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Dangerous Liaisons: Mixing Hydrocodone with Alcohol and Other Drugs

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Hydrocodone, the active ingredient in pain relievers such as Vicodin®, Anexsia®, Lorcet® and Norco®, is one of the most commonly abused prescription drugs among teens and is especially dangerous when mixed with other substances. Hydrocodone depresses the central nervous system and slows breathing. Mixing hydrocodone with other substances that also depress the central nervous system—such as alcohol, antihistamines, barbiturates, or benzodiazepines—could lead to life-threatening respiratory problems.

Hydrocodone may make you drowsy, less alert, or unable to function well physically, so it’s necessary to avoid using other medicines that also make you sleepy (such as cold medicines, other pain medications, muscle relaxants, and medicines for seizures, depression, or anxiety). The interaction between two medications could result in extreme drowsiness or coma, making it particularly dangerous to drive a car, operate machinery, or perform other activities.

Mixing hydrocodone with alcohol is extremely dangerous and can cause impairment of judgment, thinking, and psychomotor skills. Death has been reported due to overdose. Alcohol can be found in many over-the-counter medicines, such as cough syrup, so it is important to read all medicine labels to avoid the risk of taking medications that contain alcohol while using hydrocodone.

Hydrocodone is usually formulated with acetaminophen, a drug commonly found in over-the-counter pain relievers like TylenolВ®. Acetaminophen can be toxic to the liver. Extended use of pain relievers such as VicodinВ®, or mixing them with over-the-counter medicines that also contain acetaminophen, may lead to an upset stomach, internal bleeding and ulcers, and serious long-term damage.

When a doctor prescribes hydrocodone to treat a particular medical problem, he or she knows important specifics about the patient, such as weight, current condition, medical history, any particular allergies or sensitivities, and can prescribe the appropriate dose and form of the drug, warn of side effects, and monitor progress. When a person uses hydrocodone in a different form and dosage than a doctor has prescribed (with or without a prescription) or mixes it with other substances like alcohol, serious problems can occur.
What are the possible signs of trouble?

Get emergency medical help if you observe any of these signs of an allergic reaction: hives; difficulty breathing; swelling of the face, lips, tongue, or throat.

Call a doctor at once if you experience any of these serious side effects:

  • В В В shallow breathing or slow heartbeat;
  • В В В seizures (convulsions);
  • В В В cold, clammy skin;
  • В В В confusion;
  • В В В severe weakness or dizziness; or
  • В В В feeling light-headed or faint.

Dangerous Liaisons: Mixing Hydrocodone with Alcohol and Other Drugs PRINT THIS PAGE Hydrocodone, the active ingredient in pain relievers suchВ as VicodinВ®, AnexsiaВ®, LorcetВ® and NorcoВ®, is

Combining opioids and marijuana may be advantageous for pain sufferers

Study suggests using the two drugs together could reduce risk of dependency without causing cognitive problems

Researchers report combining cannabinoids with morphine did not significantly increase impulsivity or memory impairment in a study conducted in rhesus monkeys. The findings suggest using opioids and marijuana together could offer a safe way to cut opioid dosage among patients suffering from pain and thereby reduce their risk of becoming addicted to opioids.

“These data provide additional evidence supporting the notion that opioid-cannabinoid mixtures that are effective for treating pain do not have greater, and in some cases have less, adverse effects compared with larger doses of each drug alone,” said Vanessa Minervini, PhD, a postdoctoral fellow at the University of Texas Health Science Center at San Antonio.

Minervini will present the research at the American Society for Pharmacology and Experimental Therapeutics annual meeting during the 2019 Experimental Biology meeting, held April 6-9 in Orlando, Fla.

Previous studies have suggested the cannabinoids in marijuana enhance some of the pain-relieving effects of opioid drugs but do not enhance effects related to addiction and overdose. However, both drugs individually are known to slightly impair cognition, leading to a concern that such side effects could be amplified if opioids and marijuana are used together. Researchers say the new study offers encouraging evidence this is not the case.

The research comes amid a national opioid abuse crisis in which many addictions start with opioids prescribed for pain. At the same time, marijuana use is on the rise as more states legalize the drug for medical or recreational use.

“The current opioid epidemic underscores the need for safe and effective pharmacotherapies for treating pain,” said Minervini. “Combining opioid receptor agonists with drugs that relieve pain through actions at non-opioid mechanisms (for example, cannabinoid receptors) could be a useful strategy for reducing the dose of opioid needed to achieve pain relief.”

The researchers gave several monkeys moderate doses of morphine and CP55940, a synthetic drug that mimics the activity of the tetrahydrocannabinol (THC) naturally found in marijuana. They assessed impulsivity and memory with tests involving touchscreens and treats. The results showed each drug impeded performance and that giving the monkeys both drugs together had a lower effect on performance than either drug alone.

While clinical trials would need to be conducted to confirm whether these results translate to humans, monkeys tend to process drugs similarly to humans and are considered a good model for cognition.

Researchers report combining cannabinoids with morphine did not significantly increase impulsivity or memory impairment in a study conducted in rhesus monkeys. The findings suggest using opioids and marijuana together could offer a safe way to cut opioid dosage among patients suffering from pain and thereby reduce their risk of becoming addicted to opioids.