Don’t Drink Alcohol if You are Taking Methadone!

Just like benzodiazepines, alcohol can be fatal when consumed by a patient who also takes methadone.

These two substances interact in several ways.

Worst of all, alcohol inhibits the area of the brain that keeps us breathing while we sleep. So do opioids of all sorts, including methadone. But when alcohol and methadone are both in the blood stream, the effects are greater than expected, due to synergy. In other words, 1+1=3, instead of 2, as we would expect. This interaction is unpredictable. This is how overdose deaths occur with the combination of alcohol and methadone.

Besides this potentially fatal interaction, alcohol also induces, or speeds up, the metabolism of methadone. Both alcohol and methadone are metabolized by the same enzymes in the liver, and alcohol can prime the pump of the metabolic rate. Alcohol gooses the liver, speeding the metabolism of methadone, which means a patient on a previously stable dose of methadone may suddenly notice that his dose isn’t holding for the full 24 hours. This patient may ask for a dose increase, when in truth, he really needs to stop drinking alcohol completely.

Over the long term, alcohol can cause a buildup of methadone to a toxic level, if the drinking goes on long enough to cause liver scarring and shrinkage, called cirrhosis. If this condition develops, liver metabolism slows for any drug or medicine processed by the liver.

Addiction is cunning, baffling, and powerful. It’s incredible to think of a person who’s able to stop using opioids after years of addiction be defeated by alcohol. Cross addiction, which means switching from one addictive drug to another, happens all too frequently. Sometimes it’s hard to convince patients they need to stop the use of all addicting drugs, and that does include alcohol and marijuana.

33 responses to this post.

  1. As an addict taking methadone i’ve been told “don’t drink alchol” while taking methadone & knew that it was dangerous to do so. However, I didn’t know this! WOW! I think that everyone taking methadone should read this! Thank you for this information!


    • Posted by Andy on December 8, 2013 at 3:33 pm

      I am also currently taking methadone, and my counselor and the lady who doses me always tell me don’t drink alcohol. However I ignored them thinking what’s the worse that could happen. After reading this I now notice why I haven’t gotten to a stable dose! I drink often and after reading this I am never drinking again while on methadone!!! I’m glad I read this! They should put this on the front page of the handbook they give you when taking methadone!


    • Posted by chris on May 21, 2014 at 4:03 am

      i looked at alcohol as a socailly accepted drug as a recovering drug addict , i thought that was ok in recovery but come to find out …alcohol led me down the same path as drug addiction not drink if you think its ok and socailly acceptable .you will begin to exspericence the same downfalls as you did during you drug addiction . DO NOT DRINK ALCOHOL IT IS A DRUG you think you know yourself control as an addict , but addiction sneaks up on you . as it did for me with alcohol.not any illegal drugs


  2. I am a Methadone user and the thought of drinking while on it at fist didn’t cross my mind,,,,,So i would drink once and awhile without know these facts. If your taken Methadone please please read up on it before getting on the treatment.


  3. Posted by Miss Wendy Joyce on April 2, 2013 at 3:03 am

    My partner for 21 years been on methadone for about ten years has been drinking for 6 years going to the pub every day after getting his meth he would have a pint or three maybe four so something has changed he stopped going to the pub been real funny on edge real bad seeing and hearing things but only at night time I know he needs help my head is working over time can you tell me what I can do for him as I love him so much.


    • He needs medical attention, right away. He could be having hallucinations caused by damage from alcohol, or he could be having alcohol withdrawal, or some other medical illness. I’d say this is an urgent situation, get him to an ER right away.


  4. he is having withdrawls from the alcohol possibly even withdrawls from the methadone too because drinking alcohol with methadone speeds up ur metabolism so the alcohol is basically depleting the methadone from his systom making him think he needs a higher dose.if he is haulcinating he definitly needs medical attention.i myself am on methadone and have occassionally drank.good luck hope to hear some good news back on ur boyfriend or husband.


  5. my son has been in a methadone program for 1yr. now and all was going well. He started drinking alcohol . His take home was stopped because his pee test came back positive for alcohol. I have been very upset with his drinking because he never really drank before. He was addicted to hydrocodone. My question is was his take home stopped because of the alcohol present, or could it have been something else, and he is not telling me the truth.


    • There’s no way to know unless your son has signed a release for you to be able to get information from his methadone program. However, you don’t need to have a release in place to give his treatment program information. His treatment staff need to know about his alcohol use, because it sounds like he needs more help than he’s getting.


    • Posted by Jennifer on April 7, 2015 at 2:18 pm

      I’m on a program too, it’s actually been a life saving decision..I’m going on 8 years. One thing I do know, is alcohol isn’t detected in urine, it’s actually detected in a breathalyzer. So it’s probably something else.


      • Posted by DR_POOP_HOLE on September 30, 2015 at 11:39 am

        Not true, alcohol can be detected in urine – depending on the type of test. As long as you give yourself 10 hours before you dose and your last drink, you SHOULD be fine. They start breathalizing if 1.) you admit to drinking daily and at a high rate or 2.) it shows up in your urine because you really tied one on last night.

    • Posted by Rissa on November 16, 2015 at 6:07 pm

      more than likely it was something else.. i am on methadone and i have carry ons. i drink casually and smoke alot of marijuana and i have never lost a carry from doing so, ofcourse maybe your sons doctor has different preferences than mine.,


  6. Posted by Misty Payton on July 31, 2014 at 9:59 pm

    I have a 58 year old sister that has been taking methadone and she is a alcoholic, she already has a bad liver, she is drinking everyday and taking about 4 to 5 methadones a day maybe more she is not prescribed methadone, so she is having severe amnesia, she has a bad attitude towards everybody, her left side and around her back is severly swollen and she has a jaundice color.


  7. Posted by Meghan keister on May 15, 2015 at 2:11 am

    if she is jaundice her liver is failing. & her addiction is probably a lot worse then you know.


  8. Posted by Eric on December 19, 2015 at 9:38 pm

    Ive been on methadone for 5 years, 160 mg liquid. I havent had a drop to drink since I started. However tonight im going to a friends i havent seen in years, and Ill probably have a beer. I highly doubt one beer is going to hurt me in any sort of way. Ill let yall know.


  9. Posted by Fifi Ritter on January 10, 2016 at 8:55 pm

    I know someone who drinks Carlsberg Special Brew straight after taking his methadone at the clinic. I am v worried about this person. Is this dangerous. I know nothing about drugs.


  10. Posted by Brian on March 19, 2016 at 3:39 am

    I feel like Dr. Burson’s intention in providing information like this, as well as a forum for further discussion, is a wonderful display of “service”. She is obviously trying to give professional advice and health information to assist addicts in recovery. Discussing our cross addictions and alcohol use in a manner that suggests we can get away with certain quantities of any alcohol or other substance that out treatment programs have not approved is harmful. We not only start letting ourselves believe, incorrectly AGAIN, that we can control our substances without letting those substances eventually control us, we also plant those thoughts into others. Not knowing what circumstances the others may be in (early recovery, relapse thoughts, poor physical health, etc.) means we are potentially contributing to somebody’s relapse, over dose, or even death. Dr. Burson is the pro. She has already done the work and research and her conclusion was clear…we must not drink alcohol while taking methadone and we can not mix any mind altering substances or chemicals without our treatment doctor’s approval lest we risk losing the many benefits anyone with substantial clean time can tell you…you do not want to lose!


  11. Posted by jimmy on August 8, 2016 at 4:20 pm

    I am goin on holiday in a couple of weeks and I’v been on methadone script for just under a year but when I go on holiday I think there giving me methadone tablets and was wandering if you can drink I don’t normally drink after taking my methadone but when on holiday who doesn’t drink so can any body help me plzz as I’m scared ill overdose or sumthing !!


    • Please don’t drink while on methadone. I know plenty of people will say it’s OK, no problem, but alcohol can be deadly mixed with methadone.
      And not everybody drinks. According to NIAAA, about 71% of U.S. adults drank alcohol at least once in the last year. That means 29%, or nearly a third, had no alcohol at all last year.
      I hope you’ve made enough progress in your recovery that you’ve found you can have just as much fun without alcohol as with it…maybe more fun because there’s less worry.


  12. I thought I had a virus or a fucked amune system , in 3 years not one person ever explained alcohol shortens the 1/2 life of methadone , this is a massive eye opener , although I’m finding Foy on its own is causing massive depressions issues keep crying periodically everyday , is this a side affect ?


  13. You can still smoke weed but that’s just my opinion but as far as I know it doesn’t affect the methadone at all!!!!


  14. Posted by Leslie on May 13, 2017 at 1:18 am

    How long do you need to be off Methadone before drinking alcohol? My son is getting married and I would love 1 glass of champagne after no alcohol for 28 years.


  15. Posted by Alexander. G Costeines on November 26, 2017 at 7:57 pm

    I’ve always felt like the methadone was getting eaten up much faster with alcohol in my system but could never find medical evidence of that being the case. What’s your source on this info? Meaning that alcohol speeds up metabolizing if methadone? I’m not saying your wrong.


  16. Posted by Steven king on January 13, 2018 at 3:36 am

    I used to go out drinking n never had any issues. I also wasnt aware of the risks. Im about to go iut drinking now, but im only on 30 mg so i hope im fine.


  17. Posted by Ken on January 25, 2018 at 4:31 pm

    I agree entirely with what your saying except for the marijuana part. It has no harsh effects and can be extremely helpful. Iam on methadone, but it took marijuana to help me stop doing well as several people I know as it was recommended to me thank you


  18. I’m in trouble. I drink heavily, 24/7 and take methaonde (30 mg). I also have medical issues to boot. I know what I am doing is detrimental and the side effects that follow. I’m an educated woman, in the field. My addiction has literally ruined my life, I had to quit my job before I got fired and, consequently lost my benefits. “ free rehab” hasn’t worked I’ve tried county treatment and free detox to no avail. I desperately need help, my marriage is in trouble, my family don’t GAF. I’ve even reached out to go fund me. NOTHING


    • Posted by Nancy A. Tedd on December 8, 2018 at 2:10 am

      I have a friend that has used heroine for 25 years. He was doing 10 bags a day when he finally decided to get help. Went to detox 4 times but this last time it was through a state facility. But they only keep you in there for 5 days,not long enough for him. First as a recreational drug and then became addicted. He is also an alcoholic to boot! For 5 weeks now he has been going to methadone. If he didn’t he was going to become homeless. He has been attending classes for 5 weeks 3 hours a day 5 days a week. And I say what for. They tell him not to drink and what does he do? The minute he leaves there he goes to the package store to buy liquor and downs 2-3 shots and a beer. Within a 1/2 hour I call it a coma that he goes into. The same reaction he had when he was doing dope! Eyes close he starts caring a conversation with himself for hours sways back and forth. I will push him to snap out of it but he comes to for 5 minutes or so and goes right back into this trance. I DO NOT LIVE with him thank god. I’m a friend that has tried to help but I am ready to just wash my hands of him. I scream and holler at him but it doesn’t do any good. I tried to tell him he needs to stop the drinking I’m going to find you dead. He just laughs tells me I read to much crap. If I don’t find him dead he will end up burning the place down. I want to call the clinic but with the HIPPA act I cannot do anything, and I don’t want him thrown out of the program. He’s been doing this for 5 weeks now. And before that it was heroine with the shots and beers. The only difference now is methadone is legal and heroine isn’t. It’s also cheaper. He was doing $400-$500 a week habit snorting heroine not booting. I don’t know how to get to him. Just let it works it’s course I guess. He’s 63 but from all the dope he has done he looks like 75. It’s just a shame. I was told he also has wet brain. He can’t remember anything he does. Just the simple acts sometimes ask me what he should do. This is very sad. I don’t drink and I’ve never done drugs, life is hard enough without doing this crap…… Does anyone have any suggestions?


      • I’d be hard for his program to be unaware of his alcohol use, but it’s OK for you to call and tell them of his alcohol use. They can’t give you any information, but you can give it to them. Then they can make appropriate recommendations for him. This may include inpatient care, but as you say, it’s dangerous for him to go on as he is. Then too, if patients can be retained in treatment, many times they are eventually able to stop using other drugs (including alcohol) and have a better life.

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