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Opioids How can one sip of alcohol effect opiates?

Altered Perception

Altered Perception

Bluelighter
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Dec 13, 2010
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I took a high dose of Oxycodone earlier and then just as the peak was wearing off I had a sip of vodka and then within 20 minutes I began to peak again but this time it was more sedating, nauseated and then started the vomiting.

This is the first time I had alcohol while on a large dose of Oxy and I had heard about the risks and effects of mixing the two but out of curiosity I decided to experiment by drinking only just one sip of vodka to see if anything happens at all. But it took me by surprise cause I was not expecting such a small sip of alcohol to make me as sick as it did. Even my heart rate was very uncomfortably slow.

I know that opiates can increase the effects of alcohol but I assumed any interaction was due to overwhelming the nervous system by combining the tipsy/drunk effect with the opiate high. But for that to happen you would first have to drink just enough alcohol for your body to begin falling under its influence before any additional substances would have any interaction with it. But one sip is not sufficient to do that.

So am I correct to assume any effects felt from combining the two is more of a result of chemical reaction in the liver and not so much dependent on dosage or combining the highs?
 
I have never noticed a sip of vodka to make any difference in the effects of opioids for me. It may depend on the opioid (and the person) though. It is my understanding that small amounts of alcohol inhibit the enzyme CYP3A4, and larger amounts or chronic drinking induce CYP3A4, and CYP3A4 metabolizes oxycodone to an inactive metabolite, so there could potentially be an interaction there. Also, were you taking Oxycontin? I know alcohol can affect the ER formulations of some opioids.

EDIT: Found this presentation explaining some mechanisms of alcohol and opioid interactions (which do vary from opioid to opioid): Pharmacology and Pharmacokinetics of Alcohol and Opioids
 
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Thanks Swimmingdancer , that is an excellent find. Well done on that! It is exactly the information I was after.

Sorry about the delayed response, I spent the night in hospital soon after making the above post because my condition got worse. It turned out I had developed gastroparesis (a medical condition consisting of a partial paralysisof the stomach, resulting in food to go bad in the gut due to delayed gastric emptying) and the sip of alcohol just exaggerated the condition.

I have a complex medical history of Autonomic Dysfunction so after a night of vomiting and gastroparesis I figured out that the alcohol alone was not the cause but it definitely contributed to the problem when I combined it with my pain medication Oxycodone. Once again thank you for the info.
 
I have noticed this before, not with one small single sip perhaps, but certainly with a couple. I will definitely "feel" a small amount alcohol when I have opiates in my system, when the same amount would do nothing to me by itself.
 
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