ALCOHOL AND OPIOIDS

The opioid analgesics can enhance the CNS depressant effects of alcohol, which has been fatal in some cases. The CNS depressant effects of alcohol are modestly increased by normal therapeutic doses of dextropropoxyphene (propoxyphene), but in delib- erate suicidal overdosage the CNS depressant effects appear to be additive, and can be fatal. A single case report describes a fatality due to the combined CNS depressant effects of hydromorphone and alcohol. Alcohol has been associated with rapid release of hydromorphone and morphine from extended-release preparations, which could result in potentially fatal doses.
The degree of impairment and/or sedation will depend on the individual patient, the opioid dose used and the amount of alcohol consumed. However, warn all patients of the potential effects, and with larger doses counsel against driving or undertaking other skilled tasks.
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