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.