Various issues may arise when taking certain medications while drinking alcohol, which is why many medications include contraindications or warnings not to do so on the labels or in the packaging information. In some instances, it could mean that a medication might not work as well as intended, or that relatively mild effects, such as upset stomach, may be more likely. However, in other cases, such as with prescription opioids, the adverse effects could be much more serious. Percocet is one such prescription opioid, and mixing alcohol and Percocet can result in severe respiratory depression, which could result in irreversible injury and/or death.
Percocet is a combination of oxycodone and acetaminophen. In addition to several prescription opioid combinations, acetaminophen is the primary active ingredient found in many Tylenol products and other over-the-counter pain medications as well as cold and flu preparations. Acetaminophen is an antipyretic (fever reducer) and analgesic used to manage mild to moderate pain including muscle aches, premenstrual cramps, headaches, toothaches, sore throats, and fever.1
Oxycodone is a semi-synthetic opioid drug manufactured from an opiate precursor substance found in the opium poppy.2 It is prescribed to treat moderate to severe pain.3 Opioids like oxycodone attach to and activate specific receptors on nerve cells in the brain; in addition to modifying pain sensations, this activation leads to a cascade of biochemical processes that are associated with pleasurable feelings much in the same way as life-supporting functions such as eating and sexual activity are.4,5,6 Synthetic opioids are thought to be able to elicit rewarding euphoric sensations at a faster rate and on a more intense level than our own natural, endogenous opioids (e.g., endorphins), which helps to explain why synthetic opioid substances are so exquisitely addictive.4
With all opioids, the drive to repeatedly achieve a high can result in a person compulsively misusing them, which increases the risks of addiction, overdose, and death.5 Some street terms purportedly used to reference oxycodone-containing include Oxy, Oxycotton, O.C., Percs, and Hillbilly Heroin.7
Percocet Side Effects
The side effects of Percocet can range from mild to severe and may include signs or symptom such as:3,8
- Mood changes.
- Constricted pupils.
- Loss of coordination.
- Peripheral blood vessel dilation.
- Orthostatic hypotension.
- Light headedness when changing position.
- Dry mouth.
- Decreased GI tract activity.
- Stomach upset.
- Nausea, vomiting, loss of appetite.
- Changes in heartbeat.
- Slowed breathing.
- Decreased sexual desire.
- Erectile dysfunction.
- Irregular menstruation.
Dangers of Mixing Alcohol with Percocet
When Percocet and alcohol are combined, it can result in profound sedation, decreased heart rate and blood pressure, slowed or stopped breathing, unconsciousness, coma, and potential death.9,8 One of the biggest health risks of mixing the two involves slowed respiratory drive and the potential for serious respiratory depression; in such instances, breathing can become irregular, shallow, or altogether stop.10 Without immediate medical treatment—as oxygen is deprived—you may quickly incur brain injury, which could be fatal.10
Because Percocet contains acetaminophen—an analgesic with known hepatotoxicity—users must be additionally cautious when mixing it with alcohol. Acetaminophen alone can result in liver injury, but this risk becomes more likely when alcohol is simultaneously consumed. When people exceed a certain dose of acetaminophen, the liver may become overwhelmed as it struggles to metabolize the substance; when alcohol is simultaneously consumed, the liver can’t break down both substances as easily—hepatoxic metabolites and oxidative stress build up, which increases the risk of liver damage.11 More than 30,000 people each year are hospitalized for acute liver failure as a result of acetaminophen-induced hepatotoxicity.11
Signs of Overdose
With both opioids and alcohol, people who compulsively misuse large amounts of the substances may face increased overdose risks. As mentioned, taking too much acetaminophen—one component of Percocet—can result in overdose and death. Acetaminophen overdose can lead to severe liver injury; the drug accounts for more than 50% of overdose-related cases of acute liver failure in the U.S. and 20% of all liver transplant cases.11 It has been estimated that a significant portion of all acetaminophen overdoses are unintentional and occur in the context of chronic drinking and otherwise therapeutic use of combination analgesics, such as Percocet.12
In addition to the risks of acetaminophen-associated hepatotoxicity, when an opioid like Percocet is taken at larger-than-recommended doses or when it is combined with alcohol or certain other drugs, the effects can be fatal. Symptoms of opioid overdose can include:3
- Extreme drowsiness.
- Narrowed or pinpoint pupils.
- Slowed or stopped breathing.
- Weak muscles.
- Clammy skin.
- Loss of consciousness.
When it comes to drinking, alcohol poisoning or overdose may occur as blood alcohol levels rise to dangerous levels, resulting in dramatically impaired motor control and changes in several life-supporting processes such as heart-rate and breathing.13
Signs of alcohol overdose include:13
- Mental confusion.
- Difficulty staying conscious.
- Unrousable loss of consciousness.
- Dulled response time / diminished gag reflex.
- Slow heart rate.
- Difficulty breathing.
- Extremely low body temperature.
Risk factors that could increase the likelihood or severity of alcohol overdose include mixing alcohol with other drugs like opioids, consuming alcohol rapidly, binge drinking (raising the body’s blood alcohol concentration to 0.08% or higher in 2 hours, and being a teen or young adult.13 If you believe someone is experiencing an opioid or alcohol overdose, call 911 immediately.
Signs of Addiction
Addiction is a chronic, relapsing mental health disorder characterized by compulsive substance use despite the negative consequences that such use has on an individual’s life.14 The diagnosis of an alcohol use disorder is made based on a person meeting at least 2 of several criteria outlined in the Diagnostic Statistical Manual of Mental Disorders (DSM-5).
To make a diagnosis of an alcohol use disorder, for example, a doctor or therapist might ask whether, in the past 12 months, you have:15
- Spent a lot of time drinking or being sick from drinking?
- Tried to cut down or stop drinking but couldn’t?
- Experienced problems in your relationship because of alcohol?
- Had times where you drank more or longer than intended?
- Found that drinking or being sick from drinking impaired your ability to take care of family, work, or school responsibilities?
- Wanted a drink so badly that you were preoccupied by the thought of drinking?
- Reduced your engagement in once enjoyable activities so you could drink instead?
- More than once gotten into situations while drinking or after drinking that increased your risk of getting hurt?
- Continued to drink despite increased feelings of anxiety and depression or other health issues?
- Found that you need more drinks to produce the same effect as before?
- Experienced withdrawal symptoms when the effects of alcohol were wearing off?
How to Get Help
If you suspect that you or someone you care about has an opioid use disorder or is suffering from alcoholism, it may be time to seek professional help. Depending on the type of program and your insurance coverage, the cost of a treatment program for alcoholism can vary widely.
Because treatment costs can differ, you want to make sure the program you enroll yourself or your loved one in will actually work. American Addiction Centers (AAC) can improve treatment outcomes for those in recovery for alcohol use disorder. Research has shown that rehabilitation treatment can be very effective in helping individuals maintain a life of sobriety.16
Find out if your insurance covers treatment at an AAC facility by filling out the form below.
. U.S. National Library of Medicine. (2017). Acetaminophen.
. United States Drug Enforcement Administration. (n.d.). Oxycodone.
. U.S. National Library of Medicine. (2019). Oxycodone.
. University of California San Francisco. (2018). Body’s ‘natural opioids’ affect brain cells much differently than morphine.
. U.S. Department of Health and Human Services. (2018). How opioid drugs active receptors.
. Kosten, T. R., & George, T. P. (2002). The neurobiology of opioid dependence: implications for treatment. Science & practice perspectives, 1(1), 13–20.
. National Institutes of Health. (2017). Street and commercial names.
. U.S. Food and Drug Administration. (2017). Medication Guide—Percocet.
. University of Michigan. (n.d.). The Effects of Combining Alcohol with Other Drugs.
. National Institute on Drug Abuse. (2019). Prescription Opioids.
. National Institute of Health. (2016). Acetaminophen-induced Hepatotoxicity: A comprehensive update.
. Fontana R. J. (2006). Unintentional acetaminophen overdose on the rise: who is responsible? Canadian journal of gastroenterology, 20(5), 319–324.
. National Institute on Alcohol Abuse and Alcoholism. (2019). Understanding the dangers of alcohol overdose.
. National Institute on Drug Abuse. (2018). The science of drug use and addiction: The Basics.
. National Institute on Alcohol Abuse and Alcoholism. (2016). Alcohol use disorder: A comparison between the DSM-IV and the DSM-V.
. National Institute on Alcohol Abuse and Alcoholism. (2014). Treatment for Alcohol Problems: Finding and Getting Help.