Methadose – a liquid form of methadone – is used to treat people with Opioid Use Disorder (OUD).
Methadose is a brand name for methadone. Other common brand names of methadone include Dolophine. In the UK, it is estimated that 9.3% per 1000 of the population uses methadone.
In addition, methadone is often abused, leading to fatalities. In 2021, there were approximately 663 deaths related to methadone. For more information about methadone use in the UK, please see here.
Unfortunately, there is a prevailing trend among methadone users to mix it with other substances. One example, that remains problematic, is mixing methadone with alcohol.
Mixing methadone with alcohol can lead to a series of negative health issues and increase the risk of overdose. The purpose of this article is to discuss what happens when people mix methadone with alcohol.
It will discuss risk factors, potential health issues (short-term and long-term), and what treatments and help are available.
Methadone is a synthetic opioid used to treat people with Opioid Use Disorder (OUD). Its purpose is to prevent a potentially fatal detoxification – the process of the body expelling a substance.
For example, if someone suffers from heroin addiction, and begins treatment, they might be prescribed methadone. Methadone helps reduce withdrawal symptoms and allows the person to slowly detox.
Methadone does this by, essentially, depressing the body’s nervous system; this changes the way that the body responds to pain. Over time, usually, the methadone dosage is reduced, and people begin to achieve sobriety.
Methadone comes in several different types of consumption methods and dosage strengths.
These usually include:
The dosage that people are prescribed will be based on several factors, such as how severe their addiction is, their age, how long they have been using, and their treatment program.
In general, however, for people that are detoxing, the recommended dosage is between 20 to 30mg per day. (1)
Methadone can lead to a range of side effects, such as:
Unfortunately, like most substances, there are some risk factors of methadone.
Examples of this include:
These are just a few of the potential risk factors of methadone. (2)
Alcohol, as many will be familiar with, is a substance that affects people in various ways. Alcohol enters the bloodstream through a person’s stomach and small intestine.
The liver acts to break down the alcohol and remove it from the body. However, breaking down the alcohol can take time. Until the liver has done so, alcohol will continue to circulate in a person’s bloodstream.
This will impact a person’s organs in various ways, such as affecting the brain and leading to a state of inebriation. (3)
On average, it takes one hour for the liver to break down 1 unit of alcohol. For context, one beer has roughly 2 to 3 units.
Some factors might affect how quickly alcohol travels through the body, such as:
Generally speaking, methadone and alcohol should not be mixed.
Doing so can lead to a range of different health issues and people that do so are also at risk of developing alcohol dependency.
According to the latest data, about 50% of people that are being treated for methadone addiction are also alcohol dependent.
Both methadone and alcohol are central nervous system depressants.
This means that combing both can double the effects of each of them – this could lead to an overdose, serious breathing issues, heart problems, a loss of consciousness, or a coma. (4)
Other health risks include:
Continually using methadone and alcohol can be fatal. The suppressing effect that both substances have on the body can severely impact a person’s breathing.
This can lead to, in some cases, people stopping breathing completely. Combining both methadone and alcohol can also seriously damage a person’s brain.
This might lead to slurred speech, slower cognitive and motor functions, and impaired memory. The effect combing these substances has on the liver can also be severe.
Alcohol alone can cause cirrhosis or scarring on the liver. Methadone can also lead to liver damage. Therefore, combined, people are at risk of developing liver issues or, in serious cases, liver failure.
Alcohol also harms a person’s blood pressure; this can lead to health problems such as damage to the arteries and heart disease.
Finally, combining methadone and alcohol can increase the chance of a person becoming methadone and alcohol dependent.
Because each substance perpetuates the impact they have on the body and brain, both the body and brain can become quickly dependent upon the substances to function properly. (5)
As mentioned earlier, methadone is used, commonly, to help people that suffer from opioid dependency. Unfortunately, combining alcohol methadone can negatively impact this in various ways.
Studies have found that people that drink whilst undergoing Methadone Maintenance Treatment (MMT) have a high non-adherence rate.
This means that, due to alcohol consumption, people do not stick to their recommended treatment program, such as taking their daily dosage.
Further, people that are undergoing MMT are more at risk of relapse. Because alcohol lowers people’s inhibitions, they are more likely to start using again.
People that are using methadone and alcohol are also at higher risk of engaging in negative and risk-taking behaviours. (6)
Examples of this might include:
In the UK, there are several options for people suffering from methadone or alcohol dependency. Examples of this include accessing local services and outpatient or residential treatment.
With regards to the former, the UK is home to many drug and alcohol organisations that offer free support and advice.
Examples of this include:
For more information about such organisations and the services that they provide, please see here.
Alternatively, the UK is also home to both outpatient and residential treatment programs.
Outpatient programs do not require people to stay at a facility. Instead, they will attend weekly appointments, such as with a GP or at a local hospital.
Outpatient programs can be accessed either through the NHS or via a local drug and alcohol service. In both cases, these can mostly be accessed for free. (7)
The NHS does not offer residential treatment but can provide funding for private rehab. To access this, people should speak with their GP or a medical professional.
Private rehab, unfortunately, can be quite expensive. In the UK, the average cost of residential rehab is between £300 and £500 per day.
Both outpatient and residential treatment offers a similar treatment program, often following a 4 stage process:
Whether during a treatment program or on their own, therapy can be an effective way to overcome addiction and maintain sobriety.
There are many different types of therapy available for people that suffer from either/both methadone or alcohol addiction.
Common and popular therapies include:
Talk therapy focuses on, as the name suggests, talking about issues related to addiction – this might be why the addiction has occurred, using substances as a coping mechanism, or exploring past trauma.
Using contemporary research, the medical professional – a psychologist or psychiatrist – will be able to offer insights and hopefully encourage the way through the addiction.
Cognitive Behavioural Therapy is a popular and tried and tested therapy for dealing with addiction.
The reason for this is that it directly addresses the connection between thoughts and behaviours. CBT theory suggests that behaviours, such as using a substance, are usually predicated by negative thoughts.
Therefore, during CBT, people will explore their thought patterns and learn how to cognitively reappraise – the ability to change thoughts.
This should result in positive behaviour changes, such as achieving and painting sobriety.
Another popular therapy is group therapy. Group therapy involves people with a group of their peers – usually mediated by a medical professional – and talking about their experiences and struggles with addiction.
Group therapy has a proven record of helping people overcome feelings of isolation related to addiction and develop a sense of accountability. (8)
(1) Gourevitch, Marc N., Diana Hartel, Peter Tenore, Katherine Freeman, Ira Marion, Joe Hecht, and Joyce Lowinson. “Three oral formulations of methadone: a clinical and pharmacodynamic comparison.” Journal of substance abuse treatment 17, no. 3 (1999): 237-241.
(2) Joseph, Herman, Sharon Stancliff, and John Langrod. “Methadone maintenance treatment (MMT): a review of historical and clinical issues.” The Mount Sinai Journal of Medicine, New York 67, no. 5-6 (2000): 347-364.
(3) Squeglia, Lindsay M., and Kevin M. Gray. “Alcohol and drug use and the developing brain.” Current psychiatry reports 18 (2016): 1-10.
(4) El‐Bassel, Nabila, Robert F. Schilling, Joanne E. Turnbull, and Kuo‐Hsien Su. “Correlates of alcohol use among methadone patients.” Alcoholism: Clinical and Experimental Research 17, no. 3 (1993): 681-686.
(5) Ibid.
(6) Maremmani, Icro, Pier Paolo Pani, Anna Mellini, Matteo Pacini, Giada Marini, Mercedes Lovrecic, Giulio Perugi, and Marc Shinderman. “Alcohol and cocaine use and abuse among opioid addicts engaged in a methadone maintenance treatment program.” Journal of addictive diseases 26, no. 1 (2007): 61-70.
(7) Peterson, James A., Robert P. Schwartz, Shannon Gwin Mitchell, Heather Schacht Reisinger, Sharon M. Kelly, Kevin E. O’Grady, Barry S. Brown, and Michael H. Agar. “Why don’t out-of-treatment individuals enter methadone treatment programmes?.” International Journal of Drug Policy 21, no. 1 (2010): 36-42.
(8) Rothbaum, Barbara Olasov, Elizabeth A. Meadows, Patricia Resick, and David W. Foy. “Cognitive-behavioral therapy.” (2000).
Boris is our editor-in-chief at Rehab 4 Addiction. Boris is an addiction expert with more than 20 years in the field. His expertise covers a broad of topics relating to addiction, rehab and recovery. Boris is an addiction therapist and assists in the alcohol detox and rehab process. Boris has been featured on a variety of websites, including the BBC, Verywell Mind and Healthline. You can connect with Boris online at LinkedIn or X.com.
