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Mixing Heroin and Alcohol: How Safe Is It?

Alcohol is one of the most popular recreational drugs in the world. Humans have been drinking alcohol before the rise of civilizations, but it still poses a problem for people who drink it too much. But what happens when alcohol is mixed with one of the most widely used illicit drugs: heroin? Heroin and alcohol can combine in the body to produce dangerous and even deadly effects. Learn more about how alcohol and heroin work in the body and what happens when they’re in your system at the same time.

How Does Heroin Work?

Heroin is a semisynthetic opioid that’s primarily used as an illicit recreational drug. Heroin is derived from the opium poppy plant and then chemically altered in a lab. It works in a way that’s similar to other opioids, though it’s exceptionally addictive and has no current medical uses in the United States. Heroin, like other opioids, binds to opioid receptors in the brain to produce analgesia, euphoria, and sedation. Your opioid receptors exist because your body produces naturally-occurring opioids called endorphins. Endorphins are responsible for regulating your body’s pain response. They work to bind to receptors and block pain signals from being sent and received throughout the body. 

Opioid receptors are found throughout muscle tissue, bones, joints, the spine, and in your brain. When pain receptors are stimulated with something like a hot stove, it sends a signal from the site of pain to a part of your spine called the dorsal root ganglion, which relays the message to your brain. Opioids can block pain signals at the site of pain, at the spine, and in the brain. 

Heroin and other opioids are more intense than your body’s natural endorphins. They can work to stop pain dead in its tracks. However, they can also cause a euphoric relaxation and sedation along with some other side effects. In high doses, heroin can suppress the nervous system to the point of slowing down vital functions like breathing and heart rate. 

Most cases of fatal heroin overdoses cause dangerous respiratory depression where breathing is slowed or stopped to the point of causing oxygen deprivation, brain damage, coma, or death. Other side effects of heroin use include itching, constipation, nausea, and vomiting. Heroin can also cause chemical dependence and addiction. 

How Does Alcohol Work?

Alcohol is a central nervous system depressant that works to slow down excitability in the brain. The term alcohol is actually a broad word for several chemicals with a similar chemical structure. Alcohol that you drink is called ethanol, and it’s the only type of alcohol that you can safely consume. Researchers believe that humans have adapted to drink alcohol in order to consume fermented fruits and vegetation. But then it became a way to kill germs and fight disease, back when drinking water was more likely to expose you to harmful bacteria. 

However, even though we can drink ethanol, we are only adapted to handle it in moderation. Your body treats alcohol like it’s poison, processing it ahead of everything else in your system to get rid of it as soon as possible. Your body has no way to store alcohol like it can store fats and sugars, so it has no choice but to filter it out of your blood and release it as soon as possible. 

But drinking too much can introduce more alcohol than your liver can handle. When you drink, alcohol makes it into your bloodstream through your digestive system. Then your liver filters out as much alcohol as it can. If you drink one drink in a one to two hour period, your liver will be able to eliminate most of it. If you drink more than that, some will make it into your brain where it takes effect. 

In the brain, alcohol is GABAergic, which means that it primarily affects a chemical messenger called gamma-aminobutyric acid (GABA). GABA is responsible for regulating excitability in the nervous systems. Alcohol can bind to binding sites on GABA receptors that are separate from GABA’s binding site. Then the alcohol increases the effectiveness of GABA and creates more intense effects like sedation, hypnosis, euphoria, anxiety suppression, and disinhibition. 

High doses of alcohol can cause the nervous system to slow down to the point of inhibiting important nervous system functions like breathing and heart rate. Like opioids, an alcohol overdose can cause respiratory depression that ends in brain damage or death. It can also cause hypothermia, low blood pressure, seizures, and confusion.

What is Potentiation? 

Alcohol and heroin are in two different classes of drugs. Central nervous system depressants and opioids work in the brain differently, but they both work in ways that can cause some similar effects. Both can cause sedation, drowsiness, loss of motor function, and a slowing down of the nervous system. When they are taken in high doses, they can both cause your heart rate to slow down, your blood pressure to drop, and your breathing to slow down. Though these two drugs work in the brain differently, combining them can cause a dangerous phenomenon called potentiation.

Potentiation is when two or more drugs combine to create more intense effects. When opioids like heroin are taken with alcohol, it can cause symptoms like respiratory depression to come on quickly with relatively low doses. Even if you take a standard dose of each substance individually, it can cause an overdose and dangerous symptoms. Potentiation is especially dangerous when it comes to alcohol. Alcohol is often present in social settings where drugs may be taken. You may combine the two substances, not intending to mix drugs. However, some people combine substances to enhance the effects, which can be deadly. Mixing alcohol, opioids, barbiturates, benzodiazepines, and other sleeping pills can cause dangerous potentiation. 

Why Seek Addiction Treatment?

If you or someone you know is struggling with a substance use disorder that’s related to opioids or alcohol, it’s important to seek addiction treatment as soon as possible. Addiction is a disease that’s chronic and progressive. That means it can last a long time and get worse over time. If it’s not addressed or treated, addiction can have an impact on your health, relationships, finances, and legal standing. Addiction treatment can address these issues and prevent them if you seek help early. Learn more about addiction treatment to start moving toward addiction treatment today.


National Geographic. (2016, August 16). Were Humans Built to Drink Alcohol? Retrieved from

National Institute on Drug Abuse. (n.d.). Opioids. Retrieved from

National Institute on Drug Abuse. (2018, March 6). Prescription CNS Depressants. Retrieved from

Scheve, T. (2019, July 25). What are endorphins? Retrieved from

U.S. National Library of Medicine. (2004, September 16). gamma-Aminobutyric acid. Retrieved from

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