Opioid overdoses are rising in Canada, and some experts believe the pandemic is to blame. Opioid-related fatalities increased by 96% from 2020 to 2021 alone. This trend has continued into 2022 and 2023. Mixing morphine and alcohol can be even deadlier. Both substances work to depress the brain and body’s functions. They can interact with one another and increase the risk of fatal overdoses. Canadian rehab centres offer treatments to help people addicted to alcohol, morphine, or both. They can detox in a safe and comfortable environment. Additionally, rehab provides therapy and medication to make it easier to quit. If you or a loved one is addicted to painkillers and alcohol, read this guide to learn more about how these two substances interact and the treatments to help you quit once and for all.

What Is Morphine and How Does It Affect the Body?

Morphine is an opioid that affects the body by alleviating pain. Doctors may prescribe morphine for the treatment of pain. Some people also abuse morphine to get high.

Like all opioids and drugs that cause a high, morphine can be highly addictive, especially when misused. However, people can also become addicted to prescription morphine.

In Canada, morphine is a Schedule II Controlled Substance. Health Canada states that Schedule II drugs and medications have a high potential for abuse and addiction. Other Schedule II substances include oxycodone, fentanyl, and opium.

How Does Morphine Work?

The pain-killing effects of morphine come from its interaction with the opioid system. This system helps regulate pain signals. When opioids like morphine bind to the system, they reduce pain signals from the body to the brain.

Morphine’s addictive qualities come from interacting with the brain’s reward system. The brain’s reward system uses dopamine. Morphine increases dopamine levels, leading to cravings.

Opioids like morphine are incredibly addictive. More than 30,000 Canadians have died from opioid misuse since 2016. Opioid overdose is the leading cause of accidental death in Canada.

Fatalities from opioids are only increasing. 2021 and 2022 saw the highest number of opioid-related deaths since at least 2016. Nearly 8,000 Canadians died of opioid overdoses in 2021 alone.

Painkiller Addiction

Doctors prescribe painkillers when the benefits outweigh the risks. Unfortunately, people can still get addicted to painkillers, even when they use their prescription painkillers as prescribed.

Painkiller addiction is also known as opioid use disorder (OUD). Around 10% of Canadians who use opioids for pain relief get addicted. Problematic painkiller use can happen when:

• People do not take their medication as prescribed
• People share their medication with other people
• People take their medication with alcohol

Signs of an OUD include using more than the prescribed amount or struggling to reduce use. Cravings, tolerance, and withdrawal are also symptoms of an OUD.

The most common opioid withdrawal symptoms include sweating, confusion, shaking, low appetite, gastrointestinal issues, cramps, muscle aches, excessive yawning, and other flu-like symptoms.

These withdrawal symptoms are the main reason why it is so difficult for people to quit using opioids. Luckily, rehab centres like Simcoe Addiction & Mental Health offer withdrawal management programmes to help people quit opioids.

What Is Alcohol and How Does It Affect the Body?

Alcohol is a central nervous system (CNS) depressant that affects the body by decreasing control over bodily movements and functions. Slurred speech, slowed movements, and decreased alertness are signs of alcohol intoxication.

In extreme cases, alcohol can lead to blackouts. Blackouts feature gaps in someone’s memory during the time they were intoxicated. The brain fails to consolidate short-term memories into long-term storage.

How Does Alcohol Work?

Alcohol works by interacting with a neurotransmitter (NT) called GABA. GABA is the primary inhibitory NT in the brain. Increases in GABA result in less communication between brain cells that control movement and other functions.

Like opioids, alcohol also interacts with the brain’s reward system. It does not increase dopamine levels as much as opioids do. However, drinking excessively or regularly can still lead to addiction.

Alcohol Use Disorder

Around 75% of Canadian drink alcohol. About 15.6% of Canadians report drinking heavily enough to have an alcohol use disorder (AUD). The signs of an AUD are similar to those of an OUD and include the following:

• Frequent intoxication
• Struggling to limit or stop drinking alcohol
• Cravings
• Continuing to drink despite experiencing negative social, financial, or legal consequences
• Alcohol withdrawal symptoms

As with opioids, alcohol withdrawal symptoms can prevent people from quitting. Withdrawal symptoms may appear as soon as 6 hours after someone’s last drink and peak at 72 hours.

Some of the most common withdrawal symptoms of alcohol include anxiety, headaches, insomnia, shaking, and sweating. Hallucinations and seizures are severe symptoms that may occur 48 hours after quitting drinking.

Consequences of Alcohol Abuse

Sadly, alcohol abuse can be fatal. Nearly 4,000 Canadians died in 2021 due to alcohol abuse. Getting treatment is crucial for avoiding the deadly consequences of having an AUD.

Alcohol-related deaths can happen due to excessive drinking in one setting or long-term alcohol abuse. Alcohol poisoning can occur when someone drinks excessively in a short period.

Additionally, alcohol can have deadly effects in the long term. Liver damage and brain damage are expected consequences of heavy long-term drinking. Other complications of long-term heavy drinking include:

• High blood pressure
• Cardiovascular disease
• Gastrointestinal issues
• Cancer (breast, mouth, liver, colon, rectum, throat, esophagus, voice box)

Alcohol-induced psychosis is also possible. The condition features temporary symptoms like paranoia and hallucinations. The good news is that stopping alcohol use can reverse these effects.

Effects of Combining Morphine and Alcohol

Combining alcohol with any substance can be unsafe. Yet, mixing even a small amount of alcohol with painkillers like morphine can be even more dangerous.

Doctors advise against using alcohol while taking a morphine prescription. However, some people will continue to drink while using morphine. Other people intentionally mix alcohol and morphine to increase their effects.

Alcohol and morphine reduce activity in the brain. Combining these substances enhances their individual effects (e.g., dizziness, confusion, impaired speech or coordination) and increases the risk of overdose.

Signs that someone may be overdosing on alcohol and morphine include:

• Pinpoint pupils
• Loss of consciousness
• Slow breathing
• Vomiting
• Going limp
• Slue lips
• Slow heart rate

Physical injuries and risky sexual behaviour can be side effects of morphine and alcohol intoxication. Why? These substances reduce someone’s control over their body and brain.

Taking excessive amounts of these substances can also lead to coma. Sadly, it is also common for the combination of the two to result in fatalities.

Mixing Alcohol and Other Opiates

Mixing alcohol with any type of opiate is dangerous. Other opiates people may take with alcohol include:

• Codeine
• Hydrocodone
• Oxycodone
• Oxymorphone
• Hydromorphone
• Methadone
• Fentanyl
• Tramadol
• Meperidine

Like morphine, these opiates are CNS depressants. They reduce communication between brain cells, making movements slower and more deliberate. Depressants also slow cognition (i.e., thinking).

Combining these opiates with alcohol can lead to coma and even death. Liver damage, heart failure, and low blood pressure may also occur.

When someone takes alcohol with opiates, it also increases the risk of developing a substance use disorder. After all, both substances activate the dopamine reward system in the brain.

Opiates and alcohol may be rewarding on their own. Yet, when combined, that effect is even stronger. The risk of addiction is even higher when using morphine and alcohol for a long time.

Long-Term Effects of Mixing Alcohol With Morphine

Some people know exactly how much morphine and alcohol to take without it being fatal. However, combining alcohol and morphine long-term is not innocuous, either.

As mentioned earlier, combining these substances increases the risk of a substance use disorder (SUD). People who abuse morphine and alcohol also tend to have the following:

• Fewer brain cells (from alcohol abuse)
• Gastrointestinal issues (from morphine abuse)
• Trouble with memory (from alcohol abuse)
• Poor immunity (from morphine abuse)
• Difficulty focusing or learning new things (from alcohol abuse)
• Depression (from morphine abuse)
• Cardiovascular issues (from alcohol abuse)
• Insomnia (from morphine abuse)

Quitting morphine and alcohol may not be enough to reverse these side effects. The only way to keep them from happening is to avoid drinking while using opiates like morphine in the first place.

People who are addicted to alcohol and receive a morphine prescription can consider an alcohol treatment programme. Understanding when someone can and can’t drink while on painkillers is also important.

How Long After Drinking Can I Take Painkillers?

How long after drinking you can take painkillers depends on the type of painkiller and whether it is short- or long-acting. For example, morphine comes in regular and extended-release tablets.

Regular morphine tablets will exert all their effects at once. They don’t last as long as extended-release morphine. Extended-release morphine tablets deliver a small amount of morphine over a longer period.

Morphine has a half-life of two or three hours. As such, most people stop feeling its effects within four to six hours. The exact amount of time morphine stays in someone’s system depends on the route of administration.

The route of administration refers to how morphine gets into someone’s system. Oral and intravenous (IV) morphine administration methods are the most common.

Oral morphine takes effect slower than IV administration. It also lasts longer, especially if the oral tablet comes in an extended-release form.

The IV administration of morphine takes effect much faster. At the same time, it also wears off quicker.

Some opiates can last even longer. For example, fentanyl transdermal patches can affect people for up to 72 hours.

Most doctors do not recommend drinking alcohol until after finishing the entire prescription. Someone may be able to drink around 24 hours after stopping morphine. Meanwhile, someone with a fentanyl prescription may need to wait up to three days before consuming alcohol.

Statistics for Alcohol and Morphine Use

1 in 10 adults suffer from chronic pain. Many of these individuals receive a morphine prescription. Others may abuse substances, including alcohol, to self-medicate their symptoms.

Many people do not know that alcohol use can interfere with morphine’s ability to treat chronic pain. In other cases, excessive alcohol use can lead to alcoholic neuropathy, which can cause chronic pain.

According to the latest statistics, 50% of drug overdoses involve multiple substances of abuse. Using morphine and alcohol is an example of this phenomenon known as polysubstance abuse.

Alcohol is one of the most common substances involved in polysubstance abuse. Studies show that at least 1 in 4 people who binge drink also use other substances.

Additionally, 1 in 5 people who visit an emergency room for prescription drug injury also have alcohol in their system at admission. Fatalities from alcohol and opioids are on the rise, too.

From 2019 to 2020 alone, deaths from alcohol and opioid-related deaths increased by 41%.

Meanwhile, a recent study found that 23.4% of people with an opioid use disorder also have an alcohol use disorder.

Alcohol and Morphine Use Risk Factors

Gender, age, race, and socioeconomic status are connected to alcohol and morphine misuse. For example, young Black men with lower household incomes are at the highest risk of abusing these substances.

People who binge drink also have a four times higher risk of polysubstance abuse. The changes alcohol can make to the brain’s structure may contribute. However, other risk factors could also play a role.

Other risk factors for polysubstance abuse include:

• A family history of substance abuse
• A history of trauma, especially childhood trauma
• Untreated mental health conditions

Teens are also at risk for morphine and alcohol use. This is especially true of teens with parents who use substances and teens with low parental supervision. We will talk more about teen morphine and alcohol use next.

Teen Drinking and Morphine Abuse

80% of Canadian teens say they have had alcohol at least once over the past year. Many teens try alcohol for the first time as early as 7th grade.

Opioid abuse has also become a significant issue among Canadian teens. Teens get access to friends’ or parents’ painkiller prescriptions. They may share it with their friends and start using painkillers recreationally.

Teens may use drugs and alcohol to deal with stress or unaddressed trauma. Peer pressure, pop culture, and parental substance use or abuse can also make a teen more likely to use drugs and alcohol.

Experimenting with drugs and alcohol is relatively common among teens. After all, the brain does not stop maturing until someone is around 25 years of age. Before then, adolescents are prone to risk-taking behaviours like substance use.

When the brain is still maturing, it is even more susceptible to harm from substance use and abuse. Teens who start using alcohol and morphine early may face the consequences for the rest of their lives.

For example, early substance use can increase the risk of SUDs in adulthood. Studies have also found that teens who use substances early struggle with learning and memory issues.

Abuse of prescription painkillers can also result in the abuse of even deadlier opioids. For example, teens who start using prescription painkillers may eventually move on to abusing heroin.

Treatment for Co-Occurring Morphine and Alcohol Addiction

People who are tired of living with an addiction can have hope. Rehab centres like Simcoe Addiction & Mental Health offer treatment for OUDs and AUDs. Here are some of the best options for addicts.

Medical Detox

Detox is the first step before beginning any substance abuse treatment programme. Medical detox is going through withdrawals to get the drug or alcohol out of someone’s system.

In rehab, patients can undergo supervised detox. A medical professional will oversee the entire process to ensure patients are safe and relatively comfortable while experiencing withdrawal symptoms.

Detoxing at home can be dangerous. Morphine, in particular, comes with deadly withdrawal symptoms. In some cases, withdrawing from opiates like morphine can be fatal.

Medically-supervised detox reduces the risks associated with withdrawal. Additionally, patients can receive medications to help ease their symptoms.

Acamprosate, disulfiram, and naltrexone are common medications used to treat AUD. Methadone, buprenorphine, and naltrexone can help ease morphine withdrawal symptoms.

These medications are not available over-the-counter. People must attend a medically-supervised detox programme to get access to them.

Inpatient Programmes

Experts recommend inpatient treatment for people with severe co-occurring alcohol and morphine addictions. What is inpatient treatment? Inpatient programmes enable round-the-clock care for patients.

Patients live at the facility where they receive treatment. That way, they are not exposed to the temptations in the real world. Medical professionals are available 24/7.

Typically, residential rehab centres offer 30, 45, 60, or 90-day treatment sessions. Extending someone’s stay upon a therapist’s recommendation is also possible.

Inpatient programmes begin with a medical detox. Once a patient’s system is free of drugs and alcohol, they can enter their treatment programme. The facility will design a customized treatment plan for each patient’s needs.

For example, someone’s treatment plan may include individual and group counselling sessions. Patients can also see a psychotherapist to uncover potential reasons for their addictive behaviours.

Therapy sessions may include techniques like cognitive behavioural therapy (CBT). Or they may use alternative therapeutic approaches like massage therapy, exercise, and other recreational activities.

Outpatient Programs

Some people addicted to alcohol and morphine may not need an inpatient program. People with mild to moderate addictions may benefit from an outpatient programme alone.

Outpatient programmes allow patients to live at home part-time or full-time while they receive treatment. They commute to and from the treatment facility a few times a week.

This option is ideal for people who need flexibility. Patients can still go to work and spend time with their families. They can attend individual or group therapy sessions at a time that suits their schedule.

Patients who have completed inpatient treatment may also enrol in an outpatient programme. Outpatient therapy may be part of their aftercare recovery plan.

The primary goal of outpatient treatment is to help recovering addicts learn how to cope in the real world. Many people start using alcohol and painkillers as a coping mechanism.

In therapy, patients learn alternative coping strategies. That way, when stress or trauma strikes, they will not feel as tempted to use substances to deal with it.

Naltrexone for Morphine and Alcohol Addiction

Naltrexone is a medication that can treat the symptoms of morphine and alcohol withdrawal syndrome. This medication can also support someone’s journey to full recovery.

Doctors can prescribe naltrexone as an extended-release injection or an oral tablet. Professionals typically do not recommend it for teens under the age of 18 because it may come with side effects like:

• Insomnia
• Fatigue
• Anxiety
• Headaches
• Flu-like symptoms
• Gastrointestinal issues

The good news about naltrexone is that it is non-addictive. It is a safe and effective way to reduce the withdrawal symptoms of opioids and alcohol. For this reason, medical professionals often prescribe it during detox.

That’s not all, though. Naltrexone can also reduce cravings for these substances. It blocks the rewarding effects of alcohol and morphine, too, to support a lifelong journey toward sobriety.

Do You Need Treatment for Alcohol and Morphine Addiction?

Morphine and alcohol can be a deadly combination. Additionally, combining these two substances can lead to detrimental long-term consequences, including the risk for substance use disorders.

If you or a loved one is struggling with addiction to alcohol and opioids like morphine, Simcoe can help. We are a private treatment centre in Ontario offering inpatient programmes, withdrawal management services, and more.

Get in touch with Simcoe today and schedule a free consultation to learn more about our facility.