By Hugh C. McBride
You've worked your way from the depths of addiction back to a healthier life. You've enrolled in a methadone maintenance program, assumed responsibility for your past, and taken control of your future.
Considering everything you've overcome, what harm could come from having a few beers with your buddies after work? If you're still taking methadone, the answer to that last question might be "a lot."
A Dangerous Combination
According to information provided on its website, Canada's Centre for Addiction and Mental Health (CAMH) doesn't pull any punches when it comes to alcohol use by patients who are participating in a methadone maintenance program:
- Mixing methadone with alcohol can kill you.
- The danger is particularly high when you first start treatment.
- Most methadone-related deaths involve alcohol and other drugs, and occur early in treatment.
Alcohol and methadone are both depressants, both have a slowing effect on the central nervous system, and both lead to decreased breathing and heart rate. Taking alcohol and methadone at the same time, the CAMH notes, can result in a range of unpleasant effects, including heart failure:
When you mix [central nervous system] depressants together, they intensify each other’s effects. This means they can make you feel more drunk or stoned than you might expect. It also means that the effect on your breathing is intensified. Combining these drugs is extremely dangerous.
Alcohol can also have the effect of speeding up the metabolism of methadone in your body. This means that the methadone will wear off quicker, and you might end up feeling sick before it’s time to get your next dose.
The Canadian CAMH is far from the only organization to advise methadone patients to avoid alcohol. An April 1, 2009 report from the U.S. Government Accountability Office contained the following facts and statements about the dangerous relationship between alcohol and methadone:
- Taken too often, in too high a dose, or with other drugs or alcohol, methadone can cause serious side effects and death.
- Eighty-nine percent of methadone-related deaths in Florida were caused by combining methadone with alcohol or another drug.
- The top criterion for allowing a patient to take methadone at home is the absence of drug abuse or alcohol abuse.
A Prevalent Problem
The dangers of abusing alcohol while using methadone are compounded by the fact that many individuals who are enrolled in a methadone maintenance program in the United States are also suffering from alcoholism.
According to an "Alcohol Alert" that was disseminated by the National Institute on Alcohol Abuse and Alcoholism:
- Alcoholism is a common problem among people in methadone programs, affecting as many as half of such patients. Consequently, many methadone-maintained patients need to be treated simultaneously for alcoholism.
- Methadone-maintained patients enter alcohol treatment for the same reasons as other alcoholics.
- In addition to the benefits that all alcoholics derive from treatment, methadone-maintained patients, because of their high rate of chronic liver disease, receive an extra benefit: prevention of further damage to the liver.
According to a methadone maintenance treatment brochure that was created by the U.S. Centers for Disease Control and Prevention (CDC), about 25 percent of intravenous drug users who enter methadone maintenance treatment also have a history of alcohol abuse. The same document also indicates that "the long history of use, the complexity of patients’ situations and reasons for using drugs, and the biological basis of addiction" are likely to cause many patients to continue using alcohol and other drugs while receiving methadone maintenance treatment.
Progress Is Possible
Overcoming an addiction to heroin can be an imposing task. Add a requirement to also end a dependence upon alcohol, and the challenge can appear to be insurmountable.
Thankfully, neither of these assumptions is true. Thousands of individuals have overcome co-occurring disorders such as heroin addiction and alcoholism, or successfully completed dual diagnosis treatment for an addiction and a mental health disorder. But few have ever done so without effective professional intervention.
Due to the nature and severity of co-occurring addiction and alcoholism, the comprehensive care that is available at a reputable residential addiction recovery program may provide the best chance for long-term recovery.
