical detox setting where you can receive 24-hour medical care, supervision, and monitoring to ensure your safety.

What Are the Risks & Dangers Associated With Mixing?

Mixing alcohol with Dilaudid can cause life-threatening problems, even when you don’t think you’re taking too much of either substance. 

Mixing Dilaudid with alcohol can lead to overdose symptoms, including the following:[4]

  • Dizziness
  • Extreme sedation
  • Slow or uneven breathing
  • Slowed or stopped heartbeat
  • Unresponsiveness 
  • Coma

Other problems can occur too. Alcohol is a central nervous system depressant, capable of slowing your breathing and heart rates. Anytime you drink, these changes can happen.

But when you mix alcohol with other drugs, the alcohol can do the following:[2]

  • Increase the sedation other drugs can cause
  • Slow down the other drug’s removal from your body 
  • Transform some drugs into chemicals that can harm your liver

Never mix alcohol with Dilaudid. Even if you think it’s safe, you could be wrong, and the results could be deadly. 

Treatment Options for Alcohol Use Disorder and Opioid Use Disorder

While you might know that mixing Dilaudid with alcohol is unsafe, you may also feel incapable of quitting. You might need a program that uses Medication for Addiction Treatment (MAT)

In an MAT program, doctors use medications to treat opioid use disorder and alcohol use disorder. For OUD, medications like Suboxone (buprenorphine/naloxone) can rectify chemical imbalances that are caused by chronic use of drugs like Dilaudid. 

While you’re using Suboxone, you will likely not experience opioid withdrawal symptoms and cravings. Because you are not distracted by discomfort, you are able to focus on building a new life that doesn’t involve drug misuse. 

Other medications (like disulfiram, naltrexone and acamprosate) are used to treat AUD. Other medications may also be prescribed to address co-occurring disorders or individual health issues. Your treatment team can determine the right medications to use for your specific case.

You can stay in an MAT program indefinitely, and many people do. The longer you use your medications, the less likely you may be to relapse to drugs. As long as a medication continues to support your recovery efforts, it’s worth continuing.

Bicycle Health uses telemedicine to administer MAT. Meet with your doctor in a video appointment, and pick up your medications at a pharmacy near you. Contact us today to find out if this type of treatment is right for you and your future.

Reviewed By Peter Manza, PhD

Peter Manza, PhD received his BA in Psychology and Biology from the University of Rochester and his PhD in Integrative Neuroscience at Stony Brook University. He is currently working as a research scientist in Washington, DC. His research focuses on the role ... Read More

  1. Alcohol Involvement in Opioid Pain Reliever and Benzodiazepine Drug Abuse-Related Department Visits and Drug-Related Deaths: United States, 2010. Centers for Disease Control and Prevention. October 2014. Accessed April 2023.
  2. The Interrelationship Between the Use of Alcohol and Other Drugs. Office of Justice Programs Drug Court Clearinghouse and Technical Assistance Project American University. August 1999. Accessed April 2023.
  3. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
  4. FDA Drug Safety Communication: FDA Warns About Serious Risks and Death When Combining Opioid Pain or Cough Medicines with Benzodiazepines; Requires Its Strongest Warning. U.S. Food and Drug Administration. August 2016. Accessed April 2023.

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